The Feasibility of Digital Testing using a Smartphone Application for Precision Brain Health Monitoring in the Framingham Heart Study

Abstract

AbstractBackgroundEarly detection of cognitive decline is critical to identify effective treatments for Alzheimer’s disease and related dementias. The inherent heterogeneity of behaviors associated with brain health may obscure the signals derived from a typical neuropsychological evaluation, partly because of the limited frequency of assessment with which it can be conducted. This may lead to inaccurate or poor detection sensitivity. Digital health technology using smartphone applications enables frequent assessment and, thereby, more precise monitoring of brain health. The current study sought to examine the feasibility of using smartphone application‐based tasks in community‐based participants from the Framingham Heart Study (FHS).MethodThe smartphone application consists of three blocks of assessments, lasting approximately 15‐20 minutes (Figure 1). Block 1: Participants answer questions to ensure that they can see the stimuli and hear the instructions adequately. Block 2: Participants complete a series of cognitive tasks and respond to open‐ended questions which are voice recorded. Block 3: To ensure that performance is not influenced by external factors, participants respond to questions, for example, about their experiences with using the smartphone application.ResultTo date, 318 FHS participants have been enrolled into the study. Of these, as of 12/09/2022, 168 participants’ first assessment period has been completed within the two week period after being enrolled in the study. Of the 168 participants, a large majority (81%; n = 136) completed all the tasks, while the remaining 32 completed partial assessment. Table 1 reveals that the overall percentage of participants who have been enrolled in the study and the percentage of those who completed their first assessment are highly similar.ConclusionFindings reveal that older adults from a large, community‐based study are able to successfully download and complete the first set of tasks using their smartphone application. As data collection is ongoing, the number of older adults recruited into the study is expected to increase exponentially. These results indicate that it is feasible to monitor brain health on an on‐going basis using self‐administered smartphone applications, potentially creating an effective, lower cost, and scalable approach to detect significant changes in cognitive functions earlier and more accurately in the preclinical neurodegenerative process.