Smartphone tests spot cognitive decline faster than standard method

by Marcus Neitzert, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)

edited by Gaby Clark, reviewed by Robert Egan

Gaby Clark

Scientific Editor

Meet our editorial team
Behind our editorial process

Robert Egan

Associate Editor

Meet our editorial team
Behind our editorial process Editors' notes

This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

peer-reviewed publication

proofread

The GIST Add as preferred source

People with mild cognitive impairment (MCI) are at higher risk of developing dementia. Indeed, many of them experience a gradual decline in cognitive performance over time. Smartphone- or tablet-based memory tests can capture this subtle decline more quickly than conventional testing. These findings come from a study by DZNE in collaboration with university hospitals in Germany, the University of Wisconsin–Madison in the United States, and the startup neotiv.

In the researchers' view, digital tests like these could help accelerate clinical trials for new dementia drugs, particularly for Alzheimer's disease. Over the longer term, they also see potential for use in clinical routine. The results were published in the journal npj Digital Medicine and are based on data from about 200 older adults.

"Conventional methods for assessing cognitive performance are based on standardized tasks that must be completed orally or in writing—and importantly, under supervision," explains Dr. David Berron, who leads a research group at DZNE's Magdeburg site. Berron is also a co-founder of the company neotiv, whose app was used in the current study.

"By contrast, the current study involved self-administered at-home memory tests using the neotivTrials app, which allows us to collect what are known as digital biomarkers. The results show that this approach can also provide information about how cognitive performance changes over time. This subtle cognitive decline can even be detected within shorter periods, as measurements can be performed more frequently than with conventional methodology. While we did use a particular app, in my view, these results have broader implications: they provide the first evidence that cognitive decline can be assessed using remote digital tools."

The current study included a total of 202 women and men from Germany and the United States. Participants ranged in age from 52 to 85; 50 of them had MCI. People with this condition are generally still able to manage well in everyday life. However, their cognitive performance is measurably impaired.

Testing at home

Prior studies have already established that this particular mobile app, whose testing principle is based on DZNE research, can identify MCI. The current study now shows that this self-administered testing is also sensitive enough to track subtle changes in cognitive performance over time. "From a medical perspective, what matters is not only whether MCI is present, but also whether the symptoms remain stable or worsen," Berron explains.

According to Dr. Sarah Polk, first author of the current publication and a colleague of David Berron, the app's mobile approach has key advantages: "Testing can be done at home, at your own pace. All you need is a smartphone or tablet—there's no need to visit a study center or make an appointment. This makes it easy to repeat the test at short intervals with little effort."

High-frequency monitoring

In this way, changes in cognitive performance can be tracked more closely than with conventional methods, allowing effects to be detected within a relatively short period. Polk explains, "With the conventional approach, the considerable effort involved means that testing is realistically possible only once or twice a year. In contrast, our participants used the app for around seven to 12 months and tested themselves with it about every two weeks. During this period, we were already able to observe a decline in cognitive performance among people with MCI."

The reliability of such results is not a given—a new method first has to show that it truly measures what it is meant to measure. This requires a suitable benchmark. In the current study, long-term clinical data were available for every participant, gathered over an average of eight years using established procedures. The long-term trajectory derived from these data was consistent with the app-based results obtained over only a few months—providing evidence for the digital measurement's validity.

"What I found particularly impressive was that, with just a few months of app use, we were able to capture a signal that aligns with years of clinical observations. That gives us confidence that this method really measures what it is supposed to measure," Polk adds.

Shorter therapy studies, individual monitoring

"Therapy development is an obvious area of application for our digital approach—in other words, evaluating new medications for dementia," Berron says. In this context, the goal is to determine whether and how well an experimental drug can slow mental decline—ideally already at the stage of MCI, which is considered a potential precursor to dementia.

"A digital approach could help speed up clinical trials, because it could make it possible to determine whether the drug being tested has the desired effect more quickly than with conventional methods."

Looking ahead, once a larger body of data is available, this approach could be applied not only in research but also in routine clinical care, Berron surmises.

"In my view, there are two practical use cases: firstly, assessing whether cognitive abilities are developing in an age-appropriate way; and secondly, monitoring an ongoing treatment to determine whether it is having the desired effect, and to what extent. Essentially, digital assessment can facilitate individual patient monitoring."

Stages of the disease

Alzheimer's disease, the most common form of dementia, spreads gradually, progressively damaging more and more areas of the brain. The app accounts for this phenomenon: Its four subtasks, which involve memorizing images of objects and rooms or identifying differences between images, target different memory functions and therefore different brain regions. Among the participants with MCI, performance on two of these tasks was already severely impaired at the start of the study, and no further decline could be measured.

"This suggests that the associated brain regions had already been damaged to such an extent that they had reached the lower limit of their functional capacity," Berron says.

In the other two tasks, however, a gradual decline in performance over time could be measured as the disease progressed.

Even before MCI?

App-based tests, or subtasks, that no longer detect changes in individuals with MCI may nevertheless be important in even earlier disease stages, Berron suspects.

"In the earliest disease stage, subtle cognitive impairment may already be present that we simply cannot measure using conventional tests. We now aim to take a closer look at whether the digital approach might help in this regard."

Publication details

Sarah E. Polk et al, Smartphone-based detection of subtle memory decline in prodromal Alzheimer's disease, npj Digital Medicine (2026). DOI: 10.1038/s41746-026-02731-1

Journal information: npj Digital Medicine

Key medical concepts

Mild Cognitive ImpairmentAlzheimer's DiseaseBiomarkers

Clinical categories

NeurologyHealthy agingCommon illnesses & Prevention Provided by Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE) Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

Citation: Smartphone tests spot cognitive decline faster than standard method (2026, June 10) retrieved 10 June 2026 from https://medicalxpress.com/news/2026-06-smartphone-cognitive-decline-faster-standard.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.