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. 2021 Sep 30;13(1):e12243.
doi: 10.1002/dad2.12243. eCollection 2021.

Unsupervised mobile cognitive testing for use in preclinical Alzheimer's disease

Kathryn V Papp  1   2 , Aubryn Samaroo  2 , Hsiang-Chin Chou  2 , Rachel Buckley  1   2   3 , Olivia R Schneider  2 , Stephanie Hsieh  2 , Daniel Soberanes  1 , Yakeel Quiroz  2 , Michael Properzi  2 , Aaron Schultz  2 , Iván García-Magariño  4   5 , Gad A Marshall  1   2 , Jane G Burke  2 , Raya Kumar  2 , Noah Snyder  2 , Keith Johnson  2   6 , Dorene M Rentz  1   2 , Reisa A Sperling  1   2 , Rebecca E Amariglio  1   2
Affiliations

Unsupervised mobile cognitive testing for use in preclinical Alzheimer's disease

Kathryn V Papp et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Unsupervised digital cognitive testing is an appealing means to capture subtle cognitive decline in preclinical Alzheimer's disease (AD). Here, we describe development, feasibility, and validity of the Boston Remote Assessment for Neurocognitive Health (BRANCH) against in-person cognitive testing and amyloid/tau burden.

Methods: BRANCH is web-based, self-guided, and assesses memory processes vulnerable in AD. Clinically normal participants (n = 234; aged 50-89) completed BRANCH; a subset underwent in-person cognitive testing and positron emission tomography imaging. Mean accuracy across BRANCH tests (Categories, Face-Name-Occupation, Groceries, Signs) was calculated.

Results: BRANCH was feasible to complete on participants' own devices (primarily smartphones). Technical difficulties and invalid/unusable data were infrequent. BRANCH psychometric properties were sound, including good retest reliability. BRANCH was correlated with in-person cognitive testing (r = 0.617, P < .001). Lower BRANCH score was associated with greater amyloid (r = -0.205, P = .007) and entorhinal tau (r = -0.178, P = .026).

Discussion: BRANCH reliably captures meaningful cognitive information remotely, suggesting promise as a digital cognitive marker sensitive early in the AD trajectory.

Keywords: digital biomarkers; mobile testing; preclinical Alzheimer's disease; unsupervised assessment.

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Conflict of interest statement

A. Samaroo, H.C. Chou, O.R. Schneider, D. Soberanes, M. Properzi, J. Burke, R. Kumar, S. Hsieh, N. Snyder, A. Schultz, Iván García‐Magariño, R. Buckley, Y. Quiroz, and R. Amariglio report no disclosures relevant to this manuscript. K. Papp has served as a paid consultant for Biogen and Digital Cognition Technologies. G. Marshall has served as a paid consultant for Grifols Shared Services North America, Inc. and Eisai Inc. He has received honoraria/payments from Miller Medical, South Shore Hospital, and Metrowest Medical Center. D. Rentz has served as a paid consultant for Biogen, Digital Cognition Technologies, Eli Lilly, and Janssen. R. Sperling has received honoraria from Shionogi, Genentech, Oligomerix, Inc., Cytox, Prothena, Acumen, JOMDD, Renew, Alnylam Pharmaceuticals, Neuraly, Janssen, Neurocentria, AC Immune, Biogen, Eisai, Roche, and Takeda Pharmaceuticals. K. Johnson has received consulting fees from Novartis and Cerveau.

Figures

FIGURE 1
FIGURE 1
Schematic of Boston Remote Assessment for Neurocognitive Health (BRANCH) tasks.
FIGURE 2
FIGURE 2
Boston Remote Assessment for Neurocognitive Health (BRANCH) Test‐Retest Reliability. Note: The graph shows the correlation (r = 0.81, P < .001) between BRANCH composite performance at first (Test) and second (Retest) administration among 31 registry participants indicating good retest reliability
FIGURE 3
FIGURE 3
Associations between Boston Remote Assessment for Neurocognitive Health (BRANCH) composite performance and age, positron emission tomography amyloid and tau, and Preclinical Alzheimer Cognitive Composite (PACC‐5) score. For age sample, n = 234; for PACC‐5 sample, n = 160; for Pittsburgh Compound B (PiB) sample, n = 144; for flortaucipir (FTP) sample, n = 129; r values for PiB and FTP are controlled for age
See this image and copyright information in PMC

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