Examining Associations Between Smartphone Use and Clinical Severity in Frontotemporal Dementia: Proof-of-Concept Study

被引：4

作者：

Paolillo, Emily W. ^{[1
]}

Casaletto, Kaitlin B. ^{[1
]}

Clark, Annie L. ^{[1
]}

Taylor, Jack C. ^{[1
]}

Heuer, Hilary W. ^{[1
]}

Wise, Amy B. ^{[1
]}

Dhanam, Sreya ^{[1
]}

Sanderson-Cimino, Mark ^{[1
]}

Saloner, Rowan ^{[1
]}

Kramer, Joel H. ^{[1
]}

Kornak, John ^{[2
]}

Kremers, Walter ^{[3
]}

Forsberg, Leah ^{[2
,4
]}

Appleby, Brian ^{[3
,5
]}

Bayram, Ece ^{[4
,6
]}

Bozoki, Andrea ^{[5
,7
]}

Brushaber, Danielle ^{[3
]}

Darby, R. Ryan ^{[6
,8
]}

Day, Gregory S. ^{[9
]}

Dickerson, Bradford C. ^{[10
,11
]}

Domoto-Reilly, Kimiko ^{[12
]}

Elahi, Fanny ^{[13
,14
]}

Fields, Julie A. ^{[15
]}

Ghoshal, Nupur ^{[3
,16
]}

Graff-Radford, Neill ^{[9
]}

Hall, Matthew G. H. ^{[1
]}

Honig, Lawrence S. ^{[4
,17
]}

Huey, Edward ^{[5
,18
,21
]}

Lapid, Maria, I ^{[15
]}

Litvan, Irene ^{[4
,6
]}

Mackenzie, Ian R. ^{[6
,19
]}

Masdeu, Joseph C. ^{[20
]}

Mendez, Mario F. ^{[20
]}

Mester, Carly ^{[3
]}

Miyagawa, Toji ^{[2
,4
]}

Naasan, Georges ^{[22
]}

Pascual, Belen ^{[19
]}

Pressman, Peter ^{[23
]}

Ramos, Eliana Marisa ^{[21
]}

Rankin, Katherine P. ^{[1
]}

Rexach, Jessica

Rojas, Julio C. ^{[1
]}

Vandevrede, Lawren ^{[1
]}

Wong, Bonnie ^{[11
,24
]}

Wszolek, Zbigniew K. ^{[9
]}

Boeve, Bradley F. ^{[2
,4
]}

Rosen, Howard J. ^{[1
]}

Boxer, Adam L. ^{[1
]}

Staffaroni, Adam M. ^{[1
]}

机构：

[1] Univ Calif San Francisco, Weill Inst Neurosci, Memory & Aging Ctr, Dept Neurol, 675 Nelson Rising Lane,Suite,19094158, San Francisco, CA 94158 USA

[2] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA USA

[3] Mayo Clin, Dept Quantitat Hlth Sci, Div Clin Trials & Biostat, Rochester, MN USA

[4] Mayo Clin, Dept Neurol, Rochester, MN USA

[5] Case Western Reserve Univ, Dept Neurol, Cleveland, OH USA

[6] Univ Calif San Diego, Dept Neurosci, La Jolla, CA USA

[7] Univ North Carolina Chapel Hill, Dept Neurol, Chapel Hill, NC USA

[8] Vanderbilt Univ, Dept Neurol, Nashville, TN USA

[9] Mayo Clin, Dept Neurol, Jacksonville, FL USA

[10] Massachusetts Gen Hosp, Dept Neurol, Boston, MA USA

[11] Harvard Med Sch, Boston, MA USA

[12] Univ Washington, Dept Neurol, Seattle, WA USA

[13] Icahn Sch Med Mt Sinai, Deane Ctr Wellness & Cognit Hlth, Dept Neurol, New York, NY USA

[14] James J Peters Vet Affairs Med Ctr, New York, NY USA

[15] Mayo Clin, Dept Psychiat & Psychol, Rochester, MN USA

[16] Washington Univ, Knight Alzheimers Dis Res Ctr, Dept Neurol, St. Louis, MO USA

