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Smartphone-Based Neuropsychological Assessment in Parkinson’s Disease: Feasibility, Validity, and Contextually Driven Variability in Cognition

Published online by Cambridge University Press:  17 May 2021

Emma L. Weizenbaum Open the ORCID record for Emma L. Weizenbaum [Opens in a new window] ,
Daniel Fulford ,
John Torous ,
Emma Pinsky ,
Vijaya B. Kolachalama  and
Alice Cronin-Golomb
Emma L. Weizenbaum
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
Daniel Fulford
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA Department of Occupational Therapy and Rehabilitation Sciences, Boston University, Boston, MA, USA
John Torous
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Emma Pinsky
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA Department of Psychology, Bryn Mawr College, Bryn Mawr, PA, USA
Vijaya B. Kolachalama
Affiliation:
Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA Department of Computer Science, and Faculty of Computing and Data Sciences, Boston University Alzheimer’s Disease Center; Boston University, Boston, MA, USA
Alice Cronin-Golomb*
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
*
*Correspondence and reprint requests to: Alice Cronin-Golomb, Ph.D., Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2nd floor, Boston, MA 02215, USA. E-mail: alicecg@bu.edu
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Abstract

Objectives:

The prevalence of neurodegenerative disorders demands methods of accessible assessment that reliably captures cognition in daily life contexts. We investigated the feasibility of smartphone cognitive assessment in people with Parkinson’s disease (PD), who may have cognitive impairment in addition to motor-related problems that limit attending in-person clinics. We examined how daily-life factors predicted smartphone cognitive performance and examined the convergent validity of smartphone assessment with traditional neuropsychological tests.

Methods:

Twenty-seven nondemented individuals with mild–moderate PD attended one in-lab session and responded to smartphone notifications over 10 days. The smartphone app queried participants 5x/day about their location, mood, alertness, exercise, and medication state and administered mobile games of working memory and executive function.

Results:

Response rate to prompts was high, demonstrating feasibility of the approach. Between-subject reliability was high on both cognitive games. Within-subject variability was higher for working memory than executive function. Strong convergent validity was seen between traditional tests and smartphone working memory but not executive function, reflecting the latter’s ceiling effects. Participants performed better on mobile working memory tasks when at home and after recent exercise. Less self-reported daytime sleepiness and lower PD symptom burden predicted a stronger association between later time of day and higher smartphone test performance.

Conclusions:

These findings support feasibility and validity of repeat smartphone assessments of cognition and provide preliminary evidence of the effects of context on cognitive variability in PD. Further development of this accessible assessment method could increase sensitivity and specificity regarding daily cognitive dysfunction for PD and other clinical populations.

Keywords

Parkinson’s diseaseCognitionSmartphoneMobile phoneEcological sampling methodPrecision medicine
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 28 , Issue 4 , April 2022 , pp. 401 - 413
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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