WOW, you think that the elderly who are most at risk of dementia are actually using cellphones? Hell, my 95-year-old mom couldn't navigate a cellphone unless someone walked her through every step.
Risk for Dementia Is Inferable Using Smartphone Data
A novel smartphone-assisted wayfinding task may help identify older adults with subjective cognitive decline who are at higher risk for dementia, according to study findings published in PLOS Digital Health.
Researchers conducted a cross-sectional study to determine whether real-world navigation patterns captured by smartphones could serve as indicators of early cognitive changes associated with dementia. Community-dwelling adults with normal or corrected vision, smartphone access, no major mobility impairments, and no history of diseases or medication use that could affect task performance were included. The 3 patient groups included participants with subjective cognitive decline who had normal scores on standard neuropsychologic assessments, cognitively healthy older adults, and cognitively healthy younger adults. Participants completed a series of wayfinding tasks on the medical campus area of the Magdeburg campus in Germany, guided by the “Explore” mobile app. Five key performance metrics (wayfinding distance and duration, movement speed, map views, and orientation stops) were measured via smartphone global positioning system (GPS) and sensor data. Between-group differences were then analyzed using linear and generalized mixed effect models.
A total of 72 participants were included in the study, of whom 24 were younger adults, 25 were cognitively healthy older adults, and 23 were patients with subjective cognitive decline.
Differences in GPS trajectories were not predictive of patient groups.
When based on aggregated performance measures, group separation was considerably improved. Most (n=18) high-level performers were younger adults, while most of the healthy older adults (n=14) and patients with subjective cognitive decline (n=10) were characterized by a mid-level performance pattern.
The number of orientation stops differed between healthy older adults and patients with subjective cognitive decline. Compared with older participants, younger participants covered less distance, needed less time, had higher movement speeds, used the help function less frequently, and had fewer orientation stops. Patients with subjective cognitive decline vs healthy older adults had higher numbers of orientation stops (P =.007), looked at the map more often while walking (P =.059), and needed more time to complete the task (P =.088). Average movement speed did not differ between the 2 older groups (P =.371). Compared with healthy older adults, patients with subjective cognitive decline also did not cover more distance (P =.208).
Subjective cognitive decline status in older adults was predicted by the number of orientation stops, such that a higher number of orientation stops was associated with significantly greater odds of being a patient with subjective cognitive decline vs a healthy older adult (odds ratio[OR], 2.70; 95% CI, 1.47-5.86; P =.004).
A potential link between the number of orientation stops and executive functioning and environmental features in patients with subjective cognitive decline was also found.
Study limitations included the cross-sectional design and limited generalizability of results to those who are unfamiliar with smartphone navigation.
“The results of our study are a starting point for determining how smartphone data, acquired during wayfinding in the real world, can be used for the assessment of cognitive impairment in the context of dementia,” the study authors concluded.
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