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P1‐295: BEHAVIORAL SYMPTOMS AND DISTURBANCES IN DEMENTIA: A HIGHLY PREVALENT CONDITION
Author(s) -
Aigbogun Myrlene Sa,
Jones Eddie,
Husbands Joseph,
Pike James,
Houle Christy,
Kessler Rose,
Baker Ross A.
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.06.850
Subject(s) - dementia , irritability , medicine , anxiety , severe dementia , disease , psychiatry , aggression , demographics , pediatrics , clinical psychology , demography , sociology
obtain multiple ‘snapshots’ of cognitive function in real-time and in people’s natural environment. This ambulatory measurement approach allows for improved measurement precision by averaging across random sources of temporal variability. We evaluated the reliability and concurrent validity for discriminating dementia risk status of several, ultra-brief mobile tests of processing speed and memory. Methods: 199 community dwelling EAS participants aged 70+ were asked to complete 14 consecutive days of mobile assessments (6 assessments per day) using smartphones. “High risk” for dementia was defined by a score of<1⁄427 on the Free and Cued Selective Reminding Test (Derby, 2013). Each mobile assessment included tests of processing speed, spatial memory, and memory binding, as well as self-report questions (e.g., affect, fatigue, stress). Results: Overall, ambulatory measures of cognition, aggregated to the person-level, significantly discriminated risk status. Processing speed showed an absolute effect size of d1⁄4.52 (p<.01), with high dementia risk individuals performing 479 msec slower on average than those not at risk. The ambulatory tests of spatial memory (d1⁄4.63) and object-location binding (d1⁄4.64) also significantly discriminated dementia risk status (p<.01 for all). Agewas associated with slower performance on the processing speed test (p1⁄4.01) and with less accurate object-location binding (p1⁄4.03), but there was no significant age difference in spatial memory (p>.20). Scores obtained by averaging across the 14 day assessment period were highly reliable, with ICCs >.95 for each cognitive test. Generalizability theory analysis indicated that highly reliable scores (ICC>.90) could be obtained with far fewer assessments, totaling less than 3 minutes for the processing speed test and less than 10 minutes for the memory tests. Conclusions: These results support the use of mobile technology in older samples for detecting dementia risk and for obtaining high precision cognitive assessments that could improve detection of subtle cognitive changes.