Capturing cognitive capacity in the everyday environment across a continuum of cognitive decline using a smartwatch n-back task and ecological momentary assessment

Maureen Schmitter-Edgecombe; Catherine Luna; Brooke Beech; Shenghai Dai; Diane J Cook

doi:10.1037/neu0000984

Capturing cognitive capacity in the everyday environment across a continuum of cognitive decline using a smartwatch n-back task and ecological momentary assessment

Neuropsychology. 2024 Nov 18. doi: 10.1037/neu0000984. Online ahead of print.

Authors

Maureen Schmitter-Edgecombe¹, Catherine Luna¹, Brooke Beech¹, Shenghai Dai², Diane J Cook³

Affiliations

¹ Department of Psychology, Washington State University.
² College of Education, Washington State University.
³ School of Electrical Engineering and Computer Science, Washington State University.

PMID: 39556385
DOI: 10.1037/neu0000984

Abstract

Objective: Cognitive testing using mobile technologies can assist with early detection of cognitive decline. We use ecological momentary assessment to investigate the feasibility, reliability, and validity of a smartwatch n-back task (1-back) delivered to adults across the cognitive continuum.

Method: One hundred seventy-four community-dwelling individuals (M_age = 70.51) representing healthy older adults, individuals with subjective cognitive decline, and mild cognitive impairment completed a neurocognitive assessment battery and wore a smartwatch for 7+ days. Participants were prompted 4 times per day to complete an n-back task on the smartwatch.

Results: Across all groups, findings indicated an acceptable task adherence rate (> 78%; n = 174) and response rate (> 89%; n = 158 n-back analysis sample). Supporting external validity, participants with mild cognitive impairment were less accurate, had fewer total correct responses, and performed at lower initial levels than both healthy older adults and subjective cognitive decline, ω²s > .09. Intraindividual variability was greater for the mild cognitive impairment group compared to healthy older adults, but subjective cognitive decline did not differ significantly from either group, ω² = .12. For discriminant and convergent validity, n-back total correct correlated with performance on standardized assessments of executive attention, whereas intraindividual variability correlated with real-world factors (i.e., context, everyday function). Reliability assessment revealed stability for n-back measures after four to six posttraining trials and excellent test-retest reliability for total correct after 5 months. Finally, combining n-back and clinical measures improved classification accuracy.

Conclusions: Findings suggest the smartwatch n-back task is feasible for collecting cognitive data across the cognitive continuum with demonstrated reliability and validity in the everyday environment using ecological momentary assessment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Abstract

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