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GAME-CHANGING DIGITAL TOOLBOX MAY HELP DIAGNOSE DEMENTIA EARLIER
TOPICS:Boston UniversityBrainDementiaNeuroscience
By Boston University School of Medicine March 8, 2022
Detection of subtle differences in cognitive behaviors may help delay, prevent
the onset.
Detecting cognitive changes early in the onset of dementia would be a
game-changer for thousands impacted by the disease and would allow for
interventions well before significant brain changes occur.
While cognitive function is often measured using paper and pencil tests with
scores calculated by the number of correct answers, this number (score) omits a
lot of information about the process a person uses to answer a question that
might reveal important information about their brain function.
In a new study from Boston University Schools of Medicine (BUSM) and Public
Health (BUSPH), participants were tested using a digital pen that recorded the
entire process of completing the cognitive test and allowed the researchers to
pick up subtle measures of cognitive function beyond what is captured in
traditional scoring.
“Rather than just being able to say that someone performed poorly on a cognitive
test, these digital metrics allow us to delve further into the specific
cognitive and physical functions that may be underlying poor test performance
for a specific individual,” said corresponding author Mandy (Mengtian) Du, PhD,
a former graduate student at BUSPH.
Participants were asked to connect a series of dots spread out across a page in
sequential numerical order (1, 2, 3, etc.) or to alternate between numbers and
letters (such as 1, A, 2, B, and so on) while using a digital pen which records
the movement of the pen across specialized paper and allows for a time-stamped
playback of the entire drawing process. The researchers used the digital pen
data to derive measures of drawing time, meaning the amount of time that the pen
was used to draw on the paper and thinking time, or the time that the pen was
held stationary and the participant was planning their next move.
According to the researchers, the digital pen data also allowed them to quantify
the number of segments or straight lines that the participant used to complete
the connections between the dots. They then looked at how these novel digital
metrics were associated with other tests of cognitive and physical function.
They found that the digital metrics were associated with specific cognitive
functions such as processing speed, auditory attention, learning and working
memory and physical functions such as walking speed and grip strength.
“We use our brains to carry out all of the activities in our daily lives. With
digital technologies, such as digital pens or even our smart phones and activity
trackers, we have the ability to record high-precision data on our cognitive
behaviors every day,” added coauthor Stacy Andersen, PhD, assistant professor of
medicine at BUSM.
The researchers hope they will eventually be able to take what they have learned
about early, subtle digital markers of cognitive impairment and assess cognitive
health through the technologies that are used every day.
These findings appear online in the journal Alzheimer’s & Dementia: Diagnosis,
Assessment & Disease Monitoring, a journal of the Alzheimer’s Association.
Reference: “Digitally generated Trail Making Test data: Analysis using hidden
Markov modeling” by Mengtian Du, Stacy L. Andersen, Stephanie Cosentino, Robert
M. Boudreau, Thomas T. Perls and Paola Sebastiani, 8 March 2022, Alzheimer’s &
Dementia: Diagnosis, Assessment & Disease Monitoring.
DOI: 10.1002/dad2.12292
Funding for this study was provided by the National Institute on Aging
(K01AG057798 to S.L.A., 5U19AG063893 5U01AG023749 to S.C., 5U01AG023755 to
T.T.P., 5U01AG023712, 5U01AG023744, 5U01AG023746); and the Marty and Paulette
Samowitz Foundation to T.T.P.
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1. Adherence to the Australian Dietary Guidelines Is Not Associated with Brain
Structure or Cognitive Function in Older Adults
Fateme Zabetian-Targhi et al., The Journal of Nutrition, 2020
2. Long-Term Adherence to the Mediterranean Diet Is Associated with Overall
Cognitive Status, but Not Cognitive Decline, in Women
Cécilia Samieri et al., The Journal of Nutrition, 2013
3. Standardized Integration of Person-Generated Data Into Routine Clinical Care
Billy Zeng et al., JMIR Mhealth Uhealth, 2022
4. Digital Tracking of Cognitive Decline
Author: Michele Solis, IEEE PULSE, 2017
5. Clinical Study of the Effectiveness of Constant Therapy in the Treatment of
Clients With Dementia: Implications for Telepractice
Debra L. Edgar et al., SIG Perspectives
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