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Unsupervised, frequent and remote: A novel platform for personalised digital phenotyping of long-term memory in humans.

Published version
Peer-reviewed

Repository DOI


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Authors

Bauza, Marius 

Abstract

Long-term memory tests are commonly used to facilitate the diagnosis of hippocampal-related neurological disorders such as Alzheimer's disease due to their relatively high specificity and sensitivity to damage to the medial temporal lobes compared to standard commonly used clinical tests. Pathological changes in Alzheimer's disease start years before the formal diagnosis is made, partially due to testing too late. This proof-of-concept exploratory study aimed to assess the feasibility of introducing an unsupervised digital platform for continuous testing of long-term memory over long periods outside the laboratory environment. To address this challenge, we developed a novel digital platform, hAge ('healthy Age'), which integrates double spatial alternation, image recognition and visuospatial tasks for frequent remote unsupervised assessment of spatial and non-spatial long-term memory carried out continuously over eight week period. To demonstrate the feasibility of our approach, we tested whether we could achieve sufficient levels of adherence and whether the performance on hAge tasks is comparable to the performance observed in the analogous standard tests measured in the controlled laboratory environments.191 healthy adults (67% females, 18-81 years old) participated in the study. We report an estimated 42.4% adherence level with minimal inclusion criteria. In line with findings using standard laboratory tests, we showed that performance on the spatial alternation task negatively correlated with inter-trial periods and the performance levels on image recognition and visuospatial tasks could be controlled by varying image similarity. Importantly, we demonstrated that frequent engagement with the double spatial alternation task leads to a strong practice effect, previously identified as a potential measure of cognitive decline in MCI patients. Finally, we discuss how lifestyle and motivation confounds may present a serious challenge for cognitive assessment in real-world uncontrolled environments.

Description

Acknowledgements: We thank all the Participants for their participation in this study. We also thank Profs. Rik Henson, Dennis Chan and John O’Keefe for their comments on the early version of the manuscript. We thank the anonymous reviewers for their many insightful comments and suggestions.


Funder: BBSRC DTP at University of Cambridge


Funder: Wellcome Trust/Royal Society Sir Henry Dale Fellow


Funder: Isaac Newton Trust/Wellcome Trust ISSF/University of Cambridge Joint Research Grant


Funder: NVIDIA Corporation

Keywords

32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, 42 Health Sciences, Aging, Brain Disorders, Neurosciences, Alzheimer's Disease, Neurodegenerative, Dementia, Acquired Cognitive Impairment, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Clinical Research, Neurological

Journal Title

PLoS One

Conference Name

Journal ISSN

1932-6203
1932-6203

Volume Title

Publisher

Public Library of Science (PLoS)
Sponsorship
Wellcome Trust (100154/Z/12/A)
Dementia Research Institute (DRICAMKRUPIC18/19)
Kavli Foundation Dream Team (RG93383)
Isaac Newton Trust (17.37(t))