# Smartphone-Based "Burst" Cognitive Assessments

> **NIH NIH P01** · WASHINGTON UNIVERSITY · 2021 · $159,554

## Abstract

Project 4 Project Summary
Project 4 will leverage the increasing popularity of smartphones to improve upon standard in-clinic cognitive
testing, providing a robust characterization of cognition in participants enrolled in the Healthy Aging and Senile
Dementia PPG. One of the most important and face-valid indicators of Alzheimer disease (AD) is a change in
cognition, but assessing cognition in-clinic has several drawbacks. First, performance is influenced by day-to-
day fluctuations in stress, fatigue, sleep patterns, and mood. Second, the testing takes place in environments
that are fundamentally different from where cognitively demanding tasks are performed in daily life. Finally, by
design, cognition is typically assessed very infrequently, usually once per year (as currently is the case in
HASD). One solution would be to increase the frequency of in-clinic testing or to complete assessments in the
natural environments in which participants use cognition such as their homes, workplaces, while traveling, etc.,
but this is impractical and burdensome, especially for older adults.
 Project 4 will provide a solution to these difficulties by taking advantage of the increasing popularity of
smartphones. Smartphone usage is climbing in every age category, and even in older adults, 50% have and
regularly use internet-enabled smartphones. In Project 4, we have designed an iOS and Android app called the
Ambulatory Research in Cognition (ARC) app that will be installed on HASD participants' personal
smartphones. If participants do not own a smartphone or have an antiquated model, we will provide a study
phone for use while enrolled. Every six months, participants will complete extremely brief (<3 minutes each)
testing sessions 4x/day over the course of one week. Tests are averaged across the week to provide a score
that captures and normalizes natural variability and dramatically increases reliability. Pilot studies show that
ARC assessments demonstrate extraordinary reliability, ranging from 0.92 to 0.99. Another advantage is the
ability to measure variability within a day, across a week, and across the 6-month intervals of assessments.
We hypothesize that ARC assessments will be more sensitive than in-clinic assessments to disease stage and
AD biomarkers and that amyloid-positive HASD participants will show more variability in cognitive performance
than amyloid-negative participants, even in the preclinical stages of disease. If successful, the increases in
sensitivity and reliability of ARC assessments will provide extraordinary statistical power to characterize
cognitive decline in observational studies of AD. In addition, ARC assessments could benefit clinical trials by
shortening trial duration and requiring fewer participants.

## Key facts

- **NIH application ID:** 10131747
- **Project number:** 5P01AG003991-38
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Jason J Hassenstab
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $159,554
- **Award type:** 5
- **Project period:** 1997-01-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10131747

## Citation

> US National Institutes of Health, RePORTER application 10131747, Smartphone-Based "Burst" Cognitive Assessments (5P01AG003991-38). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10131747. Licensed CC0.

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