Remote and unsupervised monitoring of episodic memory decline in patients with prodromal Alzheimer's disease
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background Traditional pen‐and‐paper neuropsychological assessments are not sensitive to subtle cognitive changes in the earliest stages of Alzheimer's disease (AD), limiting their use for monitoring of cognitive performance over shorter timeframes. Here, we show that frequently administered remote and unsupervised digital cognitive assessments are better suited to capture short‐term cognitive decline in early AD. Method We investigated episodic memory trajectories using self‐administered remote digital testing in 202 participants (52–85 years) who completed unsupervised tests for at least 30 weeks. Linear mixed modeling was used to investigate main effects of cognitive status, n = 152 cognitively unimpaired (CU), n = 50 with mild cognitive impairment (MCI), and interaction effects of cognitive status by time spent in the study. Analyses were repeated, stratifying the MCI group by amyloid‐β (Aβ) burden ( n Aβ− = 21, n Aβ+ = 24). Baseline and change‐change associations with in‐person neuropsychological assessments were also examined using Pearson correlations. Result At baseline, MCI performed worse than CU on an associative memory task (Object‐in‐Room Recall, ORR), memory precision tasks for objects and scenes (Mnemonic Discrimination Task for Objects and Scenes, MDT‐OS), and a familiarity‐based memory task (Complex Scene Recognition, CSR). A short‐term decline in the familiarity‐dependent task was observed in all patients with an MCI diagnosis, while both the familiarity‐dependent memory task and memory precision for objects task were sensitive to decline in the MCI Aβ+ group specifically. Change in the remotely assessed familiarity‐dependent memory was correlated with multi‐year change on annual in‐person neuropsychological assessments. Finally, in‐person tests were not sensitive to short‐term cognitive changes in MCI. Conclusion Altogether, these findings show that frequent remote cognitive testing is a promising tool to feasibly capture subtle and short‐term cognitive decline.
Source: Alzheimer s & Dementia
Authors: Sarah E. Polk, Lindsay R Clark, Kristin E Basche, Luca Kleineidam, Wenzel Glanz, Michaela Butryn, Robert Perneczky, Katharina Buerger, Klaus Fliessbach, Christoph Laske, Annika Spottke, Anja Schneider, Jens Wiltfang, Stefan J. Teipel, Michael Wagner, Sterling C Johnson, Frank Jessen, Emrah Düzel, David Berron
Institutions: German Center for Neurodegenerative Diseases, University of Wisconsin–Madison, William S. Middleton Memorial Veterans Hospital, University of Bonn, University Hospital Bonn, Munich Cluster for Systems Neurology, Imperial College London, Ludwig-Maximilians-Universität München, Institut für Schlaganfall- und Demenzforschung, Hertie Institute for Clinical Brain Research, University of Tübingen, Universitätsmedizin Göttingen, University of Aveiro, University of Göttingen, Universitätsmedizin Rostock, University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, Otto-von-Guericke-Universität Magdeburg, Lund University, Center for Behavioral Brain Sciences
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,200
OpenAlex ID: W7117310287
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