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Harnessing AI to predict rate of brain ageing and prevent dementia

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A new AI model is able to measure how fast a patient’s brain is ageing and could be a powerful new tool for understanding, preventing and treating cognitive decline and dementia.

The first-of-its-kind tool can non-invasively track the pace of brain changes by analysing magnetic resonance imaging (MRI) scans.

Faster brain ageing closely correlates with a higher risk of cognitive impairment, said Andrei Irimia, associate professor at the USC Leonard Davis School of Gerontology and visiting associate professor of psychological medicine at King’s College London.

“This is a novel measurement that could change the way we track brain health both in the research lab and in the clinic,” he said. “Knowing how fast one’s brain is ageing can be powerful.”

Biological brain age versus chronological age

Biological age is distinct from an individual’s chronological age and two people who are the same age based on their birthdate can have very different biological ages due to how well their body is functioning and how “old” the body’s tissues appear to be at a cellular level.

Some common measures of biological age use blood samples to measure epigenetic ageing and DNA methylation, which influences the roles of genes in the cell. However, measuring biological age from blood samples is a poor strategy for measuring the brain’s age, Irimia explained.

The barrier between the brain and the bloodstream prevents blood cells from crossing into the brain, such that a blood sample from one’s arm does not directly reflect methylation and other ageing-related processes in the brain.

Conversely, taking a sample directly from a patient’s brain is a much more invasive procedure, making it unfeasible to measure DNA methylation and other aspects of brain ageing directly from living human brain cells.

Previous research by Irimia and colleagues highlighted the potential of MRI scans to non-invasively measure the biological age of the brain. The earlier model used AI analysis to compare a patient’s brain anatomy to data compiled from the MRI scans of thousands of people of various ages and cognitive health outcomes.

However, the cross-sectional nature of analysing one MRI scan to estimate brain age had major limitations, he said. While the previous model could, for instance, tell if a patient’s brain was ten years “older” than their calendar age, it couldn’t provide info on whether that additional ageing occurred earlier or later in their life, nor could it indicate whether brain ageing was speeding up.

A more accurate picture of brain ageing

A newly developed three-dimensional convolutional neural network (3D-CNN) offers a more precise way to measure how the brain ages over time.

Created in collaboration with Paul Bogdan, associate professor of electrical and computer engineering and holder of the Jack Munushian Early Career Chair at the USC Viterbi School of Engineering, the model was trained and validated on more than 3,000 MRI scans of cognitively normal adults.

Unlike traditional cross-sectional approaches, which estimate brain age from one scan at a single time point, this longitudinal method compares baseline and follow-up MRI scans from the same individual. As a result, it more accurately pinpoints neuroanatomic changes tied to accelerated or decelerated ageing. The 3D-CNN also generates interpretable “saliency maps,” which indicate the specific brain regions that are most important for determining the pace of ageing, Bogdan said.

When applied to a group of 104 cognitively healthy adults and 140 Alzheimer’s disease patients, the new model’s calculations of brain ageing speed closely correlated with changes in cognitive function tests given at both time points.

“The alignment of these measures with cognitive test results indicates that the framework may serve as an early biomarker of neurocognitive decline,” Bogdan said. “Moreover, it demonstrates its applicability in both cognitively normal individuals and those with cognitive impairment.”

He added that the model has the potential to better characterize both healthy ageing and disease trajectories, and its predictive power could one day be applied to assessing which treatments would be more effective based on individual characteristics.

“Rates of brain ageing are correlated significantly with changes in cognitive function,” Irimia said. “So, if you have a high rate of brain ageing, you’re more likely to have a high rate of degradation in cognitive function, including memory, executive speed, executive function, and processing speed. It’s not only an anatomic measure; the changes we see in the anatomy are associated with changes we see in the cognition of these individuals.”

Looking ahead

In the study, Irimia and co-authors also note how the new model was able to distinguish different rates of ageing across various regions of the brain. Delving into these differences –including how they vary based on genetics, environment, and lifestyle factors – could provide insight into how different pathologies develop in the brain, Irimia said.

The study also demonstrated that the pace of brain ageing in certain regions differed between the sexes, which might shed light onto why men and women face different risks for neurodegenerative disorders, including Alzheimer’s, he added.

Irimia said he is also excited about the potential for the new model to identify people with faster-than-normal brain ageing before they show any symptoms of cognitive impairment. While new drugs targeting Alzheimer’s have been introduced, their efficacy has been less than researchers and doctors have hoped for, potentially because patients might not be starting the drug until there is already a great deal of Alzheimer’s pathology present in the brain, he explained.

“One thing that my lab is very interested in is estimating risk for Alzheimer’s; we’d like to one day be able to say, ‘Right now, it looks like this person has a 30 per cent risk for Alzheimer’s.’ We’re not there yet, but we’re working on it,” Irimia said.

“I think this kind of measure will be very helpful to produce variables that are prognostic and can help to forecast Alzheimer’s risk. That would be really powerful, especially as we start developing potential drugs for prevention.”

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Radiology AI may improve workflows

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Radiology AI may improve workflows and patient care, but the technology also brings challenges for radiology departments, research suggests.

A focus issue from the Journal of the American College of Radiology brings together invited research and reviews exploring how AI is being used across different practice types.

