JMIR Publications

ABSTRACT

As the global burden of dementia continues to plague our healthcare system, efficient, objective, and sensitive tools to detect neurodegenerative disease and capture meaningful changes in everyday cognition increasingly are needed. Emerging digital tools present a promising option to address many drawbacks of current approaches, with contexts of use that include early detection, risk stratification, prognosis, and outcome measurement. However, most existing studies using new digital tools have lacked conceptual models to guide hypotheses and interpretation of results. In this narrative review, we propose a neuropsychological framework for use alongside one key emerging approach – digital phenotyping. The Variability in Everyday Behavior (VIBE) model is rooted in established trends from the neuropsychological, cognitive neuroscience, and computer science literature and links patterns of intraindividual variability to everyday cognition across clinical stages from healthy to mild dementia. Based on the VIBE model, we present testable hypotheses to guide the design and interpretation of digital phenotyping studies that capture everyday cognition in vivo. We conclude with methodological considerations and future directions regarding the application of the digital phenotyping approach to improve the efficiency, accessibility, accuracy, and ecological-validity of assessment of cognition in older adults.