Currently submitted to: Journal of Medical Internet Research
Date Submitted: Aug 27, 2026
Open Peer Review Period: Aug 28, 2026 - Oct 23, 2026
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Validation of a Digital Lifestyle Assessment Tool Against Established Instruments and Its Association with Cognitive Performance
ABSTRACT
Background:
The Smart Tracker is a brief online questionnaire measuring six lifestyle domains relevant to brain health, including Diet, Exercise, Cognitive Engagement, Social Engagement, Emotional Well-being (sleep and stress/depression), and Physical Well-being.
Objective:
Our primary objective evaluated criterion validity of the Smart Tracker tool against established instruments measuring similar constructs. We additionally assessed the Smart Tracker’s association with objective cognitive performance in a sample subset who completed the Cogniciti Brain Health Assessment (BHA).
Methods:
The validation sample included 570 adults (mean age 71.3, SD 9.5 years, age range 22-97; 68.9% [393/570] female) who completed the Smart Tracker alongside five validated instruments: 1) the Eating Pattern Self-Assessment (EPSA; dietary quality), 2) the Short Form International Physical Activity Questionnaire (IPAQ; exercise), 3) the Pittsburgh Sleep Quality Index (PSQI; sleep quality), 4) the Depression Anxiety Stress Scale (DASS-21 short form; psychological wellbeing), and 5) the Cognitive Reserve Index Questionnaire (CRIq; cognitive and social engagement). A nested sub-sample (n=200) additionally completed the BHA. Criterion validity was assessed using Spearman rank correlation coefficients (ρ values) with Benjamini-Hochberg false discovery rate correction to assess the strength and direction of association between each Smart Tracker domain and the corresponding validated instruments. We used a linear regression to assess the association between the Smart Tracker and BHA.
Results:
The Smart Tracker questionnaire domains showed significant moderate to high correlations with the comparator validated questionnaires assessing similar constructs. Spearman correlations were significantly positive for domains related to Diet (ρ=0.62), Exercise (ρ=0.53), Cognitive and Social Engagement (ρ=0.33), and negative in the expected direction for Emotional Well-Being related to sleep (ρ=-0.65), Stress and Depression (ρ=-0.70; all P<.001). The Smart Tracker Overall score significantly predicted BHA age-normed performance in the cognitive sub-sample (Y = 36.30·X + 47.80; R²=.043; F(1,198)=8.9, P=.003) where each 10-point increase in the Smart Tracker overall score corresponded to approximately 3.6 BHA percentile points. Meaningful ceiling effects were observed for the Smart Tracker Sleep (24.9%) and Stress/Depression (31.8%) sub-scales.
Conclusions:
The Smart Tracker demonstrates acceptable criterion validity across each of the lifestyle domains it measures and shows a modest but significant association with objective age-adjusted cognitive performance.
Citation
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