Muurling Marijn, Reus Lianne M, de Boer Casper, Wessels Sterre C, Jagesar Raj R, Vorstman Jacob A S, Kas Martien J H, Visser Pieter Jelle
Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center, Amsterdam, Netherlands.
Department of Psychology, Leiden University, Leiden, Netherlands.
JMIR Aging. 2022 May 20;5(2):e33856. doi: 10.2196/33856.
In people with cognitive impairment, loss of social interactions has a major impact on well-being. Therefore, patients would benefit from early detection of symptoms of social withdrawal. Current measurement techniques such as questionnaires are subjective and rely on recall, in contradiction to smartphone apps, which measure social behavior passively and objectively.
This study uses the remote monitoring smartphone app Behapp to assess social behavior, and aims to investigate (1) the association between social behavior, demographic characteristics, and neuropsychiatric symptoms in cognitively normal (CN) older adults, and (2) if social behavior is altered in cognitively impaired (CI) participants. In addition, we explored in a subset of individuals the association between Behapp outcomes and neuropsychiatric symptoms.
CN, subjective cognitive decline (SCD), and CI older adults installed the Behapp app on their own Android smartphone for 7 to 42 days. CI participants had a clinical diagnosis of mild cognitive impairment (MCI) or Alzheimer-type dementia. The app continuously measured communication events, app use and location. Neuropsychiatric Inventory (NPI) total scores were available for 20 SCD and 22 CI participants. Linear models were used to assess group differences on Behapp outcomes and to assess the association of Behapp outcomes with the NPI.
We included CN (n=209), SCD (n=55) and CI (n=22) participants. Older cognitively normal participants called less frequently and made less use of apps (P<.05). No sex effects were found. Compared to the CN and SCD groups, CI individuals called less unique contacts (β=-0.7 [SE 0.29], P=.049) and contacted the same contacts relatively more often (β=0.8 [SE 0.25], P=.004). They also made less use of apps (β=-0.83 [SE 0.25], P=.004). Higher total NPI scores were associated with further traveling (β=0.042 [SE 0.015], P=.03).
CI individuals show reduced social activity, especially those activities that are related to repeated and unique behavior, as measured by the smartphone app Behapp. Neuropsychiatric symptoms seemed only marginally associated with social behavior as measured with Behapp. This research shows that the Behapp app is able to objectively and passively measure altered social behavior in a cognitively impaired population.
在认知障碍患者中，社交互动的丧失对幸福感有重大影响。因此，早期发现社交退缩症状将使患者受益。目前的测量技术，如问卷调查，具有主观性且依赖回忆，这与智能手机应用程序不同，后者能被动且客观地测量社交行为。
本研究使用远程监测智能手机应用程序Behapp评估社交行为，旨在调查（1）认知正常（CN）的老年人社交行为、人口统计学特征和神经精神症状之间的关联，以及（2）认知障碍（CI）参与者的社交行为是否发生改变。此外，我们在一部分个体中探讨了Behapp结果与神经精神症状之间的关联。
CN、主观认知下降（SCD）和CI的老年人在自己的安卓智能手机上安装Behapp应用程序7至42天。CI参与者临床诊断为轻度认知障碍（MCI）或阿尔茨海默病型痴呆。该应用程序持续测量通信事件、应用程序使用情况和位置。20名SCD和22名CI参与者可获得神经精神科问卷（NPI）总分。使用线性模型评估Behapp结果的组间差异，并评估Behapp结果与NPI的关联。
我们纳入了CN（n = 209）、SCD（n = 55）和CI（n = 22）参与者。认知正常的老年参与者打电话频率较低，应用程序使用较少（P <.05）。未发现性别效应。与CN和SCD组相比，CI个体拨打的独特联系人较少（β = -0.7 [标准误0.29]，P =.049），相对更频繁地联系相同联系人（β = 0.8 [标准误0.25]，P =.004）。他们应用程序使用也较少（β = -0.83 [标准误0.25]，P =.004）。较高的NPI总分与出行距离更远有关（β = 0.042 [标准误0.015]，P =.03）。
CI个体的社交活动减少，尤其是与重复和独特行为相关的活动，这是通过智能手机应用程序Behapp测量得出的。神经精神症状似乎与Behapp测量的社交行为仅有微弱关联。这项研究表明，Behapp应用程序能够客观且被动地测量认知障碍人群中改变的社交行为。
