Development of a smartphone application for the objective detection of attentional deficits in delirium

Tieges, Zoë; Stíobhairt, Antaine; Scott, Katie; Suchorab, Klaudia; Weir, Alexander; Parks, S.; Shenkin, Susan D.; MacLullich, Alasdair M.J.

doi:10.1017/s1041610215000186

Cited by 41 publications

(40 citation statements)

References 29 publications

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“…Few studies have been performed to validate cognitive testing using a smartphone, usually in the context of a specific disorder or healthy young people [8,10,22]. The moderate correlations in our study for the attention and executive function tasks are comparable with correlations found in a other study investigating cognitive smartphone apps focusing on working memory and perceptual speed [24].…”

Section: Discussionsupporting

confidence: 84%

“…Experience with smartphone use during a clinical cognitive assessment has already been tested [7], paving the way to integration in a home setting. Feasibility and validity of smartphone-based cognitive testing has been described, although narrowed down to specific patient groups or a specific cognitive test [8-11]. Despite these advances made in conducting smartphone research, little is known in terms of the feasibility and validity of applying multiple cognitive tests using smartphone-based technologies for clinical research in larger populations.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Testing in People at Increased Risk of Dementia Using a Smartphone App: The iVitality Proof-of-Principle Study

Jongstra¹,

Wijsman²,

Cachucho³

et al. 2017

JMIR Mhealth Uhealth

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BackgroundSmartphone-assisted technologies potentially provide the opportunity for large-scale, long-term, repeated monitoring of cognitive functioning at home.ObjectiveThe aim of this proof-of-principle study was to evaluate the feasibility and validity of performing cognitive tests in people at increased risk of dementia using smartphone-based technology during a 6 months follow-up period.MethodsWe used the smartphone-based app iVitality to evaluate five cognitive tests based on conventional neuropsychological tests (Memory-Word, Trail Making, Stroop, Reaction Time, and Letter-N-Back) in healthy adults. Feasibility was tested by studying adherence of all participants to perform smartphone-based cognitive tests. Validity was studied by assessing the correlation between conventional neuropsychological tests and smartphone-based cognitive tests and by studying the effect of repeated testing.ResultsWe included 151 participants (mean age in years=57.3, standard deviation=5.3). Mean adherence to assigned smartphone tests during 6 months was 60% (SD 24.7). There was moderate correlation between the firstly made smartphone-based test and the conventional test for the Stroop test and the Trail Making test with Spearman ρ=.3-.5 (P<.001). Correlation increased for both tests when comparing the conventional test with the mean score of all attempts a participant had made, with the highest correlation for Stroop panel 3 (ρ=.62, P<.001). Performance on the Stroop and the Trail Making tests improved over time suggesting a learning effect, but the scores on the Letter-N-back, the Memory-Word, and the Reaction Time tests remained stable.ConclusionsRepeated smartphone-assisted cognitive testing is feasible with reasonable adherence and moderate relative validity for the Stroop and the Trail Making tests compared with conventional neuropsychological tests. Smartphone-based cognitive testing seems promising for large-scale data-collection in population studies.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Cognitive Testing in People at Increased Risk of Dementia Using a Smartphone App: The iVitality Proof-of-Principle Study

Jongstra¹,

Wijsman²,

Cachucho³

et al. 2017

JMIR Mhealth Uhealth

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“…No statistical difference was found between performance on the DelApp and the standard EDTB in 20 elderly cognitively healthy inpatients. DelApp also reliably differentiated patients with delirium from patients with dementia (despite comparable cognitive performances) and from those with no cognitive impairment in 156 elderly inpatients (area under the curve = 0.96 with 98% sensitivity and 93% specificity) 14. The conclusion was that DelApp provides an accessible and reliable means of monitoring delirium emergence in inpatient populations.…”

Section: Presentationmentioning

confidence: 87%

“…iVitality12 and Color-Shape Test (CST)13 aim to provide reliable means to assess cognition in ‘at-risk’ populations for dementia; DelApp14 focuses on identifying delirium in hospital inpatients. iVitality employs five digitally adapted versions of standard cognitive tests (Stroop, Reaction Time, Trail Making, N-Back and Memory-Word tests) 12.…”

Section: Presentationmentioning

confidence: 99%

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Digital technologies for the assessment of cognition: a clinical review

Chinner

Blane

Lancaster

et al. 2018

Evid Based Mental Health

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Dementia is the most widespread form of neurodegenerative disorder and is associated with an immense societal and personal cost. Prevalence of this disorder is projected to triple worldwide by 2050 leading to an urgent need to make advances in the efficiency of both its care and therapy research. Digital technologies are a rapidly advancing field that provide a previously unavailable opportunity to alleviate challenges faced by clinicians and researchers working in this area. This clinical review aimed to summarise currently available evidence on digital technologies that can be used to monitor cognition. We identified a range of pervasive digital systems, such as smartphones, smartwatches and smart homes, to assess and assist elderly demented, prodromal and preclinical populations. Generally, the studies reported good level of agreement between the digital measures and the constructs they aimed to measure. However, most of the systems are still only in the initial stages of development with limited data on acceptability in patients. Although it is clear that the use of digital technology to monitor and support the cognitive domains affected by dementia is a promising area of development, additional research validating the efficacy, utility and cost-effectiveness of these systems in patient populations is needed.

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Delirium in Older Persons

Fong

Hshieh

et al. 2017

JAMA

638

306

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Importance-Delirium is defined as an acute disorder of attention and cognition. It is a common, serious, and often fatal condition among older patients. Although often underrecognized, delirium has serious adverse effects on the individual's function and quality of life, as well as broad societal effect with substantial health care costs.Objective-To summarize the current state of the art in diagnosis and treatment of delirium and to highlight critical areas for future research to advance the field.Evidence Review-We searched Ovid MEDLINE, Embase, and the Cochrane Library for the past 6 years, from January 1, 2011 until March 16, 2017 using a combination of controlled vocabulary and keyword terms. Since delirium is more prevalent in older adults, the focus was on studies in elderly populations; studies based solely in the intensive care unit (ICU) and non-English-language articles were excluded.Findings-Of 127 articles included, 25 were clinical trials, 42 cohort studies, 5 systematic reviews and meta-analyses, and 55 were other categories. A total of 11 616 patients were represented in the treatment studies. Advances in diagnosis have included the development of brief screening tools with high sensitivity and specificity, such as the 3-Minute Diagnostic Assessment, 4 A's test, and proxy-based measures such as the Family Confusion Assessment Method. Measures of severity, such as the Confusion Assessment Method-Severity Score, can aid in monitoring response to treatment, risk stratification, and assessing prognosis. Nonpharmacologic approaches focused on risk factors such as immobility, functional decline, visual or hearing impairment, dehydration, and sleep deprivation are effective for delirium prevention and also are recommended for delirium treatment. Current recommendations for pharmacologic treatment of

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Development of a smartphone application for the objective detection of attentional deficits in delirium

Cited by 41 publications

References 29 publications

Cognitive Testing in People at Increased Risk of Dementia Using a Smartphone App: The iVitality Proof-of-Principle Study

Cognitive Testing in People at Increased Risk of Dementia Using a Smartphone App: The iVitality Proof-of-Principle Study

Digital technologies for the assessment of cognition: a clinical review

Delirium in Older Persons

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