Unobtrusive measurement of daily computer use to detect mild cognitive impairment

Abstract

Background Mild disturbances of higher order activities of daily living are present in people diagnosed with mild cognitive impairment (MCI). These deficits may be difficult to detect among those still living independently. Unobtrusive continuous assessment of a complex activity such as home computer use may detect mild functional changes and identify MCI. We sought to determine whether long-term changes in remotely monitored computer use differ in persons with MCI in comparison to cognitively intact volunteers. Methods Participants enrolled in a longitudinal cohort study of unobtrusive in-home technologies to detect cognitive and motor decline in independently living seniors were assessed for computer usage (number of days with use, mean daily usage and coefficient of variation of use) measured by remotely monitoring computer session start and end times. Results Over 230,000 computer sessions from 113 computer users (mean age, 85; 38 with MCI) were acquired during a mean of 36 months. In mixed effects models there was no difference in computer usage at baseline between MCI and intact participants controlling for age, sex, education, race and computer experience. However, over time, between MCI and intact participants, there was a significant decrease in number of days with use (p=0.01), mean daily usage (~1% greater decrease/month; p=0.009) and an increase in day-to-day use variability (p=0.002). Conclusions Computer use change can be unobtrusively monitored and indicate individuals with MCI. With 79% of those 55–64 years old now online, this may be an ecologically valid and efficient approach to track subtle clinically meaningful change with aging.

Digital technologies for the assessment of cognition: a clinical review

“…One study reported no differences in daily recorded computer activity (based on mouse movements) at baseline between groups of cognitively healthy and MCI participants. However, at follow-up two years and three years later, a significant decrease in number of days with computer use, mean daily use and an increase in day-to-day variability was found in the MCI group only 40. The authors concluded that computer usage is likely to be sensitive to cognitive change due to its reliance on multiple cognitive domains.…”

Novel Methods and Technologies for 21st-Century Clinical Trials

“…Wearable sensors can now monitor tremor for as long as 10 hours daily. 34 Remote measurement of daily computer use can detect mild cognitive impairment, 35 and smartphones can map out the geographic area where individuals with Parkinson disease live. 36 Potentially more powerful applications are on the horizon.…”

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“…More recently multiple web-based and app-based cognitive assessments have emerged [3] including digitized versions of pen and paper tasks, such as clock drawing [4] including a digital clock-drawing pen [5]. In addition, the manner in which people use technology and changes in their patterns of use has been identified as an early indicator of emerging cognitive impairment [6, 7]. Technological assessment of functional activities extends to tasks such as making tea and toast [8], coffee-making [9], as well as instrumental activities of daily living [10].…”