Smartphones and Cognition: A Review of Research Exploring the Links between Mobile Technology Habits and Cognitive Functioning

The Technological Gaze

BackgroundHypertension guidelines recommend home blood pressure (HBP) monitoring in adjunct to office blood pressure (OBP) for its greater reproducibility and prognostic utility in the prevention of cardiovascular outcomes, especially stroke. To date, the relationship between HBP and cognitive function remains unexplored.MethodsWe examined HBP as a cognitive predictor in a multi-ethnic group of community-dwelling adults aged 60 and over (N = 133) using neuropsychological measures and analyzed the data using multiple regression analyses. We also employed “everyday cognition” measures that have been found to have higher prognostic utility for real-world functioning than traditional cognitive tasks.ResultsGood to perfect HBP monitoring compliance over seven days was achieved by 88.7% of the participants with superior reliability (ICC≥.96) to office readings. Higher home systolic BP and pulse pressure predicted worse processing speed, executive function, and everyday cognitive function, whereas lower home diastolic BP predicted worse everyday cognition. Office readings were similarly associated with everyday cognitive function but with no other cognitive measures.ConclusionOur findings are the first to validate HBP as a predictor of neuropsychological function in older adults beyond cognitive screening. Differential relationships among blood pressure variables and specific cognitive domains were observed. With proper standardization and training, we demonstrated that HBP can be obtained in a multi-ethnic community-dwelling older adult cohort. Our findings emphasize the importance of employing blood pressure and cognitive measures that are adequately sensitive to detect vascular-related cognitive impairment in a relatively healthy population. Implications regarding proper HBP measurement for hypertension management, cognitive health, and everyday function are discussed.

The effects of immediate-release morphine on cognitive functioning in patients receiving chronic opioid therapy in palliative care

Stressful or traumatic events have been shown to impair cognitive functioning on laboratory-based tasks due to stress-related intrusive thoughts and avoidance. However, research on the effects of stress on everyday cognitive functioning has been lacking. A sample of 909 undergraduates completed measures of perceived stress, PTSD symptoms, and everyday cognitive failures. The results revealed that both perceived stress and PTSD symptoms uniquely predicted cognitive failures, even after controlling for a number of potentially confounding variables. Additionally, there was a significant interaction. Participants with low scores on both measures of stress reported the fewest occurrences of everyday cognitive failures. In contrast, participants with elevated scores on either measure of stress reported higher levels of cognitive failures. These results suggest that there are unique negative effects of perceived stress and PTSD symptoms on everyday cognitive functioning and sharpen our understanding of the relationship between stress and cognition.

Candidates for cardiac bypass surgery often experience cognitive decline. Such decline is likely to affect their everyday cognitive functioning. The aim of the present study was to compare cardiac patients' ratings of their everyday cognitive functioning against significant others' ratings and selected neuropsychological tests. Sixty-nine patients completed a battery of standardised cognitive tests. Patients and significant others also completed the Everyday Function Questionnaire independently of each other. Patient and significant other ratings of patients' everyday cognitive difficulties were found to be similar. Despite the similarities in ratings of difficulties, some everyday cognitive tasks were attributed to different processes. Patients' and significant others' ratings were most closely associated with the neuropsychological test of visual memory. Tests of the patients' verbal memory and fluency were only related to significant others' ratings. Test scores of attention and planning were largely unrelated to ratings by either patients or their significant others.

Self-regulation has been found to be an important contributor to a range of outcomes, with delay of gratification (a self-regulatory skill) predicting better academic, social and personal functioning. There is some evidence that individuals with Down syndrome have difficulty with delay of gratification. We investigated the question of whether this difficulty is common to intellectual disability irrespective of aetiology, or whether it presents a particular problem for those with Down syndrome. The latter was considered a possibility because of language difficulties in this group. Three groups of children with a mean MA between 36 and 60 months participated in the study: children with Down syndrome (n = 32), children with a moderate intellectual disability from a cause other than Down syndrome (n = 26) and typically developing children (n = 50). Children completed a series of measures of language and cognitive functioning and participated in a delay of gratification task. The group of children with Down syndrome delayed for a significantly shorter time than either of the other two groups that did not differ from each other. Receptive language was associated with delay time for the children with Down syndrome but not for the typically developing group, nor for the group with moderate intellectual disability. Children with Down syndrome appear to have a particular difficulty with delay of gratification. Language abilities would seem to be implicated in this difficulty, although further examination of this hypothesis is required.

