JMIR Publications

ABSTRACT

Background:

In people with cognitive impairment, loss of social interactions has a major impact on well-being. Therefore, patients would benefit from early detection of symptoms of social withdrawal. Current measurement techniques such as questionnaires are subjective and rely on recall, in contradiction to smartphone applications, which measure social behavior passively and objectively.

Objective:

This study uses the remote monitoring smartphone application BEHAPP to assess social behavior, and aims to investigate (1) the association between social behavior, demographic characteristics, and neuropsychiatric symptoms in cognitively normal older adults, and (2) if social behavior is altered in cognitively impaired (CI) participants. In addition, we explored in a subset of individuals the association between BEHAPP outcome and neuropsychiatric symptoms.

Methods:

Cognitively normal (CN, n=209), subjective cognitive decline (SCD, n=55) and CI (n=22) older adults installed the BEHAPP app on their own Android smartphone for 7-42 days. CI participants had a clinical diagnosis of mild cognitive impairment or AD-type dementia. The app continuously measured communication events, application usage and location. Neuropsychiatric Inventory (NPI) total scores were available from 20 SCD and 22 CI participants.

Results:

We found that older cognitively healthy participants called less frequently and made less use of apps. No sex effects were found. Compared to the CN and SCD groups, CI individuals called less unique contacts and contacted the same contacts relatively more often. They also made less use of apps. Higher total NPI scores were associated with further travelling.

Conclusions:

CI individuals show reduced social activity, especially those activities that are related to repeated and unique behavior, as measured by the smartphone application BEHAPP. Neuropsychiatric symptoms seemed only marginally associated with social behavior as measured with BEHAPP. This research shows that the BEHAPP application is able to objectively and passively measure altered social behavior in an cognitively impaired population.