Frontotemporal dementia (FTD) affects 10-20% of the more than 55 million people worldwide with dementia, resulting from damage to nerve cells in the frontal and temporal areas of the brain. This condition can cause negative changes in behavior, language skills, and movement functions, with no specific treatment currently available. To address barriers in FTD clinical trials, researchers at the University of California, San Francisco have developed a smartphone app featuring cognitive tests to accurately detect early signs of FTD, especially in individuals with a family history of the condition but no symptoms yet. The app could potentially replace in-person visits and help in monitoring disease progression.
The app includes a comprehensive battery of tests measuring various features of FTD such as speech, movement changes, behavior, and cognitive functioning. Tests of executive functioning, a cognitive skill often affected in FTD, were found to differentiate patients with FTD from controls and were sensitive to early disease stages. Researchers tested the app on 360 study participants, demonstrating the cognitive tests’ reliability compared to standard measures and their ability to detect dementia accurately. Poor performance on the tests was also associated with more brain volume loss, suggesting the tests’ relevance to the disease’s biology.
The mobile app is not intended for general public use but rather as a tool for accurately measuring cognition in diagnosed FTD participants. It is envisioned to accelerate advancements in observational research studies and clinical trials by screening eligible patients and deploying outcome assessments in decentralized trials. While digital neuropsychological assessments have their advantages, neuropsychologist Karen D. Sullivan raised concerns about over-reliance on brief computerized assessments in dementia, emphasizing the need for qualitative data and comprehensive neuropsychological test batteries.
Sullivan suggested that smartphone apps like the one developed could serve as one tool in a larger assessment toolbelt but should not replace human-to-human assessments and comprehensive neuropsychological evaluations. She highlighted the importance of interpreting cognitive data in conjunction with various factors that impact test results, such as problem-solving approaches, emotional responses, and daily functioning. Sullivan called for more patient experience studies and concurrent validity analysis to validate the efficacy of cognitive test scores within a broader context.
Overall, the smartphone app featuring cognitive tests for early FTD detection shows promise in addressing barriers in clinical trials and monitoring disease progression. While it offers a scalable and efficient tool for cognitive assessment, researchers and healthcare professionals continue to emphasize the need for comprehensive evaluations and human involvement in interpreting cognitive data. With further validation and development, these digital tools could complement traditional assessments and support advancements in understanding and treating FTD.
