Poster Session 11 Program Schedule
02/17/2024
10:45 am - 12:00 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues
Final Abstract #107
The “Whos” and “Wheres”: The Influence of Social Context on Remote Cognitive Assessments
Matthew Welhaf, Washington University in St. Louis, St. Louis, United States
Hannah Wilks, Washington University in St. Louis, St. Louis, United States
Andrew Aschenbrenner, Washington University in St. Louis, St. Louis, United States
John Morris, Washington University in St. Louis, St. Louis, United States
Jason Hassenstab, Washington University in St. Louis, St. Louis, United States
Category: Dementia (Alzheimer's Disease)
Keyword 1: cognitive functioning
Keyword 2: assessment
Keyword 3: aging disorders
Objective:
The increasing feasibility of using mobile cognitive assessments in older adults raises concerns about the influence of testing environments on cognitive performance. Given the portability of smartphones, mobile cognitive assessments can be completed in different locations and different social contexts which could result in more distractions and more variability in performance. The main goal of the current study was to examine how location and social surroundings impact mobile cognitive test performance and if these contextual factors differentially impact performance more for older adults who are showing clinical signs of very early Alzheimer’s disease (AD).
Participants and Methods:
Three hundred and sixty participants enrolled in ongoing studies at the Knight Alzheimer’s Disease Research Center (Knight ADRC) at Washington University in St. Louis completed remote cognitive testing on the Ambulatory Research in Cognition (ARC) smartphone platform. ARC measures episodic memory, visual working memory, and processing speed up to four times per day over the course of a week. Additionally, self-reports of testing location (Location) and Social Context (who was nearby during testing) were collected at each testing session. Clinical status was assessed by expert clinicians with the Clinical Dementia Rating® (CDR®) and participants were classified as asymptomatic (i.e., CDR 0; N = 313) or symptomatic (CDR > 0; N = 47). Mixed Effect Models predicted ARC task performance at each session from CDR status and Location or Social Context, while controlling for demographic variables including age, gender, years of education, and number of sessions completed in each Location or Social Context.
Results:
Overall, participants completed most assessments at home and without anyone else nearby. CDR status and Location both predicted episodic memory performance with symptomatic status and testing away from home being associated with poorer performance. For working memory, there was only a significant effect of location, such that completing tests away from home resulted in poorer performance. There was a significant interaction between CDR Status and Location on the processing speed task: Symptomatic participants had slower processing speed than asymptomatic participants especially when tests were completed outside of their home. Social Context also predicted poorer performance on the episodic memory and working memory tasks, but not the processing speed task.
Conclusions:
It is important to consider contextual factors like location and social environments while completing remote cognitive assessments as these factors influence performance. Our results suggest that older adults typically complete remote tests in minimally distracting environments. But, when tests are completed outside of the home, cognitive performance can be worse on tests of memory and working memory. Some cognitive measures appear to be more influenced by contextual factors than others, and such influences might result in even worse performance for those with AD. While remote, unsupervised cognitive assessments appear to provide valid and reliable data overall, some caution is warranted when interpreting data collected in different locations and social contexts. This is especially true for older adults showing early signs of AD, who are more prone to distraction.
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