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Buhl LF, Lehmann Christensen L, Diederichsen A, Lindholt JS, Kistorp CM, Glintborg D, Andersen M, Frystyk J. Impact of androgenic anabolic steroid use on cardiovascular and mental health in Danish recreational athletes: protocol for a nationwide cross-sectional cohort study as a part of the Fitness Doping in Denmark (FIDO-DK) study. BMJ Open 2024; 14:e078558. [PMID: 38719280 PMCID: PMC11086435 DOI: 10.1136/bmjopen-2023-078558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION The use of androgenic anabolic steroids (AASs) among recreational athletes is steadily increasing. However, knowledge regarding the potentially harmful effects of AAS primarily originates from case reports and small observational studies. This large-scale study aims to investigate the impact of AAS use on vascular plaque formation, preclinical coronary disease, cardiac function, circulating cardiovascular risk markers, quality of life (QoL) and mental health in a broad population of illicit AAS users. METHODS AND ANALYSES A nationwide cross-sectional cohort study including a diverse population of men and women aged ≥18 years, with current or previous illicit AAS use for at least 3 months. Conducted at Odense University Hospital, Denmark, the study comprises two parts. In part A (the pilot study), 120 recreational athletes with an AAS history will be compared with a sex-matched and age-matched control population of 60 recreational athletes with no previous AAS use. Cardiovascular outcomes include examination of non-calcified coronary plaque volume and calcium score using coronary CT angiography, myocardial structure and function via echocardiography, and assessing carotid and femoral artery plaques using ultrasonography. Retinal microvascular status is evaluated through fundus photography. Cardiovascular risk markers are measured in blood. Mental health outcomes include health-related QoL, interpersonal difficulties, body image concerns, aggression dimensions, anxiety symptoms, depressive severity and cognitive function assessed through validated questionnaires. The findings of our comprehensive study will be used to compose a less intensive investigatory cohort study of cardiovascular and mental health (part B) involving a larger group of recreational athletes with a history of illicit AAS use. ETHICS AND DISSEMINATION The study received approval from the Regional Committee on Health Research Ethics for Southern Denmark (S-20210078) and the Danish Data Protection Agency (21/28259). All participants will provide signed informed consent. Research outcomes will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT05178537.
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Affiliation(s)
- Laust Frisenberg Buhl
- Department of Endocrinology, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | | | - Axel Diederichsen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | | | - Caroline Michaela Kistorp
- Department of Hormones and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Kobenhavn, Denmark
| | - Dorte Glintborg
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
| | - Marianne Andersen
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
| | - Jan Frystyk
- Department of Endocrinology, Faculty of Health Sciences University of Southern Denmark, Odense, Denmark
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Rossetti MG, Girelli F, Perlini C, Brambilla P, Bellani M. Neuropsychological instruments for bipolar disorders: A systematic review on psychometric properties. J Affect Disord 2023; 338:358-364. [PMID: 37331381 DOI: 10.1016/j.jad.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Cognitive deficits are a core feature of bipolar disorder (BD) that persist during the euthymic phase and affect global functioning. However, nowadays, there is no consensus on the optimal tool to capture cognitive deficits in BD. Therefore, this review aims to examine the psychometric properties of tools commonly used to assess cognitive functioning in BD. METHODS Literature search was conducted on PubMed and Web of Science databases on August 1, 2022 and on April 20, 2023, yielding 1758 de-duplicated records. Thirteen studies fulfilled the inclusion criteria and were included in the review. RESULTS All tools examined showed acceptable-to-good psychometric properties suggesting that both brief cognitive screeners and comprehensive batteries may be appropriate for detecting or monitoring cognitive changes in BD. LIMITATIONS Methodological differences between the included studies precluded a direct comparison of the results. Further research is needed to investigate the psychometric properties of cognitive tools that assess also affective and social cognition. CONCLUSIONS The tools examined appear sensitive enough to distinguish between BD patients with versus without cognitive deficits, however, an optimal tool has not yet been identified. The applicability and clinical utility of the tools may depend on multiple factors such as available resources. That said, web-based instruments are expected to become the first-choice instrument for cognitive screening as they can be applied on a large scale and at an affordable cost. As for second-level assessment instruments, the BACA shows robust psychometric properties and tests both affective and non-affective cognition.
