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Technology and Dementia Preconference.

Sarah E Polk1, Lindsay R Clark2,3,4, Kristin E Basche2

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Frequent remote digital cognitive tests effectively detect early Alzheimer's disease (AD) cognitive decline. These unsupervised assessments are more sensitive to subtle changes than traditional methods, aiding in monitoring disease progression.

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Area of Science:

  • Neuroscience
  • Cognitive Science
  • Gerontology

Background:

  • Traditional pen-and-paper neuropsychological assessments lack sensitivity for detecting subtle cognitive changes in early Alzheimer's disease (AD).
  • Existing methods are limited in their ability to monitor cognitive performance over short timeframes, hindering early intervention strategies.

Purpose of the Study:

  • To evaluate the efficacy of frequent, remote, and unsupervised digital cognitive assessments in capturing short-term cognitive decline in early AD.
  • To compare the sensitivity of digital assessments with traditional in-person tests for detecting cognitive changes in individuals with mild cognitive impairment (MCI).

Main Methods:

  • Investigated episodic memory trajectories in 202 participants (52-85 years) using self-administered remote digital testing over at least 30 weeks.
  • Employed linear mixed modeling to analyze cognitive status (cognitively unimpaired vs. MCI) and its interaction with study duration.
  • Stratified MCI participants by amyloid-β (Aβ) burden and examined correlations between remote and in-person assessments.

Main Results:

  • Participants with MCI showed deficits in associative memory, memory precision, and familiarity-based memory tasks compared to cognitively unimpaired individuals.
  • A short-term decline in familiarity-dependent memory was observed in all MCI patients; specific tasks also detected decline in MCI patients with high Aβ burden.
  • Remote assessment changes correlated with long-term in-person assessment changes, while in-person tests were insensitive to short-term cognitive changes in MCI.

Conclusions:

  • Frequent remote cognitive testing offers a feasible and sensitive method for capturing subtle, short-term cognitive decline.
  • Digital cognitive assessments represent a promising advancement for monitoring cognitive health in early stages of neurodegenerative diseases like AD.
  • This approach can potentially improve the early detection and management of cognitive impairment.