Rapid, Remote, and Reliable: Smartphone-Based Burst Cognitive Assessments in Alzheimer’s Disease.

We rely on complex memory and thinking skills to function in everyday life, however, these skills fluctuate constantly due to fatigue, stress, and anxiety—and these fluctuations increase as we age. Despite this, when we study people at risk for Alzheimer’s disease (AD), we test memory and thinking in “one-shot” in an unfamiliar place (usually a clinic or hospital exam room). Some perform really well on a “good” day and others may perform more poorly on a “bad” day. These fluctuations make it extraordinarily difficult to measure true abilities. In this study, we propose to use smartphones to test memory and thinking in short “bursts” requiring less than 3 minutes each to complete. Participants can take tests wherever it is safe to use a smartphone and they take the tests multiple times per day, which provides much more accurate and reliable tests to better understand how memory and thinking change in very early AD.

I am developing smartphone-based cognitive assessments for use by older adults in global Alzheimer’s disease observational studies and clinical trials.

Using smartphones to assess cognition is, of course, not a new idea, but we leverage the ubiquity of smartphones with a unique approach that maximizes the validity and reliability of cognitive assessments. We are using careful psychometric methods to develop extremely brief and repeatable cognitive tests that participants complete on their personal smartphones. Instead of focusing on a “single-shot” assessment that can produce unreliable data, we are repeatedly sampling cognition in our participants’ natural environments–the very places in which we rely on complex cognitive operations in daily life.