NCT07041450

Brief Summary

This study evaluates a diagnostic screening solution for Alzheimer's disease (AD) using digital cognitive assessments and blood-based biomarkers. The aim is to reduce time-to-treatment for patients who may benefit from disease-modifying therapy (DMT). The study involves 500 patients referred to the MoCA Clinic in Montreal. Clinical stages will be assessed using digital tools from MoCA Test Inc. (MoCA Cognition), and biological stages via blood biomarkers. Data collected includes demographics, cognitive scores, health questionnaires, biomarker levels, and neurologist-determined eligibility for DMT. The study will result in an algorithm to support diagnostic triage and estimate the efficiency and equity of a fast-track diagnostic pathway. Exploratory endpoints include validation of self-administered digital tools, health-economic estimates, and predictors of cognitive decline.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
500

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Mar 2025

Shorter than P25 for all trials

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 14, 2025

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

May 7, 2025

Completed
2 months until next milestone

First Posted

Study publicly available on registry

June 27, 2025

Completed
6 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 14, 2025

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

March 14, 2026

Completed
Last Updated

July 1, 2025

Status Verified

June 1, 2025

Enrollment Period

9 months

First QC Date

May 7, 2025

Last Update Submit

June 26, 2025

Conditions

Keywords

blood-based biomarkersdigital cognitive assessmentdiagnostic screeningMoCAdisease-modifying therapyolder adultsearly detectionMontreal Cognitive Assessment

Outcome Measures

Primary Outcomes (1)

  • Time to diagnosis

    The primary outcome metric is the time to diagnosis for patients that are eligible vs. not eligible for anti-amyloid medication. In this case, time to diagnosis is defined by the time it takes to determine if patient is eligible anti-amyloid medication or not.

    From enrollment to 6-month follow-up

Secondary Outcomes (1)

  • Benefit of Diagnostic Screening

    Baseline to 6-month follow-up

Other Outcomes (10)

  • Validation of MoCA Solo compared to MOCA paper test

    Baseline (Visit 1) to 3 months (Visit 2)

  • Evaluation of MoCA Solo as diagnostic digital biomarker within BBM algorithm

    Baseline to 6-month follow-up

  • Accuracy, specificity, and sensitivity of XpressO as compared to the diagnosis of a neurologist.

    Baseline

  • +7 more other outcomes

Study Arms (3)

Observational Cohort

The study population will include 500 patients that have been referred to the MoCA Clinic from the Greater Montreal Area. This includes individuals with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and mild dementia. Participants complete cognitive tests, health and cognition questionnaires, and undergo a blood test for blood biomarker testing.

Diagnostic Test: Digital MoCADiagnostic Test: XpressODiagnostic Test: MoCADiagnostic Test: Blood-based Biomarkers (BBM)Other: Amyloid Treatment Screening Tool (ATST)Other: MoCA Brain Health Questionnaire (MBHQ)Other: MoCA Medical QuestionnaireOther: Functional Activities Questionnaire+ (FAQ+)

Paper MoCA Subgroup

Participants will be randomly assigned to complete either the paper MoCA or the digital MoCA Solo at Visit 1, with the other version completed at Visit 2. The Paper MoCA Subgroup will complete the paper MoCA at Visit 1.

Diagnostic Test: Digital MoCADiagnostic Test: XpressODiagnostic Test: MoCADiagnostic Test: Blood-based Biomarkers (BBM)Other: Amyloid Treatment Screening Tool (ATST)Other: MoCA Brain Health Questionnaire (MBHQ)Other: MoCA Medical QuestionnaireOther: Functional Activities Questionnaire+ (FAQ+)

MoCA Solo Subgroup

Participants will be randomly assigned to complete either the paper MoCA or the digital MoCA Solo at Visit 1, with the other version completed at Visit 2. The MoCA Solo Subgroup will complete the MoCA Solo at Visit 1.

Diagnostic Test: Digital MoCADiagnostic Test: XpressODiagnostic Test: MoCADiagnostic Test: Blood-based Biomarkers (BBM)Other: Amyloid Treatment Screening Tool (ATST)Other: MoCA Brain Health Questionnaire (MBHQ)Other: MoCA Medical QuestionnaireOther: Functional Activities Questionnaire+ (FAQ+)

Interventions

Digital MoCADIAGNOSTIC_TEST

A digital version of the Montreal Cognitive Assessment used to evaluate cognitive function. Administered on a tablet at Visit 1 or Visit 2 (randomized).

Also known as: MoCA Solo
MoCA Solo SubgroupObservational CohortPaper MoCA Subgroup
XpressODIAGNOSTIC_TEST

A digital cognitive pre-screening tool used to screen for cognitive function. Administered on a tablet at Visit 1.

