Deep Learning to Predict Future Cognitive Decline: A Multimodal Approach Using Brain MRI and Clinical Data

Predicting the trajectory of clinical decline in aging individuals is a pressing challenge, especially for people with mild cognitive impairment, Alzheimer’s disease, Parkinson’s disease, or vascular dementia. Accurate predictions can guide treatment decisions, identify risk factors, and optimize clinical trials. In this study, we compared two deep learning approaches for forecasting changes, over a 2-year interval, in the Clinical Dementia Rating scale ‘sum of boxes’ score (sobCDR). This is a key metric in dementia research, and scores range from 0 (no impairment) to 18 (severe impairment). To predict decline, we trained a hybrid convolutional neural network that integrates 3D T1-weighted brain MRI scans with tabular clinical and demographic features (including age, sex, body mass index (BMI), and baseline sobCDR). We benchmarked its performance against AutoGluon, an automated multimodal machine learning framework that selects an appropriate neural network architecture. Our results demonstrate the importance of combining image and tabular data in predictive modeling for clinical applications. Deep learning algorithms can fuse image-based brain signatures and tabular clinical data, with potential for personalized prognostics in aging and dementia.