The COMFORTage project: study protocol for the integration of multiple sources towards personalised preventions at Ace Alzheimer Center Barcelona

Abstract

Introduction: Ageing is accompanied by gradual biological and cognitive changes that increase vulnerability to chronic diseases and neurodegenerative conditions. As populations age, dementia prevalence continues to rise, highlighting the need for earlier detection and personalised prevention strategies. Against this background, the COMFORTage project, funded by Horizon Europe, brings together a multidisciplinary consortium across 12 countries to advance innovative, scalable solutions for dementia care. By integrating digital platforms, biomarker research, and precision medicine, COMFORTage seeks to develop artificial intelligence (AI)-driven tools that support more precise and adaptive interventions. Central to this effort are the Virtualized AI-Based Healthcare Platform and Patient Digital Twins, which enable personalised monitoring and decision support. Within this framework, Pilot 3 at Ace Alzheimer Center Barcelona focuses on individuals with mild cognitive impairment and mild Alzheimer's disease dementia, evaluating the effects of cognitive and functional stimulation and contributing multimodal data to optimise the AI platform. Methods: Pilot 3 is a randomised, open-label study involving retrospective and prospective datasets. Participants undergo clinical, genetic, neuropsychological, cerebrospinal fluid (CSF) and plasma biomarker assessments, magnetic resonance imaging (MRI), and spontaneous speech analysis. The primary outcomes assess cognitive decline using composite scores from the Neuropsychological Battery used in Ace (NBACE), targeting attention, memory, visuospatial/perceptual functions, executive functions, and language, over a two-year follow-up. Three digital platforms provided by the consortium will be used as cognitive and functional stimulation tools for participants. The intervention's effects on cognitive decline will be evaluated through changes in NBACE composite scores. Secondary objectives include assessing impacts on physical, psychological, social, and functional well-being; examining associations between biological variables and cognitive changes; and analyzing spontaneous speech as a remote, scalable proxy for cognitive status. Discussion: Findings from Pilot 3 will contribute to COMFORTage's broader mission, offering critical insights into the scalability and real-world implementation of AI-powered dementia care solutions. This integrated approach highlights the potential of precision medicine and advanced digital tools to elevate global standards in dementia management. Clinical Trial Registration: identifier NCT07031167.