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Affiliation(s)
- Maria Gloria Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy; Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Girelli
- UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Sirilertmekasakul C, Rattanawong W, Gongvatana A, Srikiatkhachorn A. The current state of artificial intelligence-augmented digitized neurocognitive screening test. Front Hum Neurosci 2023; 17:1133632. [PMID: 37063100 PMCID: PMC10098088 DOI: 10.3389/fnhum.2023.1133632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/20/2023] [Indexed: 04/18/2023] Open
Abstract
The cognitive screening test is a brief cognitive examination that could be easily performed in a clinical setting. However, one of the main drawbacks of this test was that only a paper-based version was available, which restricts the test to be manually administered and graded by medical personnel at the health centers. The main solution to these problems was to develop a potential remote assessment for screening individuals with cognitive impairment. Currently, multiple studies have been adopting artificial intelligence (AI) technology into these tests, evolving the conventional paper-based neurocognitive test into a digitized AI-assisted neurocognitive test. These studies provided credible evidence of the potential of AI-augmented cognitive screening tests to be better and provided the framework for future studies to further improve the implementation of AI technology in the cognitive screening test. The objective of this review article is to discuss different types of AI used in digitized cognitive screening tests and their advantages and disadvantages.
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A critical overview of tools for assessing cognition in bipolar disorder. Epidemiol Psychiatr Sci 2022; 31:e70. [PMID: 36189787 PMCID: PMC9531588 DOI: 10.1017/s2045796022000555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cognitive deficits are prevalent in bipolar disorder even during the euthymic phase, having a negative impact on global functioning and quality of life. As such, more and more mental health professionals agree that neuropsychological assessment should be considered an essential component of the clinical management of bipolar patients. However, no gold standard tool has been established so far. According to bipolar disorder experts targeting cognition, appropriate cognitive tools should be brief, easy to administer, cost-effective and validated in the target population. In this commentary, we critically appraised the strengths and limitations of the tools most commonly used to assess cognitive functioning in bipolar patients, both for screening and diagnostic purposes.
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Leese MI, Mattek N, Bernstein JPK, Dorociak KE, Gothard S, Kaye J, Hughes AM. The survey for memory, attention, and reaction time (SMART): Preliminary normative online panel data and user attitudes for a brief web-based cognitive performance measure. Clin Neuropsychol 2022:1-19. [PMID: 35930438 PMCID: PMC9899293 DOI: 10.1080/13854046.2022.2103033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
ObjectiveThe Survey for Memory, Attention, and Reaction Time (SMART) was recently introduced as a brief (<5 min), self-administered, web-based measure of cognitive performance in older adults. The purpose of this study was threefold: (1) to develop preliminary norms on the SMART; (2) to examine the relationship between demographic variables (i.e. age, sex, education), device type used, and SMART performance; and (3) to assess user attitudes of the SMART. Method A sample of 1,050 community-dwelling adults (M age =59.5 (15.2), M education = 16.5 (2.1), 67.1% female, 96% white) was recruited from an ongoing web-based research cohort. Participants completed the SMART, which consists of four face-valid cognitive tasks assessing visual memory, attention/processing speed, and executive functioning. SMART performance outcome metrics were subtest completion time (CT), click count, and total CT. Participants provided demographic information and completed a survey of user attitudes toward the SMART (i.e. usability, acceptability). Results Older age was the only demographic variable associated with slower SMART total CT (r = .60, p <.001). Education was not associated with SMART CT or click counts overall (p > .05). Male sex was generally associated with longer SMART CT (p < .001, partial eta squared = .14) on all sub-tests. Regarding acceptability, 97.3% indicated willingness to take the SMART again, with more than half willing to complete it on a weekly basis. Conclusion The preliminary normative data on the SMART indicates that it is a feasible and well-accepted web-based cognitive assessment tool that can be administered on multiple device platforms.
