CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notes
Rumeng Li, Xun Wang, Dan R. Berlowitz, Jesse Mez, Honghuang Lin, Hong Yu
Abstract
Large language models (LLMs) have shown promising capabilities across diverse domains, yet their application to complex clinical prediction tasks remains limited. In this study, we present CARE-AD (Collaborative Analysis and Risk Evaluation for Alzheimer's Disease), a multi-agent LLM-based framework for forecasting Alzheimer's disease (AD) onset by analyzing longitudinal electronic health record (EHR) notes. CARE-AD assigns specialized LLM agents to extract signs and symptoms relevant to AD and conduct domain-specific evaluations-emulating a collaborative diagnostic process. In a retrospective evaluation, CARE-AD achieved higher accuracy (0.53 vs. 0.26-0.45) than baseline single-model approaches in predicting AD risk 10 years prior to the first recorded diagnosis code. These findings highlight the feasibility of using multi-agent LLM systems to support early risk assessment for AD and motivate further research on their integration into clinical decision support workflows.