A - 06 Sensitivity of Remote App-Based Assessment of Cognition among Older Adults to Fatigue-Mediated Differences in Cognitive Functioning.

Abstract

This study assesses the sensitivity of the mobile cognitive app performance platform (mCAPP), a mobile and engaging cognitive assessment tool, to participant reported fatigue. The mCAPP includes three gamified tasks: a memory task ("Concentration"), a stroop-like task ("Brick Drop"), and a digit-symbol coding-like task ("Space Imposters"). For all games, shorter reaction times and fewer guesses indicate better performance. The cohort included 55 participants (72.73% female; age = 71.60 ± 4.48; education = 16.71 ± 2.30; 49.1% white; 49.1% Black/African American, 1.8% Multiracial) without cognitive impairment who are enrolled in the Penn ADRC cohort. Performance was analyzed as a whole and grouped into days of high (7+) and low (0-3) fatigue (range 0-10). The average fatigue rating was 2.61 ± 2.51. Overall, higher reported fatigue was weakly correlated with more time spent (ρ= 0.22) and a higher number of guesses on Concentration (ρ= 0.12; p-values<0.01). There was a significant difference in speed for those with high fatigue (M = 2.825) and low fatigue (M = 2.592; p = 0.018) on Space Imposters, but not on Brick Drop (p = 0.15). On Concentration, those with high fatigue needed a higher number of guesses (M = 5.356) compared to low fatigue (M = 5.095; p = 0.003) and more time was spent on individual guesses for those with high fatigue (M = 17.587) compared to low fatigue (M = 13.357; p < 0.001). The mCAPP can remotely detect differences in cognitive performance in self-reported high and low fatigue states. Future studies will include looking at sleep data to determine objective measures of fatigue-related behavior and in-depth analysis of performance within-subject.