Journal of Alzheimer's Disease · Nov 12, 2024
Detecting functional impairment with the Digital Clock and Recall
By Ciesla M, Toro-Serey C, Jannati A et al.
BACKGROUND: Distinguishing between mild cognitive impairment (MCI) and early dementia requires both neuropsychological and functional assessment that often relies on caregivers' insights. Contacting a patient's caregiver can be time-consuming in a physician's already-filled workday. OBJECTIVE: To assess the utility of a brief, machine learning (ML)-enabled digital cognitive assessment, the Digital Clock and Recall (DCR), for detecting functional dependence. METHODS: We evaluated whether the DCR can help identify individuals at risk of functional deficits as measured by the informant-rated Functional Activities Questionnaire (FAQ) in older individuals including cognitively unimpaired, MCI, and dementia likely due to Alzheimer's disease. RESULTS: The DCR scaled well with FAQ scores, and ML classifiers trained on multimodal DCR features demonstrated strong performance in predicting functional impairment on a held-out test set. Differences in FAQ scores between DCR-predicted classes were comparable across key demographic groups. CONCLUSIONS: The DCR can streamline the clinical decision-making, triage, and intervention planning associated with functional impairment in primary care.