Detecting Alzheimer's and enhancing memory: towards novel assessments, affordable biomarkers, and technology-driven interventions

Background: Current approaches to battle Alzheimer's Disease (AD) focus on (1) detecting the disease earlier, (2) slowing decline or enhancing memory, and (3) retaining quality of life. Recent guidelines and consensuses draw our attention towards the preclinical stages where current assessments and interventions strategies are not yet meeting the needs.
Method: Three studies were carried out to investigate (1) the neural correlates of a novel memory marker (i.e., Short-term memory binding test - STMBT), (2) the feasibility of collecting biomarker evidence using low-cost technologies which can be widely implemented in LMIC, and (3) the implication of such knowledge for theory driven interventions that rely on Virtual Reality technology. Study 1 involves behavioural and MRI data from 3 countries (UK, Spain, and Colombia). Study 2 involves data from Colombia, Argentina, and UK collected while participants performed the STMBT synchronised to EEG or eye-tracking. Study 3 presents the results from experiments carried out collaboratively in the UK and Colombia to explore the feasibility of Virtual Reality technologies to assess whether memory binding impairments underpin age-related functional decline.
Result: Study 1 shows that the STMBT detects impairments in patients with AD and in those at risk of AD. The test does not tax the function of the hippocampus and the impairments it detects, appear earlier than those detected with tests of hippocampal functions. Study 2 confirmed that by combining the STMBT with EEG or eyetracking the assessment can reach a sensitivity and a specificity of 100%. Study 3 provides preliminary evidence confirming the potential of Virtual Reality technologies to reveal the cognitive underpinnings of functional decline in old age.
Conclusion: These data highlight the need of a paradigm shift in the assessment of memory functions in the preclinical stages of AD. It also demonstrates that assessment of memory functions known to be markers of AD combined with affordable technologies can yield affordable cognitive biomarkers of AD. Finally, research that incorporates novel theories of cognitive decline in ageing to Virtual Reality technologies can accelerate the development of person-centred assessments and interventions programmes.