Longitudinal online weekly reports of non-cognitive symptoms and events can differentiate incident mild cognitive impairment from stable cognitively healthy older adults

BackgroundChanges in noncognitive symptoms such as mood, loneliness, pain, and need for assistance may be potential early markers of mild cognitive impairment (MCI) and Alzheimer's disease and related disorders (ADRD) in older adults. These changes can be subtle and fluctuating, and thus easily missed during intermittent clinic visits.ObjectiveTo assess the relationship of changes in self-perceived internal states and needs to the development of cognitive impairment over time.MethodsWeekly online reports of health-related activities and mood in relation to MCI were assessed for up to 2.9 years in older adults participating in the Oregon Life Laboratory, a study using home-based unobtrusive remote sensing of physical, cognitive, behavioral, physiological, and health-related activities.ResultsThe analytic sample included 129 cognitively healthy volunteers followed for a mean of 2.9 ± 1.2 years. Mean age was 83.5 ± 7.8 years, mean education was 15.7 ± 2.7 years, and 76% were female. Twenty-two participants (17%) developed MCI or dementia while 107 remained cognitively healthy. Over time, more of the participants destined to develop MCI reported: (1) loneliness (p = 0.049), (2) low mood (p = 0.08), (3) pain intensity (p = 0.03) and pain interference (p = 0.01), and (4) needing in-home assistance (p = 0.02) than those remaining cognitively healthy. Baseline scores assessing these symptoms were not clinically concerning, predictive of MCI, nor significantly different between groups.ConclusionsLongitudinal home-based online assessment of non-cognitive aspects of function or internal states (loneliness, mood, pain, needing more assistance) can be sensitive early indicators of changes in brain function leading to MCI and ADRD.