BackgroundIndividuals differ in how they remember the past: some richly re-experience specific details of past episodes, whereas others recall only the gist of past events. Little research has examined how such trait mnemonics, or lifelong individual differences in memory capacities, relate to cognitive aging. We specifically examined trait episodic autobiographical memory (AM, the tendency to richly re-experience episodic details of past events) in relation to complaints of everyday cognitive functioning, which are known to increase with age. Although one might predict that individuals reporting higher trait-level episodic AM would be resistant to age-related decline in everyday function, we made the opposite prediction. That is, we predicted that those with lower trait-level episodic AM would be better equipped with compensatory strategies, practiced throughout the lifespan, to cope with age-related memory decline. Those with higher trait-level episodic AM would have enhanced sensitivity to age-related cognitive changes due to their tendency to rely on their perceived above-average memory function.MethodsWe tested these predictions in 959 older adults aged 50–93 using online subjective and objective measures of memory and cognitive function. Our key measures of interest were the Survey of Autobiographical Memory, a measure of autobiographical memory abilities; and the Cognitive Failures Questionnaire, a measure of everyday cognitive function.ResultsIn keeping with our prediction, we found that complaints of day-to-day memory slips and errors (normally elevated with age) remained stable or even decreased with age among those reporting lower trait-level episodic AM, whereas those reporting higher trait-level episodic AM reported the expected age-related increase in such errors. This finding was specific to episodic AM and not observed for other autobiographical memory capacities (e.g., semantic, spatial). It was further unaccounted for by response bias or objectively assessed cognitive abilities.ConclusionsCongenitally low trait-level episodic AM may paradoxically confer a functional advantage in aging. This could be due to well-developed non-episodic strategies not present in those with higher abilities, who are more sensitive to age-related memory decline attributable to medial temporal lobe changes. Our findings emphasize the importance of considering individual differences when studying cognitive aging trajectories.

This study was conducted with the aim of researching the impact of electronic tourism marketing systems on the characteristics and behavior of the digital tourist consumer in the presence of smart mobile phone technology (as an intermediate variable). Is there an impact of the use of smart mobile phone technology and its applications on the digital tourist consumer when completing the purchase of the tourism product. The electronic questionnaire was used as a means of data collection, which was launched through the Internet. The results of the study concluded that there is a significant relationship between electronic tourism marketing systems and the characteristics and behaviors of the digital tourist consumer, as well as the existence of a significant impact relationship between smart mobile phone technology and the characteristics and behaviors of the digital tourist consumer, in addition to the existence of a significant influence relationship between smart mobile phone technology and electronic tourism marketing systems . The results confirmed the existence of a significant effect of smart mobile phone technology (as an intermediate variable) on the influence relationship between each of the electronic tourism marketing systems and the characteristics and behaviors of the digital tourist consumer. By adopting smart phone technology and its tourism applications and integrating them into tourism marketing operations in Egypt.

