CognitiveTwin: Robust Multi-Modal Digital Twins for Predicting Cognitive Decline in Alzheimer's Disease

Computer Science > Artificial Intelligence [Submitted on 24 Apr 2026] CognitiveTwin: Robust Multi-Modal Digital Twins for Predicting Cognitive Decline in Alzheimer's Disease Bulent Soykan, Gulsah Hancerliogullari Koksalmis, Hsin-Hsiung Huang, Laura J. Brattain Predicting individual cognitive decline in Alzheimer's disease (AD) is difficult due to the heterogeneity of disease progression. Reliable clinical tools require not only high accuracy but also fairness across demographics and robustness to missing data. We present CognitiveTwin, a digital twin framework that predicts patient-specific cognitive trajectories. The model integrates multi-modal longitudinal data (cognitive scores, magnetic resonance imaging, positron emission tomography, cerebrospinal fluid biomarkers, and genetics). We use a Transformer-based architecture to fuse these modalities and a Deep Markov Model to capture temporal dynamics. We trained and evaluated the framework using data from 1,666 patients in the TADPOLE (Alzheimer's Disease Neuroimaging Initiative) dataset. We assessed the model for prediction error, demographic fairness, and robustness to missing-not-at-random (MNAR) data patterns. ognitiveTwin provides accurate and personalized predictions of cognitive decline. Its demonstrated fairness across patient demographics and resilience to clinical dropout make it a reliable tool for clinical trial enrichment and personalized care planning. Comments: 18 pages, 6 figures Subjects: Artificial Intelligence (cs.AI) Cite as: arXiv:2604.22428 [cs.AI]   (or arXiv:2604.22428v1 [cs.AI] for this version)   https://doi.org/10.48550/arXiv.2604.22428 Focus to learn more Submission history From: Bulent Soykan [view email] [v1] Fri, 24 Apr 2026 10:40:51 UTC (295 KB) Access Paper: HTML (experimental) view license Current browse context: cs.AI < prev   |   next > new | recent | 2026-04 Change to browse by: cs References & Citations NASA ADS Google Scholar Semantic Scholar Export BibTeX Citation Bookmark Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer (What is the Explorer?) Connected Papers Toggle Connected Papers (What is Connected Papers?) Litmaps Toggle Litmaps (What is Litmaps?) scite.ai Toggle scite Smart Citations (What are Smart Citations?) Code, Data, Media Demos Related Papers About arXivLabs Which authors of this paper are endorsers? | Disable MathJax (What is MathJax?)