Design and Feasibility Analysis of a Smartphone-Based Digital Cognitive Assessment Study in the Framingham Heart Study

Abstract

Background: Smartphone-based digital technology is increasingly being recognized as a cost-effective, scalable, and noninvasive method of collecting longitudinal cognitive and behavioral data. Accordingly, a state-of-the-art 3-year longitudinal project focused on collecting multimodal digital data for early detection of cognitive impairment was developed.

Methods and results: A smartphone application collected 2 modalities of cognitive data, digital voice and screen-based behaviors, from the FHS (Framingham Heart Study) multigenerational Generation 2 (Gen 2) and Generation 3 (Gen 3) cohorts. To understand the feasibility of conducting a smartphone-based study, participants completed a series of questions about their smartphone and app use, as well as sensory and environmental factors that they encountered while completing the tasks on the app. Baseline data collected to date were from 537 participants (mean age=66.6 years, SD=7.0; 58.47% female). Across the younger participants from the Gen 3 cohort (n=455; mean age=60.8 years, SD=8.2; 59.12% female) and older participants from the Gen 2 cohort (n=82; mean age=74.2 years, SD=5.8; 54.88% female), an average of 76% participants agreed or strongly agreed that they felt confident about using the app, 77% on average agreed or strongly agreed that they were able to use the app on their own, and 81% on average rated the app as easy to use.

Conclusions: Based on participant ratings, the study findings are promising. At baseline, the majority of participants are able to complete the app-related tasks, follow the instructions, and encounter minimal barriers to completing the tasks independently. These data provide evidence that designing and collecting smartphone application data in an unsupervised, remote, and naturalistic setting in a large, community-based population is feasible.

Keywords: Alzheimer's disease; aging; digital health; feasibility; mobile health.

Figure 1. Participant responses by cohort about their current level of pain in fingers.

Figure 2. Participant responses by cohort about the frequency of their smartphone use.

Figure 3. Participant responses by cohort about the number of hours of smartphone use per week.

Figure 4. Participant responses by cohort about their confidence in smartphone and app use.

Figure 5. Participant responses by cohort about ease of smartphone and app use.

Figure 6. Participant responses by cohort about their ability to use the smart phone and app without support.

Figure 7. Participant responses by cohort about their perception of the schedule of tasks.

Figure 8. Participant responses by cohort about their perception of app‐related task instructions.

Figure 9. Participant responses by cohort about their level of concern regarding their privacy.

Figure 10. Type of environment selected by the participants where the app‐based task was completed.

Figure 11. Reasons selected by participants who reported that their ability to see the screen might have affected their app‐related performance.