INTRODUCTION: Early detection of Alzheimer's disease (AD) is critical for timely intervention as disease-modifying treatments emerge. Speech-based digital biomarkers offer scalable options for remotely capturing speech-derived functional changes associated with early cognitive decline, but validation across real-world populations remains limited.
METHODS: We evaluated the speech biomarker for cognition (SB-C), an automated speech-derived measure associated with cognitive status, in 736 participants across five European cohorts (Barcelonaβeta Brain Research Center's Alzheimer's at-risk cohort, European Prevention of Alzheimer's Dementia Scotland, Dementia Study of Cognitive and Biomarker Dynamics, Longitudinal Cognitive Impairment and Dementia Study, and Biomarkers for Identifying Neurodegenerative Disorders Early and Reliably [BioFINDER-Primary Care]). Participants completed verbal learning and semantic fluency tasks via automated phone or app-based platforms. SB-C performance was compared to Mini-Mental State Examination, Clinical Dementia Rating, Preclinical Alzheimer Cognitive Composite 5, and cerebrospinal fluid amyloid beta and phosphorylated tau181 biomarker status.
RESULTS: SB-C significantly differentiated cognitively unimpaired and impaired groups (P < 0.001), correlated with standard cognitive measures, and showed moderate-to-high area under the curve (0.56-0.82) for classifying biomarker positivity, with strongest results in BioFINDER-Primary Care.
DISCUSSION: SB-C is a scalable, remote speech-derived marker associated with cognitive status and AD biomarker group differences.
}}, author = {{König, Alexandra and Tröger, Johannes and Mallick, Elisa and Linz, Nicklas and Ritchie, Craig and Gregory, Sarah and Hunter, Matthew and Johnson, Kay and Benavides, Gonzalo Sánchez and Grau-Rivera, Oriol and Radoi, Andreea and Porta-Mas, Claudia and Köhler, Stefanie and Teipel, Stefan and Hansson, Oskar and Tideman, Pontus and Wuestefeld, Anika and Palmqvist, Sebastian}}, issn = {{1552-5279}}, keywords = {{Humans; Male; Female; Biomarkers/cerebrospinal fluid; Cognitive Dysfunction/diagnosis; Alzheimer Disease/diagnosis; Aged; Amyloid beta-Peptides/cerebrospinal fluid; Europe; Cohort Studies; Speech; Neuropsychological Tests; tau Proteins/cerebrospinal fluid; Aged, 80 and over; Middle Aged}}, language = {{eng}}, number = {{5}}, publisher = {{Wiley}}, series = {{Alzheimer's & dementia : the journal of the Alzheimer's Association}}, title = {{Speech-based digital cognitive assessment for clinical trials : Detecting cognitive impairment stages and AD biomarker relations across European cohorts}}, url = {{http://dx.doi.org/10.1002/alz.71462}}, doi = {{10.1002/alz.71462}}, volume = {{22}}, year = {{2026}}, }