Time of day cognitive performance differences in remote, self‐administered assessments and its association with cerebral amyloidosis
Year: 2023
Type: article
Study design: Observational Study
Abstract: Background Time of day (TOD) is known to potentially influence cognition in healthy older adults. Smartphone‐based ‘burst’ testing approaches are increasingly used in AD clinical research to assess cognition across multiple timepoints. This repeated assessment approach can therefore potentially help us understand how TOD may affect different domains of cognitive functioning in normal aging and AD. This study examined the effect of TOD, and its potential interactions with cerebral amyloidosis (Aß), on remote, smartphone‐based cognitive assessment performance. Method We recruited 73 cognitively normal adults with elevated (Aß+, n = 25) and non‐elevated (Aß‐, n = 48) Aß positron emission tomography (PET) status from the Butler Hospital Alzheimer’s Prevention Registry (mean age = 69.29, education = 16.45, 71.2% female, 89.0% White). Participants completed brief cognitive testing sessions 3x per day for 8 days using a mobile app. We used ANOVA to examine potential differences in performance on multiple cognitive tasks by TOD (see Table 1), and linear mixed models (adjusted for age, education, and session number) to determine how TOD, Aß status, and their interaction may predict episodic memory (EM) and processing speed (PS) performance. Result There were main effects of both Aß status and TOD on EM, with worse performance in the Aß+ group in the afternoon (p < .10 level; Est. = ‐0.05, SE = .02, p = .07), and in the evening (Est = ‐0.02, SE = .01, p = .02) relative to morning. A main effect of TOD on PS was also observed (Est. = ‐92.72, SE = 22.10, p < .001). Additionally, we found an interaction between Aß status and afternoon TOD on PS (Est. = 131.05, SE = 37.76, p < .001). Conclusion These findings suggest older adults may perform worse on episodic memory tasks in the evening, regardless of Aß status. Effect of TOD on PS varied by Aß status, with Aß+ individuals performing worse in the afternoon, and Aß‐ individuals performing better in the afternoon, relative to morning. While further validation is needed, these results suggest time of day is a significant factor in remote cognitive test performance and may be moderated by AD‐related pathology.
Source: Alzheimer s & Dementia
DOI: 10.1002/alz.080096
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4390193541