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JMIR Mhealth Uhealth. 2017 May 25;5(5):e68. doi: 10.2196/mhealth.6939.

Cognitive Testing in People at Increased Risk of Dementia Using a Smartphone App: The iVitality Proof-of-Principle Study.

Author information

1
Academic Medical Center, Department of Neurology, University of Amsterdam, Amsterdam, Netherlands.
2
Leiden University Medical Center, Department of gerontology & geriatrics, University of Leiden, Leiden, Netherlands.
3
Leiden Institute of Advanced Computer Sciences, LIACS, University of Leiden, Leiden, Netherlands.
4
Institute of Evidence-based Medicine in Old Age - IEMO, LUMC, Leiden, Netherlands.
5
Donders Institute for Brain, Behaviour and Cognition, Department of Neurology, Radboud UMC, Nijmegen, Netherlands.

Abstract

BACKGROUND:

Smartphone-assisted technologies potentially provide the opportunity for large-scale, long-term, repeated monitoring of cognitive functioning at home.

OBJECTIVE:

The aim of this proof-of-principle study was to evaluate the feasibility and validity of performing cognitive tests in people at increased risk of dementia using smartphone-based technology during a 6 months follow-up period.

METHODS:

We used the smartphone-based app iVitality to evaluate five cognitive tests based on conventional neuropsychological tests (Memory-Word, Trail Making, Stroop, Reaction Time, and Letter-N-Back) in healthy adults. Feasibility was tested by studying adherence of all participants to perform smartphone-based cognitive tests. Validity was studied by assessing the correlation between conventional neuropsychological tests and smartphone-based cognitive tests and by studying the effect of repeated testing.

RESULTS:

We included 151 participants (mean age in years=57.3, standard deviation=5.3). Mean adherence to assigned smartphone tests during 6 months was 60% (SD 24.7). There was moderate correlation between the firstly made smartphone-based test and the conventional test for the Stroop test and the Trail Making test with Spearman ρ=.3-.5 (P<.001). Correlation increased for both tests when comparing the conventional test with the mean score of all attempts a participant had made, with the highest correlation for Stroop panel 3 (ρ=.62, P<.001). Performance on the Stroop and the Trail Making tests improved over time suggesting a learning effect, but the scores on the Letter-N-back, the Memory-Word, and the Reaction Time tests remained stable.

CONCLUSIONS:

Repeated smartphone-assisted cognitive testing is feasible with reasonable adherence and moderate relative validity for the Stroop and the Trail Making tests compared with conventional neuropsychological tests. Smartphone-based cognitive testing seems promising for large-scale data-collection in population studies.

KEYWORDS:

cognition; neuropsychological tests; telemedicine

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