Smartphone- and tablet-based memory tests can detect subtle cognitive decline more quickly than conventional testing, according to a recent study conducted by the German Center for Neurodegenerative Diseases (DZNE) in collaboration with university hospitals in Germany, the University of Wisconsin–Madison, and the German startup neotiv. The authors suggest that digital assessment could support individual patient monitoring and clinical trials for new drugs.

The study included 202 participants (about half, women) with an average age of 70 at the start of the study. Fifty participants had mild cognitive impairment (MCI), and the rest were not cognitively impaired. Participants self-administered at-home memory tests via the neotivTrials app over seven to twelve months, testing themselves about every two weeks.

The researchers found significant changes between the individuals with MCI and those who were not cognitively impaired. For example, those with MCI showed significantly greater decline than the cognitively unimpaired group on the latent Preclinical Alzheimer’s Cognitive Composite over eight years. That group also showed significantly greater decline in familiarity-dependent memory and memory precision for objects.

"Conventional methods for assessing cognitive performance are based on standardized tasks that must be completed orally or in writing—and importantly, under supervision," explained lead author David Berron, PhD, of DZNE and cofounder of neotiv. Using the smartphone app instead enabled the researchers to collect digital biomarkers, an approach that can provide information about how cognitive performance changes over time.

Short-term changes on the remote assessments reflected long-term changes on in-person neuropsychological tests, the authors said. "What I found particularly impressive was that, with just a few months of app use, we were able to capture a signal that aligns with years of clinical observations," said lead author Sarah Polk, PhD.  "Testing can be done at home, at your own pace. All you need is a smartphone or tablet. There's no need to visit a study center or make an appointment."

To download the study, published in npj Digital Medicine, click here