在一项针对1944年出生的老年人的基于人群的研究中，基于移动应用程序的无监督认知测试。
Unsupervised mobile app-based cognitive testing in a population-based study of older adults born 1944.
作者信息
Öhman Fredrik, Berron David, Papp Kathryn V, Kern Silke, Skoog Johan, Hadarsson Bodin Timothy, Zettergren Anna, Skoog Ingmar, Schöll Michael
机构信息
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
出版信息
Front Digit Health. 2022 Nov 8;4:933265. doi: 10.3389/fdgth.2022.933265. eCollection 2022.
BACKGROUND
Mobile app-based tools have the potential to yield rapid, cost-effective, and sensitive measures for detecting dementia-related cognitive impairment in clinical and research settings. At the same time, there is a substantial need to validate these tools in real-life settings. The primary aim of this study was thus to evaluate the feasibility, validity, and reliability of mobile app-based tasks for assessing cognitive function in a population-based sample of older adults.
METHOD
A total of 172 non-demented (Clinical Dementia Rating 0 and 0.5) older participants (aged 76-77) completed two mobile app-based memory tasks-the Mnemonic Discrimination Task for Objects and Scenes (MDT-OS) and the long-term (24 h) delayed Object-In-Room Recall Task (ORR-LDR). To determine the validity of the tasks for measuring relevant cognitive functions in this population, we assessed relationships with conventional cognitive tests. In addition, psychometric properties, including test-retest reliability, and the participants' self-rated experience with mobile app-based cognitive tasks were assessed.
RESULT
MDT-OS and ORR-LDR were weakly-to-moderately correlated with the Preclinical Alzheimer's Cognitive Composite (PACC5) ( = 0.3-0.44, < .001) and with several other measures of episodic memory, processing speed, and executive function. Test-retest reliability was poor-to-moderate for one single session but improved to moderate-to-good when using the average of two sessions. We observed no significant floor or ceiling effects nor effects of education or gender on task performance. Contextual factors such as distractions and screen size did not significantly affect task performance. Most participants deemed the tasks interesting, but many rated them as highly challenging. While several participants reported distractions during tasks, most could concentrate well. However, there were difficulties in completing delayed recall tasks on time in this unsupervised and remote setting.
CONCLUSION
Our study proves the feasibility of mobile app-based cognitive assessments in a community sample of older adults, demonstrating its validity in relation to conventional cognitive measures and its reliability for repeated measurements over time. To further strengthen study adherence, future studies should implement additional measures to improve task completion on time.
背景
基于移动应用程序的工具有可能在临床和研究环境中提供快速、经济高效且灵敏的措施来检测与痴呆相关的认知障碍。与此同时，在现实生活环境中验证这些工具的需求也非常大。因此，本研究的主要目的是评估基于移动应用程序的任务在以社区为基础的老年人样本中评估认知功能的可行性、有效性和可靠性。
方法
共有172名无痴呆（临床痴呆评定量表为0和0.5）的老年参与者（年龄在76 - 77岁）完成了两项基于移动应用程序的记忆任务——物体和场景的记忆辨别任务（MDT - OS）以及长期（24小时）延迟的房间内物体回忆任务（ORR - LDR）。为了确定这些任务在测量该人群相关认知功能方面的有效性，我们评估了它们与传统认知测试的关系。此外，还评估了心理测量特性，包括重测信度，以及参与者对基于移动应用程序的认知任务的自我评定体验。
结果
MDT - OS和ORR - LDR与临床前期阿尔茨海默病认知综合量表（PACC5）呈弱至中度相关（r = 0.3 - 0.44，p <.001），并与情景记忆、处理速度和执行功能的其他多项测量指标相关。单次测试的重测信度较差至中等，但使用两次测试的平均值时，重测信度提高到中等至良好。我们未观察到显著的地板效应或天花板效应，教育程度或性别对任务表现也无影响。诸如干扰和屏幕尺寸等背景因素对任务表现没有显著影响。大多数参与者认为这些任务有趣，但许多人将其评为极具挑战性。虽然有几位参与者报告在任务过程中受到干扰，但大多数人能够很好地集中注意力。然而，在这种无监督的远程环境中，按时完成延迟回忆任务存在困难。
结论
我们的研究证明了基于移动应用程序的认知评估在社区老年人样本中的可行性，表明其相对于传统认知测量方法的有效性以及随时间重复测量的可靠性。为了进一步加强研究的依从性，未来的研究应采取额外措施以提高按时完成任务的情况。
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