Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.
Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, CA, United States.
J Med Internet Res. 2024 Nov 25;26:e51978. doi: 10.2196/51978.
BACKGROUND: Mobile cognitive testing is growing in popularity, with numerous advantages over traditional cognitive testing; however, the field lacks studies that deeply examine mobile cognitive test data from general adult samples. OBJECTIVE: This study characterized performance for a suite of 8 mobile cognitive tests from the NeuroUX platform in a sample of US adults across the adult lifespan. METHODS: Overall, 393 participants completed 8 NeuroUX cognitive tests and a brief ecological momentary assessment survey once per day on their smartphones for 10 consecutive days; each test was administered 5 times over the testing period. The tests tapped the domains of executive function, processing speed, reaction time, recognition memory, and working memory. Participants also completed a poststudy usability feedback survey. We examined alternate form test-retest reliability; practice effects; and associations between scores (averages and intraindividual variability) and demographics as well as test-taking context (ie, smartphone type, being at home vs not at home, and being alone vs not alone). RESULTS: Our final sample consisted of 393 English-speaking US residents (aged 20-79 y; female: n=198, 50.4%). Of the 367 participants who provided responses about their race and ethnicity, 258 (70.3%) were White. Of the 393 participants, 181 (46.1%) were iOS users, and 212 (53.9%) were Android users. Of 12 test scores derived from the 8 tests, 9 (75%) showed good to excellent test-retest reliability (intraclass correlation coefficients >0.76). Practice effects (ie, improvements in performance) were observed for 4 (33%) of the 12 scores. Older age was associated with worse performance on most of the test scores (9/12, 75%) and greater within-person variability for nearly all reaction time scores (3/4, 75%). Relationships with smartphone type showed better performance among iOS users and those with newer Android software versions compared to those with older software. Being at home (vs not at home) was associated with better performance on tests of processing speed. Being alone (vs not alone) was associated with better performance on tests of recognition and working memory. Poststudy feedback indicated that participants found NeuroUX easy to learn and use, an enjoyable experience, and an app that would be helpful in understanding their thinking skills. Only 4.2% (16/379) endorsed privacy concerns, and 77.3% (293/379) reported that they would be willing to share their results with their health care provider. Older age-but not other demographics-was associated with finding the tests more challenging. CONCLUSIONS: In a sample of adults across a wide age range, this study characterized features that are particularly important for the interpretation of remote, repeated mobile cognitive testing performance, including test-retest reliability, practice effects, smartphone type, and test-taking context. These data enhance the understanding and application of mobile cognitive testing, paving the way for improved clinical decision-making, personalized interventions, and advancements in cognitive research.
背景:移动认知测试越来越受欢迎,与传统认知测试相比具有许多优势; 然而,该领域缺乏深入研究一般成年人群体中移动认知测试数据的研究。
目的:本研究对来自 NeuroUX 平台的 8 种移动认知测试套件在整个成年期的美国成年人样本中的表现进行了描述。
方法:共有 393 名参与者在智能手机上每天完成 8 次 NeuroUX 认知测试和一次简短的生态瞬间评估调查,持续 10 天; 每个测试在测试期间进行 5 次。测试涉及执行功能、处理速度、反应时间、识别记忆和工作记忆领域。参与者还完成了一项学习后可用性反馈调查。我们检查了替代形式的重测信度; 练习效应; 以及分数(平均值和个体内变异性)与人口统计学以及测试环境(即智能手机类型、在家或不在家以及独自一人或不独自一人)之间的关联。
结果:我们的最终样本由 393 名讲英语的美国居民(年龄 20-79 岁; 女性:n=198,50.4%)组成。在 367 名提供有关其种族和民族信息的参与者中,258 名(70.3%)是白人。在 393 名参与者中,181 名(46.1%)是 iOS 用户,212 名(53.9%)是 Android 用户。在 8 项测试中得出的 12 项测试分数中,有 9 项(75%)表现出良好至优秀的重测信度(组内相关系数>0.76)。观察到 4 项(33%)测试分数有练习效应(即表现提高)。大多数测试分数(9/12,75%)显示年龄较大与表现较差有关,几乎所有反应时间分数(3/4,75%)的个体内变异性较大。与智能手机类型的关系表明,与较旧软件版本相比,iOS 用户和具有较新 Android 软件版本的用户表现更好。在家(与不在家相比)与处理速度测试的表现更好相关。独自一人(与不独自一人相比)与识别和工作记忆测试的表现更好相关。学习后反馈表明,参与者发现 NeuroUX 易于学习和使用,是一种愉快的体验,并且是一款有助于了解他们思维技能的应用程序。只有 4.2%(16/379)表示对隐私问题的关注,77.3%(293/379)表示他们愿意与他们的医疗保健提供者分享他们的结果。年龄较大(而不是其他人口统计学特征)与发现测试更具挑战性有关。
结论:在一个年龄范围广泛的成年人样本中,本研究描述了对于解释远程、重复的移动认知测试性能特别重要的特征,包括重测信度、练习效应、智能手机类型和测试环境。这些数据增强了对移动认知测试的理解和应用,为改善临床决策、个性化干预和认知研究的进步铺平了道路。
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