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Affiliation(s)
- Mira I. Leese
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Nora Mattek
- Oregon Center for Aging & Technology, Portland, OR, USA,Oregon Health & Science University, Portland, OR, USA
| | | | | | - Sarah Gothard
- Oregon Center for Aging & Technology, Portland, OR, USA,Oregon Health & Science University, Portland, OR, USA
| | - Jeffrey Kaye
- Oregon Center for Aging & Technology, Portland, OR, USA,Oregon Health & Science University, Portland, OR, USA
| | - Adriana M. Hughes
- Oregon Center for Aging & Technology, Portland, OR, USA,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA,Minneapolis VA Health Care System, Minneapolis, MN, USA
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Göttgens I, Oertelt-Prigione S. The Application of Human-Centered Design Approaches in Health Research and Innovation: A Narrative Review of Current Practices. JMIR Mhealth Uhealth 2021; 9:e28102. [PMID: 34874893 PMCID: PMC8691403 DOI: 10.2196/28102] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/16/2021] [Accepted: 10/21/2021] [Indexed: 12/14/2022] Open
Abstract
Background Human-centered design (HCD) approaches to health care strive to support the development of innovative, effective, and person-centered solutions for health care. Although their use is increasing, there is no integral overview describing the details of HCD methods in health innovations. Objective This review aims to explore the current practices of HCD approaches for the development of health innovations, with the aim of providing an overview of the applied methods for participatory and HCD processes and highlighting their shortcomings for further research. Methods A narrative review of health research was conducted based on systematic electronic searches in the PubMed, CINAHL, Embase, Cochrane Library, Web of Science, PsycINFO, and Sociological Abstracts (2000-2020) databases using keywords related to human-centered design, design thinking (DT), and user-centered design (UCD). Abstracts and full-text articles were screened by 2 reviewers independently based on predefined inclusion criteria. Data extraction focused on the methodology used throughout the research process, the choice of methods in different phases of the innovation cycle, and the level of engagement of end users. Results This review summarizes the application of HCD practices across various areas of health innovation. All approaches prioritized the user’s needs and the participatory and iterative nature of the design process. The design processes comprised several design cycles during which multiple qualitative and quantitative methods were used in combination with specific design methods. HCD- and DT-based research primarily targeted understanding the research context and defining the problem, whereas UCD-based work focused mainly on the direct generation of solutions. Although UCD approaches involved end users primarily as testers and informants, HCD and DT approaches involved end users most often as design partners. Conclusions We have provided an overview of the currently applied methodologies and HCD guidelines to assist health care professionals and design researchers in their methodological choices. HCD-based techniques are challenging to evaluate using traditional biomedical research methods. Previously proposed reporting guidelines are a step forward but would require a level of detail that is incompatible with the current publishing landscape. Hence, further development is needed in this area. Special focus should be placed on the congruence between the chosen methods, design strategy, and achievable outcomes. Furthermore, power dimensions, agency, and intersectionality need to be considered in co-design sessions with multiple stakeholders, especially when including vulnerable groups.
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Affiliation(s)
- Irene Göttgens
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
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Mackin RS, Rhodes E, Insel PS, Nosheny R, Finley S, Ashford M, Camacho MR, Truran D, Mosca K, Seabrook G, Morrison R, Narayan VA, Weiner M. Reliability and Validity of a Home-Based Self-Administered Computerized Test of Learning and Memory Using Speech Recognition. AGING NEUROPSYCHOLOGY AND COGNITION 2021; 29:867-881. [PMID: 34139954 PMCID: PMC10081827 DOI: 10.1080/13825585.2021.1927961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The objective of this study is to evaluate the reliability and validity of the ReVeReTM word list recall test (RWLRT), which uses speech recognition, when administered remotely and unsupervised. METHODS Prospective cohort study. Participants included 249 cognitively intact community dwelling older adults. Measures included clinician administered neuropsychological assessments at baseline and unsupervised remotely administered tests of cognition from six time-points over six months. RESULTS The RWLRT showed acceptable validity. Reliability coefficients varied across time points, with poor reliability between times 1 and 2 and fair-to-good reliability across the remaining five testing sessions. Practice effects were observed with repeated administration as expected. DISCUSSION Unsupervised computerized tests of cognition, particularly word list learning and memory tests that use speech recognition, have significant potential for large scale early detection and long-term tracking of cognitive decline due to AD.