[17] Columbia Univ, Dept Neurol, New York, NY USA

[18] Brown Univ, Dept Psychiat & Human Behav, Providence, RI USA

[19] Univ British Columbia, Dept Pathol, Vancouver, BC, Canada

[20] Houston Methodist Res Inst, Nantz Natl Alzheimer Ctr, Stanley H Appel Dept Neurol, Weill Cornell Med, Houston, TX USA

[21] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA USA

[22] Icahn Sch Med Mt Sinai, Dept Neurol, New York, NY USA

[23] Univ Colorado, Dept Neurol, Aurora, CO USA

[24] Massachusetts Gen Hosp, Harvard Med Sch, Dept Psychiat, Boston, MA USA

来源：

JMIR AGING | 2024年 / 7卷

基金：

美国国家卫生研究院;

关键词：

digital; technology; remote; monitoring; cognition; neuropsychology; cognitive impairment; neurodegenerative; screening; clinical trials; mobile phone; MILD COGNITIVE IMPAIRMENT; EVERYDAY TECHNOLOGY; BEHAVIORAL VARIANT; OLDER-ADULTS; ALZHEIMERS-DISEASE; DIAGNOSIS; LANGUAGE; CRITERIA;

D O I：

10.2196/52831

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Background: Frontotemporal lobar degeneration (FTLD) is a leading cause of dementia in individuals aged <65 years. Several challenges to conducting in -person evaluations in FTLD illustrate an urgent need to develop remote, accessible, and low -burden assessment techniques. Studies of unobtrusive monitoring of at-home computer use in older adults with mild cognitive impairment show that declining function is reflected in reduced computer use; however, associations with smartphone use are unknown. Objective: This study aims to characterize daily trajectories in smartphone battery use, a proxy for smartphone use, and examine relationships with clinical indicators of severity in FTLD. Methods: Participants were 231 adults (mean age 52.5, SD 14.9 years; n=94, 40.7% men; n=223, 96.5% non -Hispanic White) enrolled in the Advancing Research and Treatment of Frontotemporal Lobar Degeneration (ARTFL study) and Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects (LEFFTDS study) Longitudinal Frontotemporal Lobar Degeneration (ALLFTD) Mobile App study, including 49 (21.2%) with mild neurobehavioral changes and no functional impairment (ie, prodromal FTLD), 43 (18.6%) with neurobehavioral changes and functional impairment (ie, symptomatic FTLD), and 139 (60.2%) clinically normal adults, of whom 55 (39.6%) harbored heterozygous pathogenic or likely pathogenic variants in an autosomal dominant FTLD gene. Participants completed the Clinical Dementia Rating plus National Alzheimer's Coordinating Center Frontotemporal Lobar Degeneration Behavior and Language Domains (CDR+NACC FTLD) scale, a neuropsychological battery; the Neuropsychiatric Inventory; and brain magnetic resonance imaging. The ALLFTD Mobile App was installed on participants' smartphones for remote, passive, and continuous monitoring of smartphone use. Battery percentage was collected every 15 minutes over an average of 28 (SD 4.2; range 14-30) days. To determine whether temporal patterns of battery percentage varied as a function of disease severity, linear mixed effects models examined linear, quadratic, and cubic effects of the time of day and their interactions with each measure of disease severity on battery percentage. Models covaried for age, sex, smartphone type, and estimated smartphone age. Results: The CDR+NACC FTLD global score interacted with time on battery percentage such that participants with prodromal or symptomatic FTLD demonstrated less change in battery percentage throughout the day (a proxy for less smartphone use) than clinically normal participants ( P <.001 in both cases). Additional models showed that worse performance in all cognitive domains assessed (ie, executive functioning, memory, language, and visuospatial skills), more neuropsychiatric symptoms, and smaller brain volumes also associated with less battery use throughout the day ( P <.001 in all cases). Conclusions: These findings support a proof of concept that passively collected data about smartphone use behaviors associate with clinical impairment in FTLD. This work underscores the need for future studies to develop and validate passive digital markers sensitive to longitudinal clinical decline across neurodegenerative diseases, with potential to enhance real -world monitoring of neurobehavioral change.

引用

页数：17

共 69 条

[1]

[Anonymous], 2018, Framework for FDA's Real-World Evidence Program

[2]

[Anonymous], Market share of mobile operating systems worldwide 2012-2021, 2021

[3] Criteria for the diagnosis of corticobasal degeneration [J].