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

• Main Authors: Jongstra, Susan (Author), Wijsman, Liselotte Willemijn (Author), Cachucho, Ricardo (Author), Hoevenaar-Blom, Marieke Peternella (Author), Mooijaart, Simon Pieter (Author), Richard, Edo (Author)
• Format: Book
• Published: JMIR Publications, 2017-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2291-5222; 10.2196/mhealth.6939
• Keywords: Information technology; T58.5-58.64; Public aspects of medicine; RA1-1270
• Source: JMIR mHealth and uHealth, Vol 5, Iss 5, p e68 (2017)

BackgroundSmartphone-assisted technologies potentially provide the opportunity for large-scale, long-term, repeated monitoring of cognitive functioning at home. ObjectiveThe 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. MethodsWe 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. ResultsWe 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. ConclusionsRepeated 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.