90 Feasibility of Repeated Remote Memory Assessment with Mobile Devices to Detect Subtle Cognitive Decline in Older Adults

• Published in: Journal of the International Neuropsychological Society 2023-11, Vol.29 (s1), p.492-493
• Main Authors: Clark, Lindsay R, Berron, David, Peterson, Amanda J, Basche, Kristin, Allison, Samantha, Johnson, Sterling C, Duzel, Emrah
• Format: Article
• Language: English
• Subjects: Aging; Alzheimer's disease; Cognitive ability; Compliance; Memory; Middle age; Neurodegenerative diseases; Older people; Poster Session 05: Neuroimaging | Neurophysiology | Neurostimulation | Technology | Cross Cultural | Multiculturalism | Career Development; Retention; Smartphones; Teleneuropsychology/Technology; Temporal lobe; Usability
• ISSN: 1355-6177; 1469-7661
• DOI: 10.1017/S1355617723006380

Objective:Frequent and remote cognitive assessment may improve sensitivity to subtle cognitive decline associated with preclinical Alzheimer’s disease (AD). The objective of this study was to evaluate the feasibility and acceptability of repeated remote memory assessment in late middle-aged and older adults.Participants and Methods:We recruited participants from a longitudinal aging cohort to complete three medial temporal lobe-based memory paradigms (Object-In-Room Recall [ORR], Mnemonic Discrimination for Objects and Scenes [MDT-OS], Complex Scene Recognition [CSR]) using the neotiv application at repeated intervals over one year. We conducted initial telephone calls to perform screening, consent, and download instructions. Participants were assigned 24 remote sessions on a smartphone or tablet and were alerted via push notification when an assignment was ready to complete. Participants were randomly assigned to: (1) complete memory tests every other week or (2) complete memory tests for multiple days within one week every other month. Each remote session lasts approximately 10 minutes and includes one memory paradigm and brief usability/acceptability questionnaires followed by a delayed retrieval session 90 minutes later. Feasibility metrics examined included participation, retention, compliance, and usability/acceptability.Results:Of 150 participants recruited, 113 consented and were enrolled into the study (participation rate = 75%). Current retention rate is 75%, with 85/113 currently active (n=73) or completed (n=12). Of the 85 active or completed participants, the mean age is 68.7 (range = 4882), 64% are women, 70% used a smartphone (30% tablet), 84 are cognitively unimpaired and 1 has mild cognitive impairment. The primary threat to retention was participants consenting into the study but never registering in the app or completing their first scheduled assignment. After enrollment, 130 telephone calls were made by study staff to facilitate registration into the app or to remind participants to complete tasks. 74-80% of participants completed delayed retrieval tasks within 30 minutes of push notification, but average retrieval time was 125137 minutes post-learning trials. Regarding acceptability/usability, 94% agreed the application was easy to use, 56% enjoyed completing the mobile memory tests (36% felt neutral), 40% prefer remote mobile memory tests to standard in-person paper and pencil tests, and 50% understood the test instructions. 87% felt