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Affiliation(s)
- R Scott Mackin
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA.,Center for Imaging of Neurodegenerative Diseases (CIND) San Francisco Veterans Affair Medical Center, USA
| | - Emma Rhodes
- Center for Imaging of Neurodegenerative Diseases (CIND) San Francisco Veterans Affair Medical Center, USA.,Mental Illness Research Education and Clinical Centers, Veterans Administration Medical Center, San Francisco, CA, USA
| | - Philip S Insel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - Rachel Nosheny
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA.,Center for Imaging of Neurodegenerative Diseases (CIND) San Francisco Veterans Affair Medical Center, USA
| | - Shannon Finley
- Center for Imaging of Neurodegenerative Diseases (CIND) San Francisco Veterans Affair Medical Center, USA
| | - Miriam Ashford
- Center for Imaging of Neurodegenerative Diseases (CIND) San Francisco Veterans Affair Medical Center, USA
| | - Monica R Camacho
- Center for Imaging of Neurodegenerative Diseases (CIND) San Francisco Veterans Affair Medical Center, USA
| | - Diana Truran
- Center for Imaging of Neurodegenerative Diseases (CIND) San Francisco Veterans Affair Medical Center, USA
| | | | | | | | | | - Michael Weiner
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA.,Center for Imaging of Neurodegenerative Diseases (CIND) San Francisco Veterans Affair Medical Center, USA.,Department of Radiology, University of California, San Francisco, USA
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Internet-based cognitive assessment tool: Sensitivity and validity of a new online cognition screening tool for patients with bipolar disorder. J Affect Disord 2021; 289:125-134. [PMID: 33979722 DOI: 10.1016/j.jad.2021.04.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/11/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The International Society for Bipolar Disorders Targeting Cognition Task Force recommends the Screen for Cognitive Impairment in Psychiatry (SCIP) to screen for cognitive impairment in bipolar disorder. However, SCIP must be administered by a healthcare professional, which is often impossible due to time and resource constraints. Web-based, self-administered cognition screening tools may enable assessment and monitoring of patients' cognition at a much larger scale to a reduced cost. For this purpose, we developed the Internet-Based Cognitive Assessment Tool (ICAT) as a modified web-based version of SCIP. This study aimed to investigate the sensitivity and validity of ICAT for cognition assessment in bipolar disorder. METHOD Thirty-five patients with bipolar disorder in full or partial remission and 35 healthy controls completed ICAT on a computer, the standard paper-and-pencil SCIP and a subjective cognition questionnaire and were rated for mood symptoms and functioning at the Copenhagen Affective Disorders Research Centre. RESULTS Patients displayed cognitive impairments compared to controls on the ICAT (t (61)=3.67, p<.001, d=0.93). There was a strong correlation between ICAT and SCIP Total Scores (r(61)=.72, p<.000) and moderate to strong correlations on subtest scores (r=.48-.63, ps<.001). Across all participants, lower ICAT scores correlated with more subjective cognitive complaints (r(59)=-.43, p<.001) and poorer psychosocial functioning (r(62)=-.47, p<.001). CONCLUSION ICAT is a sensitive and valid web-based tool for cognition assessment in patients with bipolar disorder. This highlights ICAT as a novel web-based cognition screening tool that is feasible for largescale assessment and monitoring of cognition in the clinical management of bipolar disorder.
