TY - JOUR
T1 - Assessment of Social Behavior Using a Passive Monitoring App in Cognitively Normal and Cognitively Impaired Older Adults
T2 - Observational Study
AU - Muurling, Marijn
AU - Reus, Lianne M.
AU - de Boer, Casper
AU - Wessels, Sterre C.
AU - Jagesar, Raj R.
AU - Vorstman, Jacob A. S.
AU - Kas, Martien J. H.
AU - Visser, Pieter Jelle
N1 - Funding Information: JASV serves as a consultant for NoBias Therapeutics Inc. MJHK received (unrelated) research funding from Novartis during the conduct of the study. The other authors do not report any declarations of interests. Funding Information: The PRISM project [32] has received funding under grant 115916 from the Innovative Medicines Initiative 2 Joint Undertaking (IMI JU). This joint undertaking receives support from the European Union’s Horizon 2020 Research and Innovation Program and the European Federation of Pharmaceutical Industries and Associations (EFPIA). This publication reflects only the authors' views and neither IMI JU nor EFPIA nor the European Commission are liable for any use that may be made of the information contained therein. Participant recruitment was accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies [22]. Hersenonderzoek.nl is funded by grant 73305095003 from the ZonMw-Memorabel, a project in the context of the Dutch Deltaplan Dementie, the Alzheimer‘s Society in the Netherlands, and Brain Foundation Netherlands. Publisher Copyright: ©Marijn Muurling, Lianne M Reus, Casper de Boer, Sterre C Wessels, Raj R Jagesar, Jacob A S Vorstman, Martien J H Kas, Pieter Jelle Visser.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - 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 apps, which measure social behavior passively and objectively. Objective: This study uses the remote monitoring smartphone app Behapp to assess social behavior, and aims to investigate (1) the association between social behavior, demographic characteristics, and neuropsychiatric symptoms in cognitively normal (CN) 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 outcomes and neuropsychiatric symptoms. Methods: CN, subjective cognitive decline (SCD), and CI older adults installed the Behapp app on their own Android smartphone for 7 to 42 days. CI participants had a clinical diagnosis of mild cognitive impairment (MCI) or Alzheimer-type dementia. The app continuously measured communication events, app use and location. Neuropsychiatric Inventory (NPI) total scores were available for 20 SCD and 22 CI participants. Linear models were used to assess group differences on Behapp outcomes and to assess the association of Behapp outcomes with the NPI. Results: We included CN (n=209), SCD (n=55) and CI (n=22) participants. Older cognitively normal participants called less frequently and made less use of apps (P<.05). No sex effects were found. Compared to the CN and SCD groups, CI individuals called less unique contacts (β=–0.7 [SE 0.29], P=.049) and contacted the same contacts relatively more often (β=0.8 [SE 0.25], P=.004). They also made less use of apps (β=–0.83 [SE 0.25], P=.004). Higher total NPI scores were associated with further traveling (β=0.042 [SE 0.015], P=.03). Conclusions: CI individuals show reduced social activity, especially those activities that are related to repeated and unique behavior, as measured by the smartphone app Behapp. Neuropsychiatric symptoms seemed only marginally associated with social behavior as measured with Behapp. This research shows that the Behapp app is able to objectively and passively measure altered social behavior in a cognitively impaired population.
AB - 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 apps, which measure social behavior passively and objectively. Objective: This study uses the remote monitoring smartphone app Behapp to assess social behavior, and aims to investigate (1) the association between social behavior, demographic characteristics, and neuropsychiatric symptoms in cognitively normal (CN) 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 outcomes and neuropsychiatric symptoms. Methods: CN, subjective cognitive decline (SCD), and CI older adults installed the Behapp app on their own Android smartphone for 7 to 42 days. CI participants had a clinical diagnosis of mild cognitive impairment (MCI) or Alzheimer-type dementia. The app continuously measured communication events, app use and location. Neuropsychiatric Inventory (NPI) total scores were available for 20 SCD and 22 CI participants. Linear models were used to assess group differences on Behapp outcomes and to assess the association of Behapp outcomes with the NPI. Results: We included CN (n=209), SCD (n=55) and CI (n=22) participants. Older cognitively normal participants called less frequently and made less use of apps (P<.05). No sex effects were found. Compared to the CN and SCD groups, CI individuals called less unique contacts (β=–0.7 [SE 0.29], P=.049) and contacted the same contacts relatively more often (β=0.8 [SE 0.25], P=.004). They also made less use of apps (β=–0.83 [SE 0.25], P=.004). Higher total NPI scores were associated with further traveling (β=0.042 [SE 0.015], P=.03). Conclusions: CI individuals show reduced social activity, especially those activities that are related to repeated and unique behavior, as measured by the smartphone app Behapp. Neuropsychiatric symptoms seemed only marginally associated with social behavior as measured with Behapp. This research shows that the Behapp app is able to objectively and passively measure altered social behavior in a cognitively impaired population.
KW - cognitive
KW - cognitive impairment
KW - dementia
KW - mHealth
KW - mental health
KW - mobile app
KW - passive monitoring
KW - smartphone app
KW - social behavior
KW - social withdrawal
KW - well-being
UR - http://www.scopus.com/inward/record.url?scp=85130624339&partnerID=8YFLogxK
U2 - https://doi.org/10.2196/33856
DO - https://doi.org/10.2196/33856
M3 - Article
C2 - 35594063
SN - 2561-7605
VL - 5
JO - JMIR Aging
JF - JMIR Aging
IS - 2
M1 - e33856
ER -