Independent memory test via smartphone can recognise signs of Alzheimer's disease
Digital approach to pave the way for better early diagnosis
Special test tasks on smartphones can be used to recognise "mild cognitive impairment" - which may indicate Alzheimer's disease - with a high degree of accuracy. This is reported by researchers from the DZNE, Otto von Guericke University Magdeburg and the US University of Wisconsin-Madison together with the Magdeburg-based company "neotiv" in the scientific journal "npj Digital Medicine". Their study is based on data from 199 older adults. The results emphasise the potential of mobile apps for Alzheimer's research, clinical studies and routine medical care. The app analysed here is now being offered to medical practices to support the early detection of memory problems.
Memory impairment is a key symptom of Alzheimer's disease. It is therefore obvious that the severity and development over time of such memory problems play a central role in the diagnosis of the disease and in Alzheimer's research. In current clinical practice, such memory tests are carried out under the guidance of a healthcare professional.The people tested have to solve standardised tasks in writing or in conversation: for example, remembering and repeating words, spontaneously naming as many terms as possible on a certain topic or drawing geometric figures according to instructions.All of these tests require professional supervision, otherwise the results are not meaningful.These tests can therefore not be carried out alone, for example at home.
Prof Emrah Düzel, a neuroscientist at the DZNE site in Magdeburg and at Magdeburg University Hospital, as well as an entrepreneur in the medical technology sector, advocates a new approach: "There are advantages to being able to carry out such tests independently and only having to visit a practice to evaluate the results. Just as we know it from a long-term ECG, for example. Such tests without supervision would help to recognise clinically relevant memory disorders at an early stage and record disease progression more closely than is currently possible. In view of the latest developments in Alzheimer's
Photo: Prof. Dr Emrah Düzel. Photo: Sarah Kossmann/UMMD
Comparison between self-tests at home and under supervision in the clinic
In addition to his work in dementia research, Düzel is also "Chief Medical Officer" of "neotiv", a Magdeburg start-up with which the DZNE has been cooperating for several years. The company has developed an app that enables independent memory tests without the need for professional supervision. The software runs on smartphones and tablets and has been scientifically validated. It is used in Alzheimer's research and is now also offered as a diagnostic tool for doctors' surgeries for the early detection of mild cognitive impairment. In specialist jargon, this is also referred to as "mild cognitive impairment" - or MCI for short. Although MCI has little impact on the daily lives of those affected, they have an increased risk of developing Alzheimer's dementia within a few years.
Dr David Berron, research group leader at the DZNE and co-founder of neotiv, explains: "As part of the validation, we used both this novel test procedure, which does not require direct supervision, and an established neuropsychological examination in the clinic. This has shown that the new method is comparable to clinical examinations and recognises mild cognitive impairment, also known as MCI, with a high degree of accuracy. This technology has enormous potential to provide physicians with information that can be used to improve the quality of care.
Participants from Germany and the USA
A total of 199 women and men over the age of 60 took part in the current study. They were located either in Germany or the USA and were each involved in one of two long-term studies, both of which deal with Alzheimer's - the most common dementia disease: the so-called DELCODE study by the DZNE and the WRAP study by the University of Wisconsin-Madison. The study group reflected different cognitive states that occur in practice: It included people who were cognitively healthy, people with MCI, and others with subjectively perceived but unmeasurable memory complaints. The diagnosis was based on examinations using an established procedure that includes memory and language tasks. In addition, all test subjects carried out multiple memory tests with the neotiv app over a period of at least six weeks. They used their own smartphones or tablets for this purpose. The test subjects tested themselves independently - and wherever it was convenient for them. "Most of our WRAP participants were able to complete the digital tasks independently and were satisfied with the tasks and the digital platform," says Lindsay Clark from the University of Wisconsin-Madison. The PhD neuropsychologist is leading the study "Assessing Memory with Mobile Devices" there.
Memorise pictures and recognise differences
"Testing with the neotiv app is interactive and comprises three types of memory tasks. These address different areas of the brain that can be affected in different phases of Alzheimer's disease. This is the result of many years of research," explains Düzel. Essentially, these tests involve memorising images or recognising differences between images that are displayed by the app. Using a specially developed parameter, the German-American research team was able to compare the results of the app with the findings of the established clinical method.
"Our study shows that memory complaints can be meaningfully assessed using this digital method," says Düzel. "If the results of the digital test indicate that a memory impairment typical of MCI is present, this paves the way for further clinical investigations. If the test results indicate that memory performance is within the age-specific normal range, the all-clear can be given for the time being. And for Alzheimer's research, this provides a digital tool for assessing cognitive abilities that can be used in clinical trials. This is already happening in Germany, the USA, Sweden and other countries."
Outlook
Further investigations are in preparation or already underway. The novel memory test is to be trialled on even larger study groups, and the researchers also want to investigate whether it can be used to track the development of Alzheimer's disease over a longer period of time. Berron: "Information about how quickly memory deteriorates over time is important for doctors and patients. It is also relevant for clinical trials, as new treatments aim to slow down the rate of cognitive decline." The neuroscientist describes the challenges: "In order to further develop such self-tests, a patient's clinical data must be linked to self-tests outside the clinic, from everyday life. This is no easy task, but as our current study shows, the field of research is making progress."
Original publication
A Remote Digital Memory Composite to Detect Cognitive Impairment in Memory Clinic Samples in Unsupervised Settings using Mobile Devices, Berron et al, npj Digital Medicine (2024), DOI: 10.1038/s41746-024-00999-9, URL: https://doi.org/10.1038/s41746-024-00999-9
About the German Centre for Neurodegenerative Diseases (DZNE)
The DZNE is a research institute for neurodegenerative diseases such as Alzheimer's, Parkinson's and ALS, which are associated with dementia, movement disorders and other serious health impairments.To date, there is no cure for these diseases, which place an enormous burden on countless sufferers, their families and the healthcare system.The DZNE aims to develop innovative strategies for prevention, diagnosis, care and treatment and to put them into practice.It has ten locations throughout Germany and co-operates with universities, university hospitals and other institutions in Germany and abroad.The DZNE is funded by the state and is a member of the Helmholtz Association and the German Centres for Health Research. www.dzne.de
Media contact
Dr. Marcus Neitzert, Communications Office German Centre for Neurodegenerative Diseases (DZNE), Tel.: 0228 43302-267, e-mail: