Examining Associations Between Smartphone Use and Clinical Severity in Frontotemporal Dementia: Proof-of-Concept...

Area of Science:

• Neuroscience
• Digital Health
• Gerontology

Background:

• Frontotemporal lobar degeneration (FTLD) is a primary cause of dementia in individuals under 65.
• In-person assessments for FTLD present challenges, highlighting the need for remote, accessible monitoring tools.
• Previous studies show reduced computer use correlates with cognitive decline, but smartphone use associations are unclear.

Purpose of the Study:

• To analyze daily smartphone battery usage patterns as a proxy for smartphone activity in FTLD patients.
• To investigate the correlation between smartphone usage patterns and clinical indicators of FTLD severity.

Main Methods:

• 231 adults (including clinically normal, prodromal FTLD, and symptomatic FTLD) had the ALLFTD Mobile App installed on their smartphones.
• Passive, continuous monitoring of smartphone battery percentage was collected every 15 minutes over an average of 28 days.
• Linear mixed-effects models analyzed temporal battery percentage variations against clinical severity measures (CDR+NACC FTLD, cognitive tests, neuropsychiatric inventory, MRI volumes), controlling for covariates.

Main Results:

• Participants with prodromal or symptomatic FTLD showed significantly less daily fluctuation in battery percentage, indicating reduced smartphone use compared to controls (P<.001).
• Worse performance in cognitive domains (executive function, memory, language, visuospatial skills), increased neuropsychiatric symptoms, and smaller brain volumes were all associated with decreased daily battery use (P<.001).
• CDR+NACC FTLD global scores interacted with time of day, confirming reduced daily smartphone activity in FTLD groups.

Conclusions:

• Passively collected smartphone usage data, reflected in battery drain patterns, is a viable digital marker associated with clinical impairment in FTLD.
• This study provides proof of concept for using smartphone behavior as a remote monitoring tool for neurodegenerative diseases.
• Future research should focus on validating passive digital markers for tracking longitudinal neurobehavioral changes in FTLD and other neurodegenerative conditions.