Newly developed treatments for slowing the progression of Alzheimer’s disease will be entering healthcare systems very soon. For them to be as effective as possible, the disease has to be detected as early as possible. However, Alzheimer’s has a silent onset and slow progression. This makes it difficult to capture the impact of Alzheimer’s when it first hits the brain, which can be up to 20 years before dementia. With recent technological advances, these challenges can now be addressed. One the one hand, first signs of Alzheimer’s can now be reliably detected in blood. On the other hand, the rising adoption of digital technologies eliminates barriers for cognitive testing and enables frequent testing in the comfort of the home. Combining these two developments will allow cost-efficient and effective screening for early Alzheimer’s on a population level that will dramatically improve patient management but also clinical trial recruitment. The start-up company neotiv has combined digital technology with cognitive tests, derived from the latest discoveries in brain research, resulting in a novel digital cognitive assessment battery for tracking the cognitive signatures of Alzheimer’s. In this study, the applicability of the neotiv tests for detecting pathology signatures in preclinical Alzheimer’s disease will be investigated in thousands of middle-aged individuals within the Swedish Västra Götaland Region, as part of the REAL AD study, headed by Professor Michael Schöll (UGOT). Study participants will perform the neotiv tests on their smartphones at regular intervals for a period of 3 years, while undergoing parallel blood biomarker asessments. It will be investigated how the neotiv tests can be used for real-world screening for preclinical Alzheimer’s, the prognosis of future cognitive decline, as well as monitoring change over time. In this way, its applicability in national healthcare settings and as outcome measure in treatment trials will be determined.