Nester Caroline O, García de la Garza Ángel, Mogle Jacqueline A, Wang Cuiling, Katz Mindy J, Ayers Emmeline, Lipton Richard B, Verghese Joe, Rabin Laura A
Department of Psychology, The Graduate Center City University of New York New York New York USA.
Department of Psychology, Queens College City University of New York New York New York USA.
Health Sci Rep. 2025 Jul 2;8(7):e70744. doi: 10.1002/hsr2.70744. eCollection 2025 Jul.
Motoric cognitive risk syndrome (MCR), a predementia condition that combines slow gait speed and subjective cognitive concerns (SCC), has broad diagnostic accessibility in resource poor settings as it is inexpensive and simple to diagnose. The ability to diagnose MCR remotely via smartphone would further increase the convenience and applicability of this syndrome. In this pilot study, we investigated the feasibility of implementing daily dairy reported SCC via smartphone in diverse individuals with MCR. Study aims included: (1) examine smartphone SCC to detect clinical status in MCR, (2) investigate the association of smartphone SCC with traditional in-clinic SCC measures; and (3) compare the relative ability of smartphone and in-clinic SCC to detect clinical status in MCR.
Einstein Aging Study participants ( = 247, M = 77.49 ± 4.82, %female = 66, M = 15.18 ± 3.65, %non-Hispanic white = 47, %non-Hispanic black = 39) completed the daily memory lapses checklist via smartphone (14-day daily dairy assessment of in vivo experiences of SCC) and a traditional in-person assessment of SCC (the cognitive change index) at annual study visits. Gait assessment and MCR diagnosis were assigned at baseline in-person assessment (MCR, = 36). Clinical status was determined through clinical dementia rating scale sum of boxes. Linear mixed-effects models tested the association between smartphone based and in-person SCC measures with clinical status, controlling for covariates.
Smartphone and in-person SCC measures were highly correlated. We found significant associations between SCC and clinical status for both smartphone and in-person SCC measures in MCR. Linear mixed-effects models revealed similar associations between smartphone-based and in-person SCC with clinical status.
Results represent a step toward viability of remote, smartphone-based assessment of SCC in MCR. Findings illustrate the merit of future research exploring a fully remote MCR diagnosis, with implications for dissemination of MCR in underserved, remote settings and more equitable access to early dementia detection in diverse populations.
运动认知风险综合征（MCR）是一种痴呆前状态，它结合了步态速度缓慢和主观认知问题（SCC），由于其诊断成本低廉且操作简单，在资源匮乏的环境中具有广泛的诊断可及性。通过智能手机远程诊断MCR将进一步提高该综合征的便利性和适用性。在这项试点研究中，我们调查了通过智能手机让患有MCR的不同个体每日报告SCC的可行性。研究目的包括：（1）检查智能手机SCC以检测MCR中的临床状态；（2）调查智能手机SCC与传统门诊SCC测量方法之间的关联；（3）比较智能手机SCC和门诊SCC检测MCR临床状态的相对能力。
爱因斯坦衰老研究的参与者（n = 247，平均年龄M = 77.49 ± 4.82岁，女性占66%，平均教育年限M = 15.18 ± 3.65年，非西班牙裔白人占47%，非西班牙裔黑人占39%）通过智能手机完成每日记忆失误清单（对SCC的体内体验进行为期14天的每日记录评估），并在年度研究访视时进行传统的面对面SCC评估（认知变化指数）。在基线面对面评估时进行步态评估和MCR诊断（MCR患者，n = 36）。通过临床痴呆评定量表框分总和确定临床状态。线性混合效应模型测试了基于智能手机和面对面的SCC测量方法与临床状态之间的关联，并对协变量进行了控制。
智能手机和面对面的SCC测量方法高度相关。我们发现，在MCR中，智能手机和面对面的SCC测量方法的SCC与临床状态之间均存在显著关联。线性混合效应模型显示，基于智能手机和面对面的SCC与临床状态之间的关联相似。
研究结果朝着在MCR中通过智能手机进行远程SCC评估的可行性迈出了一步。研究结果说明了未来探索完全远程MCR诊断的研究价值，这对于在服务不足的偏远地区传播MCR以及不同人群更公平地获得早期痴呆检测具有重要意义。
