Preprint: Detecting Preclinical Alzheimer’s Disease Risk in Cognitively Normal Adults Using Speech Acoustics: Validation with Plasma p-Tau217 and APOE-ε4 Status

Authors: Mehrdad Dadgostar, Lindsay C. Hanford, Maryam Tavakoli, Steven E. Arnold, David H. Salat, Tatiana Sitnikova, Pia Kivisakk Webb, Jordan R. Green, Hengru Liu, Brian D. Richburg, Mariam Tkeshelashvili, Marziye Eshghi Abstract INTRODUCTION We tested whether spontaneous speech acoustics provide a scalable digital marker of biologically defined Alzheimer’s disease (AD) risk. METHODS Forty-nine cognitively unimpaired older adults were stratified within APOE genotype into Low-, Moderate-, and High-Risk groups based on log₁₀-transformed plasma p-tau217. Acoustic features were extracted from spontaneous speech and entered into multiclass SVM classifiers with leave-one-out cross-validation, with and without genetic-algorithm feature selection and age. Parallel models using neuropsychological measures were evaluated for comparison. Feature contributions were interpreted using SHAP. RESULTS Speech-based models substantially outperformed cognition-only models and exceeded chance performance for three-group classification (33.3%), achieving up to 77% accuracy compared with 47%…

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Publication: Validation of commercial sleep-tracking wearables and nearables in healthy young and older adults

Authors: M.E. Searles, A. Licata, M. Cucinotta, K. Kainec, and R.M.C. Spencer Abstract Study objectives: Changes in sleep with aging are associated with risk for Alzheimer’s and other neurological diseases, risk of accidents, and can be a predictor of health decline. For this reason, continuous sleep monitoring is of great interest for researchers, clinicians, and family members. The objective of this study was to assess the validity of consumer sleep-tracking devices in older relative to young adults. Methods: Analyses were based on one night of sleep assessed in young (19-24 years; n=13) and older adults (56-80 years; n=19). Participants wore sleep-tracking wearables (Fitbit Sense 2, Oura Ring) and nearables (Withings Sleep Mat, Sleep Score Max) were positioned nearby. Sleep measures were compared to polysomnography. Results: Results suggest that devices may be less accurate in older…

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Publication: Replicable Bandits for Digital Health Interventions

Authors: Kelly W Zhang, Nowell Closser, Anna L Trella, Susan A Murphy Abstract Adaptive treatment assignment algorithms, such as bandit algorithms, are increasingly used in digital health intervention clinical trials. Frequently the data collected from these trials is used to conduct causal inference and related data analyses to decide how to refine the intervention, and whether to roll-out the intervention more broadly. This work studies inference for estimands that depend on the adaptive algorithm itself; a simple example is the mean reward under the adaptive algorithm. Specifically, we investigate the replicability of statistical analyses concerning such estimands when using data from trials deploying adaptive treatment assignment algorithms. We demonstrate that many standard statistical estimators can be inconsistent and fail to be replicable across repetitions of the clinical trial, even as the sample size grows large.…

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