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Capizzi R, Fisher M, Biagianti B, Ghiasi N, Currie A, Fitzpatrick K, Albertini N, Vinogradov S. Testing a Novel Web-Based Neurocognitive Battery in the General Community: Validation and Usability Study. J Med Internet Res 2021; 23:e25082. [PMID: 33955839 PMCID: PMC8138705 DOI: 10.2196/25082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/04/2021] [Accepted: 03/16/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In recent years, there has been increased interest in the development of remote psychological assessments. These platforms increase accessibility and allow clinicians to monitor important health metrics, thereby informing patient-centered treatment. OBJECTIVE In this study, we report the properties and usability of a new web-based neurocognitive assessment battery and present a normative data set for future use. METHODS A total of 781 participants completed a portion of 8 tasks that captured performance in auditory processing, visual-spatial working memory, visual-spatial learning, cognitive flexibility, and emotional processing. A subset of individuals (n=195) completed a 5-question survey measuring the acceptability of the tasks. RESULTS Between 252 and 426 participants completed each task. Younger individuals outperformed their older counterparts in 6 of the 8 tasks. Therefore, central tendency data metrics were presented using 7 different age bins. The broad majority of participants found the tasks interesting and enjoyable and endorsed some interest in playing them at home. Only 1 of 195 individuals endorsed not at all for the statement, "I understood the instructions." Older individuals were less likely to understand the instructions; however, 72% (49/68) of individuals over the age of 60 years still felt that they mostly or very much understood the instructions. CONCLUSIONS Overall, the tasks were found to be widely acceptable to the participants. The use of web-based neurocognitive tasks such as these may increase the ability to deploy precise data-informed interventions to a wider population.
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Affiliation(s)
- Riley Capizzi
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Bruno Biagianti
- Department of Research and Development, Posit Science Corporation, San Francisco, CA, United States
| | - Neelufaer Ghiasi
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Ariel Currie
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Karrie Fitzpatrick
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Nicholas Albertini
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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Jonell P, Moëll B, Håkansson K, Henter GE, Kucherenko T, Mikheeva O, Hagman G, Holleman J, Kivipelto M, Kjellström H, Gustafson J, Beskow J. Multimodal Capture of Patient Behaviour for Improved Detection of Early Dementia: Clinical Feasibility and Preliminary Results. FRONTIERS IN COMPUTER SCIENCE 2021. [DOI: 10.3389/fcomp.2021.642633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Non-invasive automatic screening for Alzheimer’s disease has the potential to improve diagnostic accuracy while lowering healthcare costs. Previous research has shown that patterns in speech, language, gaze, and drawing can help detect early signs of cognitive decline. In this paper, we describe a highly multimodal system for unobtrusively capturing data during real clinical interviews conducted as part of cognitive assessments for Alzheimer’s disease. The system uses nine different sensor devices (smartphones, a tablet, an eye tracker, a microphone array, and a wristband) to record interaction data during a specialist’s first clinical interview with a patient, and is currently in use at Karolinska University Hospital in Stockholm, Sweden. Furthermore, complementary information in the form of brain imaging, psychological tests, speech therapist assessment, and clinical meta-data is also available for each patient. We detail our data-collection and analysis procedure and present preliminary findings that relate measures extracted from the multimodal recordings to clinical assessments and established biomarkers, based on data from 25 patients gathered thus far. Our findings demonstrate feasibility for our proposed methodology and indicate that the collected data can be used to improve clinical assessments of early dementia.
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Hafiz P, Maxhuni A, Bardram JE. Analysis of Perceived Human Factors and Participants’ Demographics during a Cognitive Assessment Study with a Smartwatch. 2020 IEEE INTERNATIONAL CONFERENCE ON HEALTHCARE INFORMATICS (ICHI) 2020. [DOI: 10.1109/ichi48887.2020.9374342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
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The landscape of cognitive function in recovered COVID-19 patients. J Psychiatr Res 2020; 129:98-102. [PMID: 32912598 PMCID: PMC7324344 DOI: 10.1016/j.jpsychires.2020.06.022] [Citation(s) in RCA: 256] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023]
Abstract
This study aims to evaluate the impacts of COVID-19 on cognitive functions in recovered patients and its relationship with inflammatory profiles. Twenty-nine patients recovered from COVID-19 as confirmed by negative nucleic tests for two consecutive times were recruited. A total of 29 age-, gender- and education-matched healthy controls were also recruited. The cognitive functions of all subjects were evaluated by the iPad-based online neuropsychological tests, including the Trail Making Test (TMT), Sign Coding Test (SCT), Continuous Performance Test (CPT), and Digital Span Test (DST). Blood samples from all patients were collected for examining inflammatory profiles, including interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and C-reactive protein (CRP). The relationship between cognitive functions and inflammatory profiles were analyzed by Pearson correlation. In results, although no significant differences were found in TMT, SCT, and DST between the two groups, patients with COVID-19 scored lower in the correct number of the second and third parts of CPT, they also scored higher in the missing number of the third part of CPT (all P < 0.05). In patients with COVID-19, there was a trend of significant difference for lower reaction time in the first and second parts of CPT (P = 0.050, and 0.051, respectively), as well as the lower correct number of the second part of CPT (P = 0.050). Correlation analysis showed that the reaction time for the first and second parts of CPT was positively correlated with the CRP levels (r = 0.557 and 0.410, P < 0.05). In conclusion, our findings indicated that cognitive impairments exist even in patients recovered from COVID-19, and might be possibly linked to the underlying inflammatory processes.
