Improving Interpretability in Alzheimer's Prediction via Joint Learning of ADAS-Cog Scores

Accurate prediction of clinical scores is critical for early detection and prognosis of Alzheimers disease (AD). While existing approaches primarily focus on forecasting the ADAS-Cog global score, they often overlook the predictive value of its sub-scores (13 items), which capture domain-specific cognitive decline. In this study, we propose a multi task learning (MTL) framework that jointly predicts the global ADAS-Cog score and its sub-scores (13 items) at Month 24 using baseline MRI and longitudinal clinical scores from baseline and Month 6. The main goal is to examine how each sub scores particularly those associated with MRI features contribute to the prediction of the global score, an aspect largely neglected in prior MTL studies. We employ Vision Transformer (ViT) and Swin Transformer architectures to extract imaging features, which are fused with longitudinal clinical inputs to model cognitive progression. Our results show that incorporating sub-score learning improves global score prediction. Subscore level analysis reveals that a small subset especially Q1 (Word Recall), Q4 (Delayed Recall), and Q8 (Word Recognition) consistently dominates the predicted global score. However, some of these influential sub-scores exhibit high prediction errors, pointing to model instability. Further analysis suggests that this is caused by clinical feature dominance, where the model prioritizes easily predictable clinical scores over more complex MRI derived features. These findings emphasize the need for improved multimodal fusion and adaptive loss weighting to achieve more balanced learning. Our study demonstrates the value of sub score informed modeling and provides insights into building more interpretable and clinically robust AD prediction frameworks. (Github repo provided)

A Weighted Vision Transformer-Based Multi-Task Learning Framework for Predicting ADAS-Cog Scores

Prognostic modeling is essential for forecasting future clinical scores and enabling early detection of Alzheimers disease (AD). While most existing methods focus on predicting the ADAS-Cog global score, they often overlook the predictive value of its 13 sub-scores, which reflect distinct cognitive domains. Some sub-scores may exert greater influence on determining global scores. Assigning higher loss weights to these clinically meaningful sub-scores can guide the model to focus on more relevant cognitive domains, enhancing both predictive accuracy and interpretability. In this study, we propose a weighted Vision Transformer (ViT)-based multi-task learning (MTL) framework to jointly predict the ADAS-Cog global score using baseline MRI scans and its 13 sub-scores at Month 24. Our framework integrates ViT as a feature extractor and systematically investigates the impact of sub-score-specific loss weighting on model performance. Results show that our proposed weighting strategies are group-dependent: strong weighting improves performance for MCI subjects with more heterogeneous MRI patterns, while moderate weighting is more effective for CN subjects with lower variability. Our findings suggest that uniform weighting underutilizes key sub-scores and limits generalization. The proposed framework offers a flexible, interpretable approach to AD prognosis using end-to-end MRI-based learning. (Github repo link will be provided after review)