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Alty J, Goldberg LR, Roccati E, Lawler K, Bai Q, Huang G, Bindoff AD, Li R, Wang X, St George RJ, Rudd K, Bartlett L, Collins JM, Aiyede M, Fernando N, Bhagwat A, Giffard J, Salmon K, McDonald S, King AE, Vickers JC. Development of a smartphone screening test for preclinical Alzheimer's disease and validation across the dementia continuum. BMC Neurol 2024; 24:127. [PMID: 38627686 PMCID: PMC11020184 DOI: 10.1186/s12883-024-03609-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/21/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Dementia prevalence is predicted to triple to 152 million globally by 2050. Alzheimer's disease (AD) constitutes 70% of cases. There is an urgent need to identify individuals with preclinical AD, a 10-20-year period of progressive brain pathology without noticeable cognitive symptoms, for targeted risk reduction. Current tests of AD pathology are either too invasive, specialised or expensive for population-level assessments. Cognitive tests are normal in preclinical AD. Emerging evidence demonstrates that movement analysis is sensitive to AD across the disease continuum, including preclinical AD. Our new smartphone test, TapTalk, combines analysis of hand and speech-like movements to detect AD risk. This study aims to [1] determine which combinations of hand-speech movement data most accurately predict preclinical AD [2], determine usability, reliability, and validity of TapTalk in cognitively asymptomatic older adults and [3], prospectively validate TapTalk in older adults who have cognitive symptoms against cognitive tests and clinical diagnoses of Mild Cognitive Impairment and AD dementia. METHODS Aim 1 will be addressed in a cross-sectional study of at least 500 cognitively asymptomatic older adults who will complete computerised tests comprising measures of hand motor control (finger tapping) and oro-motor control (syllabic diadochokinesis). So far, 1382 adults, mean (SD) age 66.20 (7.65) years, range 50-92 (72.07% female) have been recruited. Motor measures will be compared to a blood-based AD biomarker, phosphorylated tau 181 to develop an algorithm that classifies preclinical AD risk. Aim 2 comprises three sub-studies in cognitively asymptomatic adults: (i) a cross-sectional study of 30-40 adults to determine the validity of data collection from different types of smartphones, (ii) a prospective cohort study of 50-100 adults ≥ 50 years old to determine usability and test-retest reliability, and (iii) a prospective cohort study of ~1,000 adults ≥ 50 years old to validate against cognitive measures. Aim 3 will be addressed in a cross-sectional study of ~200 participants with cognitive symptoms to validate TapTalk against Montreal Cognitive Assessment and interdisciplinary consensus diagnosis. DISCUSSION This study will establish the precision of TapTalk to identify preclinical AD and estimate risk of cognitive decline. If accurate, this innovative smartphone app will enable low-cost, accessible screening of individuals for AD risk. This will have wide applications in public health initiatives and clinical trials. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT06114914, 29 October 2023. Retrospectively registered.
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Affiliation(s)
- Jane Alty
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia.
- School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia.
- Royal Hobart Hospital, Hobart, TAS, 7001, Australia.
| | - Lynette R Goldberg
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Eddy Roccati
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Katherine Lawler
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Quan Bai
- School of Information and Communication Technology, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Guan Huang
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Aidan D Bindoff
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Renjie Li
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
- School of Information and Communication Technology, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Xinyi Wang
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Rebecca J St George
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Kaylee Rudd
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Larissa Bartlett
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Jessica M Collins
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Mimieveshiofuo Aiyede
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | | | - Anju Bhagwat
- Royal Hobart Hospital, Hobart, TAS, 7001, Australia
| | - Julia Giffard
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Katharine Salmon
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
- Royal Hobart Hospital, Hobart, TAS, 7001, Australia
| | - Scott McDonald
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - Anna E King
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
| | - James C Vickers
- Wicking Dementia Research and Education Centre, University of Tasmania, Liverpool Street, Hobart, TAS, 7001, Australia
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Li R, Wang X, Lawler K, Garg S, St George RJ, Bindoff AD, Bartlett L, Roccati E, King AE, Vickers JC, Bai Q, Alty J. Brief webcam test of hand movements predicts episodic memory, executive function, and working memory in a community sample of cognitively asymptomatic older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12520. [PMID: 38274411 PMCID: PMC10809289 DOI: 10.1002/dad2.12520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Low-cost simple tests for preclinical Alzheimer's disease are a research priority. We evaluated whether remote unsupervised webcam recordings of finger-tapping were associated with cognitive performance in older adults. METHODS A total of 404 cognitively-asymptomatic participants (64.6 [6.77] years; 70.8% female) completed 10-second finger-tapping tests (Tasmanian [TAS] Test) and cognitive tests (Cambridge Neuropsychological Test Automated Battery [CANTAB]) online at home. Regression models including hand movement features were compared with null models (comprising age, sex, and education level); change in Akaike Information Criterion greater than 2 (ΔAIC > 2) denoted statistical difference. RESULTS Hand movement features improved prediction of episodic memory, executive function, and working memory scores (ΔAIC > 2). Dominant hand features outperformed nondominant hand features for episodic memory (ΔAIC = 2.5), executive function (ΔAIC = 4.8), and working memory (ΔAIC = 2.2). DISCUSSION This brief webcam test improved prediction of cognitive performance compared to age, sex, and education. Finger-tapping holds potential as a remote language-agnostic screening tool to stratify community cohorts at risk for cognitive decline.
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Affiliation(s)
- Renjie Li
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
- School of ICTUniversity of TasmaniaHobartTasmaniaAustralia
| | - Xinyi Wang
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
| | - Katherine Lawler
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
- School of Allied HealthHuman Services and SportLa Trobe UniversityMelbourneVictoriaAustralia
| | - Saurabh Garg
- School of ICTUniversity of TasmaniaHobartTasmaniaAustralia
| | | | - Aidan D. Bindoff
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
| | - Larissa Bartlett
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
| | - Eddy Roccati
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
| | - Anna E. King
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
| | - James C. Vickers
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
| | - Quan Bai
- School of ICTUniversity of TasmaniaHobartTasmaniaAustralia
| | - Jane Alty
- Wicking Dementia Research and Education CentreUniversity of TasmaniaHobartTasmaniaAustralia
- School of MedicineUniversity of TasmaniaHobartTasmaniaAustralia
- Neurology DepartmentRoyal Hobart HospitalHobartTasmaniaAustralia
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