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Hafiz P, Bardram JE. The Ubiquitous Cognitive Assessment Tool for Smartwatches: Design, Implementation, and Evaluation Study. JMIR Mhealth Uhealth 2020; 8:e17506. [PMID: 32478664 PMCID: PMC7296405 DOI: 10.2196/17506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/10/2020] [Accepted: 03/31/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Cognitive functioning plays a significant role in individuals' mental health, since fluctuations in memory, attention, and executive functions influence their daily task performance. Existing digital cognitive assessment tools cannot be administered in the wild and their test sets are not brief enough to capture frequent fluctuations throughout the day. The ubiquitous availability of mobile and wearable devices may allow their incorporation into a suitable platform for real-world cognitive assessment. OBJECTIVE The aims of this study were threefold: (1) to evaluate a smartwatch-based tool for the assessment of cognitive performance, (2) to investigate the usability of this tool, and (3) to understand participants' perceptions regarding the application of a smartwatch in cognitive assessment. METHODS We built the Ubiquitous Cognitive Assessment Tool (UbiCAT) on a smartwatch-based platform. UbiCAT implements three cognitive tests-an Arrow test, a Letter test, and a Color test-adapted from the two-choice reaction-time, N-back, and Stroop tests, respectively. These tests were designed together with domain experts. We evaluated the UbiCAT test measures against standard computer-based tests with 21 healthy adults by applying statistical analyses significant at the 95% level. Usability testing for each UbiCAT app was performed using the Mobile App Rating Scale (MARS) questionnaire. The NASA-TLX (Task Load Index) questionnaire was used to measure cognitive workload during the N-back test. Participants rated perceived discomfort of wearing a smartwatch during the tests using a 7-point Likert scale. Upon finishing the experiment, an interview was conducted with each participant. The interviews were transcribed and semantic analysis was performed to group the findings. RESULTS Pearson correlation analysis between the total correct responses obtained from the UbiCAT and the computer-based tests revealed a significant strong correlation (r=.78, P<.001). One-way analysis of variance (ANOVA) showed a significant effect of the N-back difficulty level on the participants' performance measures. The study also demonstrated usability ratings above 4 out of 5 in terms of aesthetics, functionality, and information. Low discomfort (<3 out of 7) was reported by our participants after using the UbiCAT. Seven themes were extracted from the transcripts of the interviews conducted with our participants. CONCLUSIONS UbiCAT is a smartwatch-based tool that assesses three key cognitive domains. Usability ratings showed that participants were engaged with the UbiCAT tests and did not feel any discomfort. The majority of the participants were interested in using the UbiCAT, although some preferred computer-based tests, which might be due to the widespread use of personal computers. The UbiCAT can be administered in the wild with mentally ill patients to assess their attention, working memory, and executive function.
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Affiliation(s)
- Pegah Hafiz
- Digital Health Section, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark.,Copenhagen Center for Health Technology, Kongens Lyngby, Denmark
| | - Jakob Eyvind Bardram
- Digital Health Section, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark.,Copenhagen Center for Health Technology, Kongens Lyngby, Denmark
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