Regular cognitive self-monitoring in community-dwelling older adults using an internet-based tool

ABSTRACT

Introduction: Monitoring for various health conditions (e.g., breast cancer, hypertension) has become common practice. However, there is still no established tool for regular monitoring of cognition. In this pilot longitudinal study, we examined the utility and feasibility of internet-based cognitive self-monitoring using data from the first 12 months of this ongoing study. Method: Cognitively healthy community-dwelling older adults (Montreal Cognitive Assessment ≥ 26) were enrolled on a rolling basis and were trained in self-administration of the internet-based version of the CogState Brief Battery. The battery uses playing cards and includes Detection, Identification, One Back, and One Card Learning subtasks. Results: Of the 118 participants enrolled, 26 dropped out, mostly around first in-home session. Common reasons for participant attrition were internet browser problems, health problems, and computer problems. Common reasons for delayed session completion were being busy, being out of town, and health problems. Participants needed about one reminder phone call per four completed sessions or one reminder email per five completed sessions. Performance across the monthly sessions showed slight (but significant) improvement on three of the four tasks. Change in performance was unaffected by individual characteristics with the exception of previous computer use, with less frequent users showing greater improvement on One Card Learning. We also found low intraindividual variability in monthly test scores beyond the first self-administered testing session. Conclusions: Internet-based self-monitoring offers a potentially feasible and effective method of continuous cognitive monitoring among older adults.

KEYWORDS:

• Cognitive aging
• Attitude to computers
• Healthy volunteers
• Health promotion
• Prevention and control

Acknowledgements

The authors thank the study participants and other contributors to this study including but not limited to Elizabeth Crowley, Raahil Patel, Clairee Peterson, Katlyn Dady, Mate Fabian, Rejine Varughese, and Shivani Trivedi who helped recruit, test, and coordinate study participants and with data entry assistance.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Funding was provided by the USF Health Byrd Alzheimer’s Institute at the University of South Florida. CogState Ltd. gave us free access to the program, and collected and transformed all data, which were then made freely available to the authors. Cogstate researchers were not involved in data analysis or any stage of manuscript preparation.