Paz Scribano Parada, María de laValladares Rodríguez, Sonia MaríaLosada Durán, Raquel2026-02-062026-02-062025-01-28de la Paz Scribano Parada, M., Palau, F. G., Rodríguez, S. V., Rincon, M., Barroeta, M. J. R., Rodriguez, M. G., Aguado, Y. B., Blanco, A. H., Díaz-López, E., Mayoral, M. B., & Durán, R. L. (2025). Preclinical Cognitive Markers of Alzheimer Disease and Early Diagnosis Using Virtual Reality and Artificial Intelligence: Literature Review. JMIR Medical Informatics, 13. https://doi.org/10.2196/62914https://hdl.handle.net/10347/45715Background: This review explores the potential of virtual reality (VR) and artificial intelligence (AI) to identify preclinical cognitive markers of Alzheimer disease (AD). By synthesizing recent studies, it aims to advance early diagnostic methods to detect AD before significant symptoms occur. Objective: Research emphasizes the significance of early detection in AD during the preclinical phase, which does not involve cognitive impairment but nevertheless requires reliable biomarkers. Current biomarkers face challenges, prompting the exploration of cognitive behavior indicators beyond episodic memory. Methods: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched Scopus, PubMed, and Google Scholar for studies on neuropsychiatric disorders utilizing conversational data. Results: Following an analysis of 38 selected articles, we highlight verbal episodic memory as a sensitive preclinical AD marker, with supporting evidence from neuroimaging and genetic profiling. Executive functions precede memory decline, while processing speed is a significant correlate. The potential of VR remains underexplored, and AI algorithms offer a multidimensional approach to early neurocognitive disorder diagnosis. Conclusions: Emerging technologies like VR and AI show promise for preclinical diagnostics, but thorough validation and regulation for clinical safety and efficacy are necessary. Continued technological advancements are expected to enhance early detection and management of AD.eng© María de la Paz Scribano Parada, Fátima González Palau, Sonia Valladares Rodríguez, Mariano Rincon, Maria José Rico Barroeta, Marta García Rodriguez, Yolanda Bueno Aguado, Ana Herrero Blanco, Estela Díaz-López, Margarita Bachiller Mayoral, Raquel Losada Durán. Originally published in JMIR Medical Informatics (https://medinform.jmir.org), 28.01.2025. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecom- mons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on https://medinform.jmir.org/, as well as this copyright and license information must be included.Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/AIAlzheimer diseaseArtificial intelligenceDementiaEarly detectionLiterature reviewMild cognitive impairmentQualitative reviewVirtual realityjournal article2025-12-1210.2196/629142291-9694open access2291-9694