Barriers include insufficient infrastructure, strict institutional regulations and a lack of insurance reimbursement, all of which can hamper the integration of AI into routine clinical workflows.

Radiology, the branch of medicine that uses imaging such as X-rays and scans to diagnose and treat disease, is widely seen as one of the fields most likely to be reshaped by AI.

The research includes contributions arguing that workflow improvement is not simply a secondary benefit of AI, but a main determinant of whether a tool succeeds.

Gelareh Sadigh, associate editor for health services research at the Journal of the American College of Radiology, said: “When thoughtfully implemented, AI can complement human expertise and improve efficiency and patient care.

“Successful workflow optimisation requires the integration of AI technology into routine workflows.

“This can be hampered by insufficient infrastructure, strict institutional regulations, and lack of insurance reimbursement.

“Poor integration of AI may degrade workflows, satisfaction, and safety and perpetuate bias in healthcare.”

According to Dr Sadigh, the articles in the focus issue reflect a broader shift in radiology: workflow is not a secondary benefit of AI, but a key factor in whether a tool is successful.

If AI is going to meaningfully help radiology, it must make care delivery better and not more complicated.

Ruth C. Carlos, editor-in-chief of the Journal of the American College of Radiology, said: “This focus issue provides meaningful signposts for AI effectiveness as we navigate a rapidly shifting landscape.”

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AI system could help identify Alzheimer’s earlier

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An AI tool could help identify Alzheimer’s disease around two years earlier by analysing signals already recorded in patients’ clinical records.

DementAI, a prototype developed by consultancy Katalyze Data, analyses existing medical record data to flag patients who may show early signs of the condition but have not yet been referred for specialist assessment.

Built as an end-to-end working prototype, the system connects stages clinicians often manage separately, from analysing medical records to applying models within decision pathways.

It is designed to work using information healthcare providers already hold, turning fragmented data into actionable insight without adding new screening burdens.

The system combines structured medical records, brain activity data and unstructured clinical information, using synthetic data where appropriate to support development.

By blending these signals, it aims to detect subtle patterns of decline that may be difficult to identify during short consultations.

Tamás Bosznay, principal consultant at Katalyze Data, said: “We are in a race against time when it comes to dementia.

“Early identification can make a meaningful difference to how patients and families experience the condition.

“But without better ways of finding people sooner, those opportunities can be lost.

“We didn’t build DementAI just to make predictions; we built it to buy patients time.

“By surfacing the signals already hiding in plain sight within clinical records, the system is designed to help ensure that when care teams are ready to act, the right patients are identified earlier and more consistently.”

DementAI was developed as part of the SAS Hackathon 2025, where it won the healthcare and life sciences category.

The team is now seeking engagement with NHS trusts to explore pilot deployments that could validate the model’s impact and support efforts to reduce delays in diagnosis.

Dr Iain Brown, global head of AI and data science at SAS, said: “Synthetic data, agentic AI concepts and governance are not ‘nice-to-haves’ in sensitive settings like healthcare.

“They are what make innovation usable at scale.

“DementAI shows how artificial intelligence can be applied in a way that is both ambitious and responsible.

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Smart lights linked to fewer care home falls

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AI smart lights in care homes were linked to up to 75 per cent fewer hospital visits after falls, according to an NHS evaluation.

The study examined 87 rooms across seven care homes providing residential, nursing, dementia and assisted living care.

Researchers compared six months of baseline data with six months after installing Nobi Smart Lights, AI-enabled ceiling-mounted devices designed to detect falls and alert staff within seconds.

The lights also turn on automatically when residents get out of bed, helping reduce the risk of night-time falls. Some homes reported zero fall-related hospital admissions during the evaluation period, while ambulance call-outs fell by up to 65 per cent.

Staff reported greater confidence when responding to unwitnessed incidents and said they spent less time reconstructing events or completing documentation.

Better visibility also helped staff distinguish genuine falls from controlled descents, where someone lowers themselves to the floor intentionally or slowly, allowing more incidents to be managed safely inside the care home.

The evaluation was carried out by the Suffolk and North East Essex Integrated Care Board.

“The Nobi light gives me peace of mind because Mum does fall a lot,” said the daughter of a resident at a participating Suffolk care home.

“I felt guilty about her going into a home, but now I know staff are alerted instantly and can be there straight away.”

The work formed part of the Integrated Care Board’s Digitising Social Care Programme, which supports care providers to adopt digital tools.

Implementation was delivered in partnership with Porters Care, one of Nobi’s UK partners, with support from Suffolk County Council and participating care providers.

Using NHS reference costs, the evaluation estimated £89,000 in avoided emergency care costs over six months, equivalent to a projected return on investment of around 196 per cent over three years.

Roeland Pilgrims, chief executive and co-founder of Nobi, said: “This independent NHS evaluation shows how intelligent care technology can deliver measurable improvements for residents, care teams and the wider health system.

“By giving staff timely, reliable insight, we can help reduce avoidable hospital admissions while improving safety, dignity and peace of mind.”

David Knowles, managing director of Porters Care, added: “These findings show the real-world impact of smart technology in care homes.

“By improving how falls are detected and understood, Nobi helps teams make clearer decisions and avoid unnecessary hospital admissions, while keeping residents safe.”

Further independent NHS-led evaluations are underway in other regions of the UK.

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