학술논문
Unsupervised high-frequency smartphone-based cognitive assessments are reliable, valid, and feasible in older adults at risk for Alzheimer's disease.
Document Type
Academic Journal
Author
Nicosia J; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Aschenbrenner AJ; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Balota DA; Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.; Sliwinski MJ; Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.; Tahan M; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Adams S; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Stout SS; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Wilks H; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Gordon BA; Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.; Department of Radiology, Washington University, School of Medicine, St. Louis, MO, USA.; Benzinger TLS; Department of Radiology, Washington University, School of Medicine, St. Louis, MO, USA.; Fagan AM; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Xiong C; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Division of Biostatistics, Washington University, School of Medicine, St. Louis, MO, USA.; Bateman RJ; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Morris JC; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Hassenstab J; Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University, School of Medicine, St. Louis, MO, USA.; Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
Source
Publisher: Cambridge University Press Country of Publication: England NLM ID: 9503760 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1469-7661 (Electronic) Linking ISSN: 13556177 NLM ISO Abbreviation: J Int Neuropsychol Soc Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: Smartphones have the potential for capturing subtle changes in cognition that characterize preclinical Alzheimer's disease (AD) in older adults. The Ambulatory Research in Cognition (ARC) smartphone application is based on principles from ecological momentary assessment (EMA) and administers brief tests of associative memory, processing speed, and working memory up to 4 times per day over 7 consecutive days. ARC was designed to be administered unsupervised using participants' personal devices in their everyday environments.
Methods: We evaluated the reliability and validity of ARC in a sample of 268 cognitively normal older adults (ages 65-97 years) and 22 individuals with very mild dementia (ages 61-88 years). Participants completed at least one 7-day cycle of ARC testing and conventional cognitive assessments; most also completed cerebrospinal fluid, amyloid and tau positron emission tomography, and structural magnetic resonance imaging studies.
Results: First, ARC tasks were reliable as between-person reliability across the 7-day cycle and test-retest reliabilities at 6-month and 1-year follow-ups all exceeded 0.85. Second, ARC demonstrated construct validity as evidenced by correlations with conventional cognitive measures ( r = 0.53 between composite scores). Third, ARC measures correlated with AD biomarker burden at baseline to a similar degree as conventional cognitive measures. Finally, the intensive 7-day cycle indicated that ARC was feasible (86.50% approached chose to enroll), well tolerated (80.42% adherence, 4.83% dropout), and was rated favorably by older adult participants.
Conclusions: Overall, the results suggest that ARC is reliable and valid and represents a feasible tool for assessing cognitive changes associated with the earliest stages of AD.
Methods: We evaluated the reliability and validity of ARC in a sample of 268 cognitively normal older adults (ages 65-97 years) and 22 individuals with very mild dementia (ages 61-88 years). Participants completed at least one 7-day cycle of ARC testing and conventional cognitive assessments; most also completed cerebrospinal fluid, amyloid and tau positron emission tomography, and structural magnetic resonance imaging studies.
Results: First, ARC tasks were reliable as between-person reliability across the 7-day cycle and test-retest reliabilities at 6-month and 1-year follow-ups all exceeded 0.85. Second, ARC demonstrated construct validity as evidenced by correlations with conventional cognitive measures ( r = 0.53 between composite scores). Third, ARC measures correlated with AD biomarker burden at baseline to a similar degree as conventional cognitive measures. Finally, the intensive 7-day cycle indicated that ARC was feasible (86.50% approached chose to enroll), well tolerated (80.42% adherence, 4.83% dropout), and was rated favorably by older adult participants.
Conclusions: Overall, the results suggest that ARC is reliable and valid and represents a feasible tool for assessing cognitive changes associated with the earliest stages of AD.