BackgroundThe Anti-Amyloid in Asymptomatic Alzheimer’s Disease (A4) Study failed to show a treatment benefit with solanezumab, but the longitudinal consequences of elevated amyloid were observed in study participants with objective decline on the Preclinical Alzheimer Cognitive Composite (PACC) and subjective decline on the combined Cognitive Function Index (participant + study partner CFI), during the trial period.ObjectivesWe sought to expand on previous findings by comparing longitudinal patterns of participant and study partner CFI separately and their associations with the PACC stratified by baseline amyloid tertile over the course of the A4 Study.DesignCognitively unimpaired older adult participants and their study partners were independently administered the CFI at screen prior to amyloid PET disclosure and then at 3 subsequent visits (week 48, week 168, week 240) of the study. PACC collected at visits concurrent with CFI administration were also examined longitudinally.SettingThe A4 Study was conducted at 67 sites in Australia, Canada, Japan, and the United States.Participants1,147 participants with elevated amyloid based on florbetapir PET were enrolled in the A4 Study and included in these analyses. 583 were on placebo and 564 were treated with solanezumab.MeasurementsThe PACC was used to assess objective cognitive performance and the CFI was used to assess change in everyday cognitive functioning by the participant and their study partner independently. Amyloid level was characterized by Centiloid tertiles (<46.1 CL, 46.1 to 77.2 CL, >77.2 CL). Participants were aware of their elevated amyloid status, but not their CL tertile, or specific level of amyloid. Longitudinal correlations between participant and study partner CFI and PACC were examined at all visits where assessments were available. The impact of baseline amyloid tertile on CFI and PACC associations was also examined.ResultsBoth participant and study partner CFI increased over the duration of the study indicating worsening cognitive functioning. Results did not differ by treatment group. The association between higher CFI and worse PACC for both for participant and study partner became progressively stronger over the course of the study. PACC had a significantly higher correlation with study partner CFI than with participant CFI by week 168. The stronger correlations between study partner CFI and PACC were driven by those in the highest amyloid tertile.ConclusionBoth participant and study partner report captured subtle changes in everyday cognitive functioning for participants with biomarker confirmed and disclosed preclinical AD. Moreover, study partner report was most highly aligned with cognitive decline, particularly among those with the highest amyloid load.

AimsIn patients with a history of chronic alcohol abuse, neurocognitive disorders (NCD) are not uncommon. The current study aimed to explore the course of cognitive performance, as measured by the Montreal Cognitive Assessment (MoCA), and everyday cognitive functioning, as measured by the Patient Competency Rating Scale (PCRS), in a large group of patients with alcohol use disorder (AUD) admitted to the Center of Excellence for Korsakov and Alcohol-related Cognitive Impairments.MethodsA multiple time-series design was used, in which the MoCA was administered at three time points of assessment, and the PCRS was completed by both the patient and a clinician at two time points, all during clinical treatment.ResultsA total of 524 patients were included, 71 of whom were diagnosed with AUD only, 284 with AUD and mild NCD (ARCI) and 169 with AUD, major NCD and fulfilling criteria for Korsakoff’s syndrome (KS).ConclusionsCognitive performance improved for all three groups during treatment, sustained abstinence and recovery from AUD. A low memory performance on the MoCA without improvement over time was predictive for KS, while improvement on this domain did not differentiate between AUD and ARCI. Changes in overall cognitive performance and orientation in patients with KS were positively related to changes in everyday cognitive functioning.

Everyday functioning becomes a challenge with aging, particularly among frail oldest-old adults. Several factors have been identified as influencing everyday activities realization, including physical and cognitive functioning. However, the influence of cognitive resources as a compensatory factor in the context of physical frailty deserves further consideration. This study aims to investigate in older adults physically frail the possible compensatory role of cognitive resources to perform everyday tasks. Two groups of community-dwelling old participants (n = 26 per group) matched for their age and cognitive resources, have been drawn according to their level of physical functioning. Two measures of everyday functioning have been assessed: one self-reported by the participant (the IADL scale) and one performance-based measure (the TIADL tasks). Participants performed equally the TIADL tasks irrespective of their physical condition. Contrariwise, participants with low physical functioning reported more everyday difficulties than their counterparts with a high level of physical functioning. Additionally, regressions analyses revealed differential influence of cognitive resources on performance and reported measures of everyday functioning. Our data suggests that cognitive resources are more strongly involved in the performance-based IADL measure in situation of physical frailty. Additionally, for participants with low physical functioning, lower cognitive resources are associated with more perceived difficulties in everyday life. These results highlight the compensatory role of cognitive resources in physically frail older adults, and suggest that an overestimation of everyday difficulties compared to performance on IADL tasks is an early indicator of physical decline and cognitive compensation.

