ABSTRACT
Introduction:
Although the
growth of digital tools for cognitive
health assessment, there's a lack of known
reference values and clinical implications for these digital
methods. This study aims to establish
reference values for digital neuropsychological
measures obtained through the
smartphone-based cognitive assessment application, Defense Automated Neurocognitive Assessment (DANA), and to identify clinical
risk factors associated with these
measures.
Methods:
The sample included 932 cognitively intact participants from the
Framingham Heart Study,
who completed at least one DANA task. Participants were stratified into subgroups based on
sex and three
age groups.
Reference values were established for digital cognitive assessments within each
age group, divided by
sex, at the 2.5th, 25th, 50th, 75th, and 97.5th percentile thresholds. To validate these values, 57 cognitively intact participants from
Boston University Alzheimer's Disease Research Center were included.
Associations between 19 clinical
risk factors and these digital neuropsychological
measures were examined by a backward elimination strategy.
Results:
Age- and
sex-specific
reference values were generated for three DANA tasks. Participants below 60 had median
response times for the Go-No-Go task of 796 ms (
men) and 823 ms (
women), with age-related increases in both sexes. Validation cohort results mostly aligned with these references. Different tasks showed unique clinical correlations. For instance,
response time in the Code Substitution task correlated positively with total
cholesterol and diabetes, but negatively with
high-density lipoprotein and
low-density lipoprotein cholesterol levels, and
triglycerides.
Discussion:
This study established and validated
reference values for digital neuropsychological
measures of DANA in cognitively intact
white participants, potentially improving their use in
future clinical studies and practice.