Technology-natives and technology-adopters: Age differences in remote cognitive assessment in Alzheimer disease.

INTRODUCTION

Cognitive changes in the asymptomatic stages of Alzheimer disease (AD) are subtle and difficult to detect using conventional cognitive tests. High-frequency smartphone-based testing may improve sensitivity to these changes, but generational differences in technology use could influence performance. We examined generational differences in cognition using remote, high-frequency smartphone assessments.

METHODS

Older adults (N = 444) from the Knight Alzheimer Disease Research Center and young and middle-aged adults (N = 113) from the Dominantly Inherited Alzheimer Network (DIAN) completed an in-clinic cognitive battery and brief smartphone tests up to four times daily for 7 days. We compared adherence, reliability, practice effects, and correlations with in-clinic measures.

RESULTS

Older adults showed higher adherence than younger participants (78% vs 59%). Younger adults achieved higher reliability with fewer sessions and exhibited much smaller practice effects. Smartphone to in-clinic test correlations were strong in both young-to-middle-aged and older adults.

DISCUSSION: Generational differences have important implications for the design and implementation of smartphone-based cognitive studies.