a novel real-world study suggested.
During a smartphone-assisted scavenger hunt on a university campus, researchers observed that older adults with subjective cognitive decline (SCD) paused more frequently, likely to reorient themselves, than those without SCD. This behavior served as an identifier of individuals with SCD.
“Deficits in spatial navigation are one of the first signs of Alzheimer’s disease,” said study investigator Nadine Diersch, PhD, guest researcher with the German Center for Neurodegenerative Diseases (DZNE), Tübingen.
This study, said Diersch, provides “first evidence of how a digital footprint for early dementia-related cognitive decline might look like in real-world settings during a short (less than 30 minutes) and remotely performed wayfinding task.”
The study was published online in PLOS Digital Health.
Trouble With Orientation
A total of 72 men and women in their mid-20s to mid-60s participated in the study; 23 of the 48 older adults had SCD but still scored normally on neuropsychological assessments.
All study participants were instructed to independently find five buildings on the medical campus of the Otto-von-Guericke-University Magdeburg in Germany, guided by a smartphone app developed by the study team. Their patterns of movement were tracked by GPS.
All participants had similar knowledge of the campus, and all were experienced in using smartphones. They also practiced using the app beforehand.
In most cases, participants reached the five destinations in less than half an hour. The younger participants performed better than the older ones; on average, the younger adults walked shorter distances and generally did not use the help function on the app as often as the older ones.
In the older adults, the number of orientation stops was predictive of SCD status. The adults with SCD tended to hesitate more at intersections. A decline in executive functioning might explain this finding, Diersch said.
“Intact executive functioning is an important component of efficient navigation, for example, when switching between different navigation strategies or planning a route. However, since this was the first study on that subject, more research is needed to determine the precise contribution of different cognitive processes on digital wayfinding data,” said Diersch.
With more study, “we think that such a smartphone-assisted wayfinding task, performed in the immediate surroundings, could be used as a low-threshold screening tool — for example, to stratify subjects with regard to the need of extended cognitive and clinical diagnostics in specialized care,” she added.
‘A Game Changer’
Commenting on the research, Shaheen Lakhan, MD, PhD, neurologist and researcher based in Miami, Florida, who wasn’t involved in the research, said the findings have the potential to “revolutionize” dementia care.
“We’ve seen smartphones transform everything from banking to dating — now they’re set to reshape brain health monitoring. This ingenious digital scavenger hunt detects cognitive decline in real-world scenarios, bypassing costly, complex tests. It’s a game changer,” said Lakhan.
“Just as we track our steps and calories, we could soon track our cognitive health with a tap. This isn’t just innovation; it’s the future of dementia prevention and care unfolding on our smartphone screens. We’re not just talking about convenience. We’re talking about catching Alzheimer’s before it catches us,” he added.
The next phase, Lakhan noted, would be to develop smartphone apps as digital therapeutics, not just to detect cognitive decline but to treat or even prevent it.
“Imagine your phone not only flagging potential issues but also providing personalized brain training exercises to keep your mind sharp and resilient against dementia,” Lakhan said.
This work was funded by the Deutsche Forschungsgemeinschaft (German Research Foundation) within the Collaborative Research Center “Neural Resources of Cognition” and a DZNE Innovation-2-Application Award. Diersch is now a full-time employee of neotiv. Lakhan had no relevant disclosures.
A version of this article first appeared on Medscape.com.