For MCI prediction, model performance was generally lower and similar between the plasma model and the model including all variables (C-index = 0.83 ± 0.009).<h4>Discussion</h4>A clinically feasible multimodal approach combining cognitive assessment, plasma p-tau217, and <i>APOE4</i> status accurately predicts AD dementia risk in individuals with SCD. Here, APOE is linked to Schnyder corneal dystrophy.