Journal Article

DZNE-2026-01126

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Detection of Age-Related Cognitive Decline Over Short Time Frames Using Digital Multiday Learning Assessments: Longitudinal Study.

Blotenberg, I. (First author)DZNE* ; Kim, H. ; Soberanes, D. ; Dubbelman, M. A. ; Minto, L. R. ; Udeogu, O. J. ; Lubbat, V. ; Buckley, R. F. ; Marshall, G. A. ; Johnson, K. A. ; Rentz, D. M. ; Sperling, R. A. ; Papp, K. V. ; Amariglio, R. E.

2026
JMIR Publications Inc. Toronto, ON

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Please use a persistent id in citations: doi:10.2196/100917

Abstract: High-resolution digital cognitive tools administered at frequent intervals enable the study of age-related cognitive change at a previously unattainable level of granularity. Computational modeling further enables the simultaneous examination of multiple aspects of cognitive performance.The objective of this study was to examine whether repeated digital multiday learning assessments can detect age-related cognitive decline over short time frames in cognitively unimpaired older adults and to quantify age-related differences in process-based cognitive markers derived from computational modeling.A total of 209 cognitively unimpaired older adults (mean age 73.6, SD 8.2 years; n=136, 65.1% female) from the Harvard Aging Brain Study and affiliated studies were administered the Boston Remote Assessment for Neurocognitive Health, which includes the face-name task, a paired associative learning task. Daily median response times for correct responses were used as the primary outcome. A new version of the face-name task was administered across up to 4 testing intervals over a mean of 2.8 (SD 0.4) years. Using computational modeling, we estimated longitudinal changes in peak performance, a practice-adjusted marker of an individual's best expected response time, as an indicator of age-related cognitive decline. We further examined age-related differences in peak performance, stability (within-person variability), learning within and across testing intervals, and between-interval forgetting, with embedded linear regressions for age, sex, years of education, and device type.Peak performance slowed by 0.04 seconds per year (95% credible interval 0.02-0.06; approximately 2% per year), indicating age-related cognitive decline. Higher age (+1-SD) was associated with slower peak performance (+0.19 seconds, 95% credible interval 0.12-0.26), steeper annual slowing in peak performance (+0.036 seconds per year), greater within-person variability (+0.043 seconds), reduced learning across testing intervals, and more forgetting.Our findings indicate that a digital multiday learning paradigm combined with computational modeling of response times sensitively detects age-related cognitive decline over short timescales (<3 years), which are difficult to capture in conventional study designs relying on infrequent assessments. In addition, this approach identifies specific process-based cognitive markers associated with aging, including slower performance, reduced stability, and diminished learning across testing intervals.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Longitudinal Studies (MeSH) ; Aged (MeSH) ; Male (MeSH) ; Cognitive Dysfunction: diagnosis (MeSH) ; Neuropsychological Tests (MeSH) ; Aging: psychology (MeSH) ; Aged, 80 and over (MeSH) ; Time Factors (MeSH) ; Alzheimer disease ; associative memory ; cognitive aging ; computational modeling ; digital biomarkers ; digital cognitive assessment ; learning ; longitudinal study ; mobile health ; older adults ; remote assessment ; response time

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Contributing Institute(s):

1. Interventional Health Care Research (IHCR) (AG Thyrian)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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Database coverage:
; ; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; DOAJ Seal ; Emerging Sources Citation Index ; Fees ; IF < 5 ; JCR ; SCOPUS ; Web of Science Core Collection

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