Background
Decline in episodic memory is a strong marker of neurodegenerative diseases, making it an important target for cognitive assessment. We present a new remote, repeatable, and brief ...assessment of episodic memory and visual short‐term memory (VSTM) for smart phone deployment. We evaluated this task for sensitivity to age and established cognitive measures of memory and attention.
Method
The task consists of a learning phase where participants see a sequence of items, then are asked to replicate the item order and location by dragging and dropping these items on‐screen. A recall phase follows a minimum 12‐hour delay, with replication of the earlier response. Each session takes less than 2 minutes. The first phase supplies metrics of spatial and order precision VSTM, with the second phase characterising long‐term episodic memory.
Experiment 1 (n = 133) compares the task with CANTAB assessments of visuospatial memory. In Experiment 2 (n = 80) the novel task was repeated twice daily for a week, alongside momentary mood ratings, and a more comprehensive battery of CANTAB tasks at baseline.
In Experiment 1, multiple regression and dominance analyses explore the independent and shared variance of measures in explaining age. In Experiment 2, clustering and multivariate autoregressive models outline differences in timeseries relationships between mood and memory, and age.
Result
Experiment 1 revealed that CANTAB measures and novel spatial and order metrics were correlated with age (r = .20 to r = .37, adjusted P = <.05). Multiple regression showed models with CANTAB Paired Associate Learning (PAL) score, and delayed novel spatial metrics were significantly predictive of age (t = ‐4.08, 3.17, p <.005). The dominance analysis revealed novel immediate precision overlapped with existing measures in predicting Age, while delayed precision had more unique variance (4.6% vs 0.62% unique sample variance explained in Age, accounting for PAL).
Experiment 2 characterised variance in individual learning curves over time and differing autoregressive processes associated with age and CANTAB measures.
Conclusion
We present a brief novel episodic memory task that can be deployed remotely, with delayed spatial precision significantly predictive of healthy Ageing. Additionally, we show this test’s suitability as a repeated assessment, compatible with high‐frequency study designs in older populations.
Background
Delivering episodic memory tests on a mobile device can support increased accessibility across diverse health settings. This is particularly important for increasing access to memory ...screening tools for participants at risk of memory impairment including Alzheimer’s and dementia.
CANTAB PAL task is a short (8‐12 minutes) task of memory performance that is currently validated for delivery on a tablet, laptop or desktop device. Cambridge Cognition developed a prototype version of PAL that can be delivered on a smartphone (iPhone or Android). A key component of making the task available on smartphone is to understand the comparability to the original version of the task. For tasks delivered direct to patient, usability becomes even more important. This study was designed to evaluate the comparability and usability of PAL on smartphone device.
Method
Participants (N = 98, mean age 55 ± 5.59 years, gender balanced (50% (49)) were recruited through the Prolific platform to remotely complete both smartphone and desktop versions of CANTAB PAL on two consecutive days followed by a usability questionnaire. A cross‐over design was used with 50:50 participants smartphone first: desktop first to counterbalance for exposure to the task. Participants used their own devices for assessment and the device operating system was captured.
Result
Most participants used Android smartphones (74.1% (69)) and Windows desktops (90% (81)). Smartphone and desktop versions of PAL were shown to be highly correlated (r = 0.61, p < 0.05). Average performance was better on the desktop device; an upwards bias estimated as 3.52 (±1.96 SD 27 to ‐20) adjusted errors. The usability questionnaire found that 76.6% (59) participants strongly agreed they found the instructions clear and easy to follow and 42.9% (33) strongly agreed that they could see the symbols easily on their mobile phone. Most participants preferred using PAL on a desktop device in terms of ease of use (70.1% (54)) and enjoyment 66.2% (51).
Conclusion
We have shown good correlation between iPhone and computer versions of the test, but with some important caveats. The usability data collected here will inform improvements to ensure suitability of PAL on a smartphone device for near patient assessments.
Cognitive symptoms are common in major depressive disorder and may help to identify patients who need treatment or who are not experiencing adequate treatment response. Digital tools providing ...real-time data assessing cognitive function could help support patient treatment and remediation of cognitive and mood symptoms.
The aim of this study was to examine feasibility and validity of a wearable high-frequency cognitive and mood assessment app over 6 weeks, corresponding to when antidepressant pharmacotherapy begins to show efficacy.
A total of 30 patients (aged 19-63 years; 19 women) with mild-to-moderate depression participated in the study. The new Cognition Kit app was delivered via the Apple Watch, providing a high-resolution touch screen display for task presentation and logging responses. Cognition was assessed by the n-back task up to 3 times daily and depressed mood by 3 short questions once daily. Adherence was defined as participants completing at least 1 assessment daily. Selected tests sensitive to depression from the Cambridge Neuropsychological Test Automated Battery and validated questionnaires of depression symptom severity were administered on 3 occasions (weeks 1, 3, and 6). Exploratory analyses examined the relationship between mood and cognitive measures acquired in low- and high-frequency assessment.
Adherence was excellent for mood and cognitive assessments (95% and 96%, respectively), did not deteriorate over time, and was not influenced by depression symptom severity or cognitive function at study onset. Analyses examining the relationship between high-frequency cognitive and mood assessment and validated measures showed good correspondence. Daily mood assessments correlated moderately with validated depression questionnaires (r=0.45-0.69 for total daily mood score), and daily cognitive assessments correlated moderately with validated cognitive tests sensitive to depression (r=0.37-0.50 for mean n-back).
This study supports the feasibility and validity of high-frequency assessment of cognition and mood using wearable devices over an extended period in patients with major depressive disorder.
Background
Decline in episodic memory is a strong marker of neurodegenerative diseases, making it an important target for cognitive assessment. We present a new remote, repeatable, and brief ...assessment of episodic memory and visual short‐term memory (VSTM) for smart phone deployment. We evaluated this task for sensitivity to age and established cognitive measures of memory and attention.
Method
The task consists of a learning phase where participants see a sequence of items, then are asked to replicate the item order and location by dragging and dropping these items on‐screen. A recall phase follows a minimum 12‐hour delay, with replication of the earlier response. Each session takes less than 2 minutes. The first phase supplies metrics of spatial and order precision VSTM, with the second phase characterising long‐term episodic memory.
Experiment 1 (n=133) compares the task with CANTAB assessments of visuospatial memory. In Experiment 2 (n=80) the novel task was repeated twice daily for a week, alongside momentary mood ratings, and a more comprehensive battery of CANTAB tasks at baseline.
In Experiment 1, multiple regression and dominance analyses explore the independent and shared variance of measures in explaining age. In Experiment 2, clustering and multivariate autoregressive models outline differences in timeseries relationships between mood and memory, and age.
Result
Experiment 1 revealed that CANTAB measures and novel spatial and order metrics were correlated with age (r=.20 to r=.37, adjusted P= <.05). Multiple regression showed models with CANTAB Paired Associate Learning (PAL) score, and delayed novel spatial metrics were significantly predictive of age (t= ‐4.08, 3.17, p <.005). The dominance analysis revealed novel immediate precision overlapped with existing measures in predicting Age, while delayed precision had more unique variance (4.6% vs 0.62% unique sample variance explained in Age, accounting for PAL).
Experiment 2 characterised variance in individual learning curves over time and differing autoregressive processes associated with age and CANTAB measures.
Conclusion
We present a brief novel episodic memory task that can be deployed remotely, with delayed spatial precision significantly predictive of healthy Ageing. Additionally, we show this test’s suitability as a repeated assessment, compatible with high‐frequency study designs in older populations.
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