Smartphone-Based "Burst" Cognitive Assessments

项目4项目概要 项目4将利用智能手机的日益普及来改善标准的临床认知 测试，为参加健康老龄化和老年 痴呆PPG。阿尔茨海默病（AD）最重要和最有效的指标之一是阿尔茨海默病（AD）的变化。 认知，但在临床上评估认知有几个缺点。首先，性能受日常影响， 压力、疲劳、睡眠模式和情绪的日波动。第二，测试发生在 这与日常生活中执行认知要求高的任务有着根本的不同。最后通过 设计，认知通常很少评估，通常每年一次（如目前的情况下， HASD）。一种解决方案是增加诊所内检测的频率或在 参与者使用认知的自然环境，如他们的家，工作场所，旅行时等， 但这是不切实际的，并且是繁重的，特别是对于老年人。 项目4将利用日益普及的 智能手机智能手机的使用率在每个年龄段都在攀升，即使在老年人中，也有50%的人拥有智能手机， 经常使用能上网的智能手机。在Project 4中，我们设计了一个iOS和Android应用程序，称为 将安装在HASD参与者个人电脑上的动态认知研究（ARC）应用程序 智能手机如果参与者没有智能手机或拥有过时的型号，我们将提供一项研究 手机使用，同时登记。每六个月，参与者将完成非常简短的（<3分钟） 在一周内每天进行4次测试。测试是在一周内平均提供一个分数 捕捉自然变化并将其标准化，显著提高可靠性。试点研究表明， ARC评估显示出非凡的可靠性，范围从0.92到0.99。另一个优点是 能够测量一天内、一周内和6个月评估间隔内的变异性。 我们假设ARC评估比临床评估对疾病分期更敏感， AD生物标志物和淀粉样蛋白阳性HASD参与者将显示更多的认知表现的变异性 比淀粉样蛋白阴性的参与者，即使在疾病的临床前阶段。如果成功， ARC评估的灵敏度和可靠性将提供非凡的统计能力来表征 AD观察性研究中的认知功能下降。此外，ARC评估可以通过以下方式使临床试验受益： 缩短试验时间，减少参与者。

Project 4 Project Summary Project 4 will leverage the increasing popularity of smartphones to improve upon standard in-clinic cognitive testing, providing a robust characterization of cognition in participants enrolled in the Healthy Aging and Senile Dementia PPG. One of the most important and face-valid indicators of Alzheimer disease (AD) is a change in cognition, but assessing cognition in-clinic has several drawbacks. First, performance is influenced by day-to- day fluctuations in stress, fatigue, sleep patterns, and mood. Second, the testing takes place in environments that are fundamentally different from where cognitively demanding tasks are performed in daily life. Finally, by design, cognition is typically assessed very infrequently, usually once per year (as currently is the case in HASD). One solution would be to increase the frequency of in-clinic testing or to complete assessments in the natural environments in which participants use cognition such as their homes, workplaces, while traveling, etc., but this is impractical and burdensome, especially for older adults. Project 4 will provide a solution to these difficulties by taking advantage of the increasing popularity of smartphones. Smartphone usage is climbing in every age category, and even in older adults, 50% have and regularly use internet-enabled smartphones. In Project 4, we have designed an iOS and Android app called the Ambulatory Research in Cognition (ARC) app that will be installed on HASD participants' personal smartphones. If participants do not own a smartphone or have an antiquated model, we will provide a study phone for use while enrolled. Every six months, participants will complete extremely brief (<3 minutes each) testing sessions 4x/day over the course of one week. Tests are averaged across the week to provide a score that captures and normalizes natural variability and dramatically increases reliability. Pilot studies show that ARC assessments demonstrate extraordinary reliability, ranging from 0.92 to 0.99. Another advantage is the ability to measure variability within a day, across a week, and across the 6-month intervals of assessments. We hypothesize that ARC assessments will be more sensitive than in-clinic assessments to disease stage and AD biomarkers and that amyloid-positive HASD participants will show more variability in cognitive performance than amyloid-negative participants, even in the preclinical stages of disease. If successful, the increases in sensitivity and reliability of ARC assessments will provide extraordinary statistical power to characterize cognitive decline in observational studies of AD. In addition, ARC assessments could benefit clinical trials by shortening trial duration and requiring fewer participants.