Smartphone-based cognitive testing app reliably predicted, diagnosed FTLD

A smartphone-based cognitive testing application (app) was effective at predicting and diagnosing frontotemporal lobar degeneration (FTLD) in an NIA-funded study. The research results, published in JAMA Network Open, suggest the app may potentially aid in early diagnosis and remote monitoring of people living with FTLD.

FTLD is a group of neurological disorders including frontotemporal dementia and other frontotemporal disorders. Symptoms can include dramatic personality or behavior changes, impaired cognition, difficulty with speech and language, and/or impaired motor function. FTLD is rare and usually appears in people in their mid-40s to mid-60s. It is difficult to diagnose because symptoms can resemble other conditions, such as psychiatric disorders.

A research team led by scientists at the University of California, San Francisco studied 360 people over a three-year period. The participants, who had an average age of 54, were divided into three groups: healthy controls, those with an FTLD diagnosis, and those who carried a genetic variant associated with FTLD but did not yet show any symptoms.

Participants installed the app on their phones and performed tests of executive functioning - the brain's ability to plan and prioritize, tune out distractions, and control impulses - and memory tasks three times over a two-week period. The app collected a wide variety of additional data, including voice recordings, body movements, walking, balance, and different facets of language.

The mobile app successfully detected early signs of FTLD in participants who carried a genetic variant associated with the disease but had not yet developed symptoms. The self-directed tests using the mobile app proved as sensitive as similar evaluations performed in-person in clinical settings. The app was able to differentiate participants with more severe, dementia-level cases of FTLD from controls, and the app's testing results also matched up reliably with other measures of FTLD severity and related reductions in brain volume.

This study showed the potential of a smartphone-based app for the early diagnosis of FTLD and monitoring of symptoms remotely. More research is needed to validate the app in a larger, more diverse group of participants.

This research was supported in part by NIA grants AG063911, AG077557, AG62677, AG045390, AG032306, AG016976, AG058233, AG038791, AG02350, AG019724, AG062422, AG032289-11, AG077557, K23AG061253, and K24AG045333.

These activities relate to NIH's AD+ADRD Research Implementation Milestone 3.G, "FTD Basic and Clinical Research: Data and research infrastructure."

Reference: Staffaroni AM, et al. Reliability and validity of smartphone cognitive testing for frontotemporal lobar degeneration. JAMA Network Open. 2024. Epub April 1. doi:10.1001/jamanetworkopen.2024.4266.