Apps & Smartphones Detecting Dementia Better Than Standard Tests

Apps & Smartphones Detecting Dementia Better Than Standard Tests

Apps & Smartphones Detecting Dementia Better Than Standard Tests

A recent study found an innovative smartphone application (app) to be highly accurate in detecting a rare form of dementia. The study, published in the medical journal JAMA Network Open, suggests that the app can identify frontotemporal dementia (FTD) before symptoms appear in people at high risk of developing the brain disorder.

Moreover, the tests done through the app were as sensitive as the “gold-standard” neuropsychological evaluations done in a clinic, according to researchers at the University of California, San Francisco (UCSF) who conducted the study.

The study’s authors noted that research on frontotemporal dementia (FTD) has been challenging because of problems in detecting the brain disease early and difficulty monitoring how people respond to treatments, which are most effective in the initial stages of the disorder.

According to the National Institute on Aging (NIA), FTD is a rare form of dementia caused by damage to neurons in the frontal and temporal lobes of the brain. This type of dementia affects behavior, cognition, language, and motor functioning and is particularly prevalent among individuals under the age of 60.

The UCSF research team noted that FTD is the number one cause of dementia in patients under 60, with up to 30 percent of cases attributed to genetics. The investigators explained that FTD has three main variants, and the most common one causes dramatic personality shifts, which can manifest as a lack of empathy, apathy, impulsivity, compulsive eating, and socially and sexually inappropriate behavior. The second variant affects movement, and the third impacts speech, language, and comprehension, which is the variant that actor Bruce Willis is reported to have.

Willis, now 69, was diagnosed with FTD in 2023, a year after he announced his retirement from acting. TV talk show host Wendy Williams, now 59, was also diagnosed with FTD in 2023 after undergoing a battery of medical tests.

FTD is difficult to diagnose because some symptoms are similar to those of other conditions, according to the NIA. What makes it even more confusing is a person can have FTD along with another type of dementia, such as Alzheimer’s disease, the most common type of dementia.

These factors can make it difficult to recruit participants for clinical trials, the UCSF researchers said.

To diagnose FTD, the NIA says that a doctor may:

  • Perform an exam and ask about symptoms
  • Look at personal and family medical history
  • Use laboratory tests to help rule out other conditions
  • Order genetic testing
  • Conduct tests to assess memory, thinking, language skills, and physical functioning
  • Order imaging of the brain

“Most FTD patients are diagnosed relatively late in the disease, because they are young, and their symptoms are mistaken for psychiatric disorders,” Dr. Adam Boxer, the study’s senior author and an endowed professor in memory and aging at the UCSF Department of Neurology, said in a news release. “We’ve heard from families that they often suspect their loved one has FTD long before a physician agrees that is the diagnosis.”

FTD Symptoms

The NIA notes that family members and friends often misunderstand FTD symptoms because the behavioral changes in people can be mistaken as a psychiatric disorder.

Some of the FTD symptoms include:

  • Unusual behaviors
  • Emotional problems
  • Trouble communicating
  • Difficulty with work
  • Difficulty with walking

The NIA says it is important to understand that people with FTD cannot control their behaviors and other symptoms and lack any awareness of their illness. In addition, people may have just one symptom in the early stages of FTD, according to the NIA.

Other symptoms appear as the disease progresses and affect more parts of the brain. Like other dementias, FTD is a progressive condition that worsens over time.

The FTD Study

As part of their study, the UCSF research team tracked 360 participants who were enrolled in ongoing studies at 18 centers of a North American Frontotemporal Lobar Degeneration research consortium. The average age of the participants was 54 years old. Of the participants, 60 percent did not have FTD or were gene carriers who had not yet developed symptoms, 20 percent had early signs of the disease, and 21 percent had symptoms.

Dr. Boxer and Adam Staffaroni, the study’s first author, developed the app with Datacubed Health, a Pennsylvania-based software company. The tests included executive functions such as planning and prioritizing, filtering distractions, and controlling impulses. In FTD, the part of the brain responsible for executive functioning shrinks as the disease progresses, according to the researchers.

Using the smartphone app, participants performed executive functioning tasks and an associative memory task during three 25—to 35-minute assessment sessions over 11 days.

“We developed the capability to record speech while participants engaged with several different tests,” Staffaroni, a clinical neuropsychologist and associate professor in the UCSF Department of Neurology and the Weill Institute for Neurosciences, said in a news release. “We also created tests of walking, balance, and slowed  movements, as well as different aspects of language.”

According to the study, the smartphone tests distinguished between participants with dementia and those without symptoms with a 93 percent accuracy rate.

Although there are currently no plans to make the app available to the public, the UCSF researchers believe the new mobile technology can help in the more than 30 FTD clinical trials that are underway or in the planning stages.

“A major barrier has been a lack of outcome measures that can be easily collected and are sensitive to treatment effects at early stages of the disease,” said Staffaroni. “We hope that smartphone assessments will facilitate new trials of promising therapies.”

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