MoCA Solo SubgroupObservational CohortPaper MoCA Subgroup
MoCADIAGNOSTIC_TEST

The standard paper-baed Montreal Cognitive Assessment used to evaluate cognitive function. Administered at Visit 1 or Visit 2 (randomized), opposite the digital MoCA.

MoCA Solo SubgroupObservational CohortPaper MoCA Subgroup

Participants provide a blood sample that is analyzed for Alzheimer's disease-related biomarkers, including PrecivityAD2 and MTBR. These biomarkers are used to assess the biological stage of disease and support diagnostic triage and eligibility assessment for disease-modifying therapy (DMT)

MoCA Solo SubgroupObservational CohortPaper MoCA Subgroup

A questionnaire administered to assess eligibility for amyloid-targeted therapies. Both clinician and patient-centered versions are used.

MoCA Solo SubgroupObservational CohortPaper MoCA Subgroup

A questionnaire designed to capture participants' physical health, emotional well-being, diet, exercise, and social engagement as it relates to cognitive health. Responses are used as part of exploratory analyses to evaluate associations with cognitive status and Alzheimer's disease diagnosis.

MoCA Solo SubgroupObservational CohortPaper MoCA Subgroup

A structured questionnaire administered to participants to gather information on their medical history, including prior diagnoses, medications, and other health conditions. This data helps to contextualize cognitive symptoms and support diagnostic decision-making in the study.

MoCA Solo SubgroupObservational CohortPaper MoCA Subgroup

A questionnaire designed to assess the participant's ability to perform daily activities, providing insights into their functional status and cognitive impairment. It is a longer version of the original FAQ questionnaire. It is used as part of the screening and exploratory analysis to better understand the relationship between functional abilities and Alzheimer's disease progression.

MoCA Solo SubgroupObservational CohortPaper MoCA Subgroup

Eligibility Criteria

Age55 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

The study population will include 500 patients that have been referred to the MoCA Clinic from the Greater Montreal Area. There will be a mix of English and French speaking with approximately 80% having French as a first language.

You may qualify if:

  • Must be referred to the MoCA Clinic; including both new patients and existing patients who have been seen \>1 year ago
  • Present with cognitive impairment or cognitive complaints.
  • Must have the ability to understand the purpose and risk of the Study and provide informed consent.
  • Must have an identified study partner (informant/care partner), who has frequent and sufficient contact with the participant to be able to provide accurate information about the participant's cognitive and functional abilities. The study partner must be available by phone to provide information to the study staff about the participant and agrees to attend one in-person visit at the MoCA Clinic which requires partner input. The study partner should be available for the duration of the study.

You may not qualify if:

  • An established diagnosis (other than AD), that is a cause for a candidate's cognitive impairment (e.g. substance abuse, cerebrovascular conditions, Lewy body dementia, fronto-temporal dementia, recent head trauma).
  • Blood donation (1 unit) within 1 month prior to Study screening.
  • Inability to comply with requirements to complete essential components of the Study (e.g. visual impairment, severe kidney disease or ongoing kidney treatment)
  • Patients already enrolled in any clinical trial for AD at time of Study screening
  • Other unspecified reasons that, in the opinion of the Principal Investigator, or MoCA Clinic and Institute, make the candidate unsuitable for enrolment.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

MoCA Clinic and Institute

Greenfield Park, Quebec, J4V 2J2, Canada

RECRUITING

Related Publications (1)

  • Klil-Drori S, Bodenstein KC, Sun S, Kojok L, Gruber J, Ghantous Y, Cummings J, Nasreddine Z. Montreal Cognitive Assessment (MoCA) XpressO: Validation of a digital self-administered cognitive prescreening tool. J Am Geriatr Soc. 2024 Aug;72(8):2516-2522. doi: 10.1111/jgs.18902. Epub 2024 Apr 1.

    PMID: 38558263BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

Participants consent for optional storage of 14ml of blood plasma for future biomarker and genetic analysis.

MeSH Terms

Conditions

Cognitive DysfunctionAlzheimer DiseaseDementia

Condition Hierarchy (Ancestors)

Cognition DisordersNeurocognitive DisordersMental DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesTauopathiesNeurodegenerative Diseases

Study Officials

  • Ziad Nasreddine, MD

    MoCA Clinic

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 7, 2025

First Posted

June 27, 2025

Study Start

March 14, 2025

Primary Completion

December 14, 2025

Study Completion

March 14, 2026

Last Updated

July 1, 2025

Record last verified: 2025-06

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