Repeated memory‐based assessments: Implications for clinical trials and practice: Using digital technology to drive clinical innovation in brain‐behavior relationships: A new era in neuropsychology. (7th December 2020)

• Record Type: Journal Article
• Authors: Papp, Kathryn V.; Samaroo, Aubryn H.; Chou, Hsiang‐Chin Lori; Buckley, Rachel F.; Rentz, Dorene; Sperling, Reisa A.; Amariglio, Rebecca
• Is Part Of: Alzheimer's & dementia. Volume 16(2020)Supplement 6
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-07
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.038143
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Detailed longitudinal neuropsychological assessment in the Harvard Aging Brain Study (HABS) and related studies has revealed that subtle decrements in associative and semantic memory, as well as reduced practice effects for repeated items may be the earliest cognitive changes in preclinical AD. Utilizing digital, repeated, and remote assessment of these cognitive functions has the potential to increase the rapidity and ease with which these subtle changes can be detected. We previously showed that diminished practice effects on a challenging iPad‐based monthly face‐name memory paradigm was associated with neuroimaging markers of amyloid and tau in normal older adults participating in HABS. These findings inspired the development of the Boston Remote Assessment of Neurocognitive Health (BRANCH), a smartphone‐based associative and semantic memory assessment using stimuli and tasks relevant to everyday life designed for serial assessment. Method: We describe the development, feasibility, and pilot data from a smartphone‐based memory assessment administered daily (over consecutive days) in normal older adults using their own devices. BRANCH includes 2 measures of paired associative learning (faces and names, groceries and prices), an associative memory test with facilitated encoding (categories), and a continuous visual recognition task (street signs). A total of 41 pilot participants (mean age=76.1; 64% female) completed 1 version of BRANCH in clinic and 4 versions remotely on their own mobile device for 4 consecutive days. Participants also completed standard paper and pencil testing and a questionnaire about their experience completing the task. Result: BRANCH was feasible with a total of 80% of individuals completing all assessments in the correct order. It was acceptable to participants with 64% finding the tasks at‐least somewhat to highly engaging. Older age and general cognition (e.g., MMSE) was associated with worse performance across memory tasks. Improved performance (practice effect) was observed on daily administration of paired associative memory tasks (Figure 1.). Conclusion: A theoretically and evidence‐based digital memory assessment with ecologically‐valid tasks and stimuli is feasible for older adults to complete independently on their own devices. Digital assessment over multiple timepoints has the potential to drastically improve the efficiency with which cognitive performance and subtle decline can be captured.