&lt;p&gt;High self-control, better delay of gratification, and future thinking have long been linked theoretically and, more recently, empirically, yet evidence of the causal relationships between them is non-existent. The present research aimed firstly to elucidate the nature of the relationships between self-control, delay of gratification and future thinking, and secondly to investigate whether they are rooted in our physiology. In Study 1, a sample of 174 undergraduates completed a self-report survey three times with 2-month intervals in between. Longitudinal mediation path models were constructed to determine whether and how self-control would function as a mediator between delay of gratification at Time 1 and consideration of future consequences at Time 3. Results showed that delay of gratification predicted higher self-control, which in turn predicted higher concern for future consequences (CFC-F) and a lower concern for immediate consequences (CFC-I). Study 2 further explored this relationship by investigating whether temporal orientation grouping – high- vs. low-CFC – would predict subsequent levels of self-control and delay of gratification in a study of 71 undergraduates. Heart rate variability and cortisol were also examined. Results showed that by grouping participants in terms of CFC it was possible to predict subsequent levels of self-control and gratification delay abilities as expected. While there were no between-groups physiological differences, the methodology allowed for the novel discovery that cortisol was related to cognitive facets of self-control, while HRV was related to emotional functions associated with low self-control (i.e., worry and rumination). These results further highlight the importance of self-control in both our psychological and physiological functioning.&lt;/p&gt;

&lt;p&gt;High self-control, better delay of gratification, and future thinking have long been linked theoretically and, more recently, empirically, yet evidence of the causal relationships between them is non-existent. The present research aimed firstly to elucidate the nature of the relationships between self-control, delay of gratification and future thinking, and secondly to investigate whether they are rooted in our physiology. In Study 1, a sample of 174 undergraduates completed a self-report survey three times with 2-month intervals in between. Longitudinal mediation path models were constructed to determine whether and how self-control would function as a mediator between delay of gratification at Time 1 and consideration of future consequences at Time 3. Results showed that delay of gratification predicted higher self-control, which in turn predicted higher concern for future consequences (CFC-F) and a lower concern for immediate consequences (CFC-I). Study 2 further explored this relationship by investigating whether temporal orientation grouping – high- vs. low-CFC – would predict subsequent levels of self-control and delay of gratification in a study of 71 undergraduates. Heart rate variability and cortisol were also examined. Results showed that by grouping participants in terms of CFC it was possible to predict subsequent levels of self-control and gratification delay abilities as expected. While there were no between-groups physiological differences, the methodology allowed for the novel discovery that cortisol was related to cognitive facets of self-control, while HRV was related to emotional functions associated with low self-control (i.e., worry and rumination). These results further highlight the importance of self-control in both our psychological and physiological functioning.&lt;/p&gt;

The present study examined 2 approaches to the measurement of everyday cognition in older adults. Measures differing in the degree of structure offered for solving problems in the domains of medication use, financial management, and food preparation and nutrition were administered to a sample of 130 community-dwelling older adults ranging in age from 60 to 90 (M = 73 years, SD = 7.02 years). Well-defined and ill-defined everyday problem-solving measures, which varied in the amount of means-end-related information provided to participants, were used. The study found that (a) well- and ill-defined measures were moderately interrelated, (b) the 2 approaches were differentially related to basic cognitive abilities, and (c) together the 2 approaches explained over half of the variance in older adults' everyday instrumental functioning and were in fact better predictors of everyday functioning than traditional psychometric cognitive measures. Discussion focuses on the differential importance of both methods for assessing older adults' everyday cognitive functioning.

More realistic assessment tools are imperative for a better understanding of the impact of age-related cognitive deficits on functional status. With this in mind, we probed the ability of the EcoKitchen, a non-immersive virtual environment task with increasing executively demanding kitchen chores, to detect the effects of aging on the simulated everyday functioning of healthy adults. Fifty-three adults (age between 23 and 77 years) were assessed with the EcoKitchen and a set of conventional paper-and-pencil neuropsychological tests. The associations between the baseline features of study participants and each of the two different assessment methods were examined. The associations between the EcoKitchen variables and an executive composite score were also explored. Our results showed that older individuals present deficits in the performance of both the EcoKitchen task and standard assessment methods. Notably, we found that, unlike conventional tests, accuracy in the EcoKitchen task was not related to the education level and IQ score of participants. Moreover, the EcoKitchen performance time was significantly correlated with executive tests. We have demonstrated that the EcoKitchen task, an ecologically relevant computerized neuropsychological assessment tool, might be more suitable than classic paper-and-pencil tests to capture the impact of aging on everyday cognitive function, as it proved to be less prone to the influence of confounding factors. Additionally, we have shown that executive function plays an important role in the timely performance of cognitively challenging virtual environment tasks.