JMIR Publications

ABSTRACT

Background:

Mobile cognitive testing is growing in popularity given the numerous advantages over traditional cognitive testing; however, there is a notable lack of comprehensive normative data available for these assessment tools.

Objective:

The aims of this study were to characterize performance for a suite of mobile cognitive tests from the NeuroUX platform in a sample of community-based adults across the lifespan.

Methods:

Three hundred and ninety-four English-speaking, U.S. residents (aged 20-79; 50% female; 70% White) were recruited. Participants completed four out of eight NeuroUX cognitive tests and a brief EMA survey once daily on their smartphones for 10 consecutive days; each test was administered 5 times over the testing period. The tests tapped the domains of executive functions, processing speed, reaction time, recognition memory, and working memory. Participants also completed a post-study usability feedback survey. We examined alternate form test-retest reliability, practice effects, and associations between scores (averages and intraindividual variability) and demographics, as well as test-taking context (i.e., phone type, at home vs. not at home, and alone vs. not alone).

Results:

Forty-six percent of participants were iOS users and 54% were Android users. Five test scores showed good to excellent test-retest reliability (ICCs > 0.76). Statistically significant practice effects (i.e., improvements in performance) were observed for four tests. Older age associated with worse performance on most of the tests, and greater within-person variability for nearly all reaction time scores. Relationships with other demographic characteristics and phone type were also observed. Being home (vs. not at home) was associated with better performance on tests of processing speed, but not on other tests. Being alone (vs. not alone) was associated with better performance on tests of recognition and working memory. Post-study feedback indicated that participants found NeuroUX easy to learn and use, an enjoyable experience, and an app that would be helpful in understanding their thinking skills. Only 4% (n=16) endorsed privacy concerns, and 78% (n=293) reported they would be willing to their results with their healthcare provider. Older age (but not other demographics) was associated with finding the tests more challenging.

Conclusions:

This study fills a critical gap in the existing literature by providing normative data derived from brief, repeated, and self-administered mobile cognitive tests. We characterized features that are particularly important for interpretation of performance in the repeated testing format, including test-retest reliability and practice effects, as well as features that are important to consider in remote, smartphone-based testing contexts, including smartphone software type and test-taking context. These data enhance the understanding and application of mobile cognitive testing, paving the way for improved clinical decision-making, personalized interventions, and advancements in cognitive research.