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. 2024 Mar 21:7:e48265.
doi: 10.2196/48265.

Performance Differences of a Touch-Based Serial Reaction Time Task in Healthy Older Participants and Older Participants With Cognitive Impairment on a Tablet: Experimental Study

Christian Mychajliw #  1   2 , Heiko Holz #  2   3   4 , Nathalie Minuth  1   2 , Kristina Dawidowsky  1   2 , Gerhard Wilhelm Eschweiler  1 , Florian Gerhard Metzger  1   5 , Franz Wortha  2   4   6
Affiliations

Performance Differences of a Touch-Based Serial Reaction Time Task in Healthy Older Participants and Older Participants With Cognitive Impairment on a Tablet: Experimental Study

Christian Mychajliw et al. JMIR Aging. .

Abstract

Background: Digital neuropsychological tools for diagnosing neurodegenerative diseases in the older population are becoming more relevant and widely adopted because of their diagnostic capabilities. In this context, explicit memory is mainly examined. The assessment of implicit memory occurs to a lesser extent. A common measure for this assessment is the serial reaction time task (SRTT).

Objective: This study aims to develop and empirically test a digital tablet-based SRTT in older participants with cognitive impairment (CoI) and healthy control (HC) participants. On the basis of the parameters of response accuracy, reaction time, and learning curve, we measure implicit learning and compare the HC and CoI groups.

Methods: A total of 45 individuals (n=27, 60% HCs and n=18, 40% participants with CoI-diagnosed by an interdisciplinary team) completed a tablet-based SRTT. They were presented with 4 blocks of stimuli in sequence and a fifth block that consisted of stimuli appearing in random order. Statistical and machine learning modeling approaches were used to investigate how healthy individuals and individuals with CoI differed in their task performance and implicit learning.

Results: Linear mixed-effects models showed that individuals with CoI had significantly higher error rates (b=-3.64, SE 0.86; z=-4.25; P<.001); higher reaction times (F1,41=22.32; P<.001); and lower implicit learning, measured via the response increase between sequence blocks and the random block (β=-0.34; SE 0.12; t=-2.81; P=.007). Furthermore, machine learning models based on these findings were able to reliably and accurately predict whether an individual was in the HC or CoI group, with an average prediction accuracy of 77.13% (95% CI 74.67%-81.33%).

Conclusions: Our results showed that the HC and CoI groups differed substantially in their performance in the SRTT. This highlights the promising potential of implicit learning paradigms in the detection of CoI. The short testing paradigm based on these results is easy to use in clinical practice.

Keywords: Alzheimer; MCI; SRTT; aging; cognitive impairment; dementia; implicit learning; mild cognitive impairment; mobile digital assessments; neurodegeneration; neuropsychology; older individuals; serial reaction time task; tablet-based testing.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Illustration of the serial reaction task paradigm used in this study and the expected reaction times for healthy participants. (A) Touch-based variant used in the study. The participants’ task was to respond with their finger to the target stimulus in the form of a ship’s wheel on the tablet. (B) Expected reaction times for healthy participants. After the sequence is repeated in the first 4 blocks, leading to a decrease in participants’ reaction time, a random sequence occurs in block 5, resulting in a significant increase in participants’ reaction time.
Figure 2
Figure 2
View of the setup and task in the app used for the study. Participants were allowed to rest their hands on the table.
Figure 3
Figure 3
Circular order of the serial reaction time task.
Figure 4
Figure 4
The compass design of the serial reaction time task developed to meet the needs of older participants.
Figure 5
Figure 5
Average response accuracy by group and block. Bars represent the SE of the mean. CoI: participants with cognitive impairment; HC: healthy controls.
Figure 6
Figure 6
Descriptive statistics of the average reaction times per group and block. Bars represent the SE of the mean. (A) untransformed reaction times and (B) z-transformed reaction times. CoI: participants with cognitive impairment; HC: healthy controls.
Figure 7
Figure 7
Receiver operating characteristic (ROC) curve for the prediction of cognitive impairment.
See this image and copyright information in PMC

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