Wearable Technology for High-Frequency Cognitive and Mood Assessment in Major Depressive Disorder: Longitudinal Observational Study

Francesca Cormack; Maggie McCue; Nick Taptiklis; Caroline Skirrow; Emilie Glazer; Elli Panagopoulos; Tempest A van Schaik; Ben Fehnert; James King; Jennifer H Barnett

doi:10.2196/12814

Wearable Technology for High-Frequency Cognitive and Mood Assessment in Major Depressive Disorder: Longitudinal Observational Study

JMIR Ment Health. 2019 Nov 18;6(11):e12814. doi: 10.2196/12814.

Authors

Francesca Cormack^{1

2}, Maggie McCue³, Nick Taptiklis^{1

2}, Caroline Skirrow^{1

4}, Emilie Glazer^{2

5}, Elli Panagopoulos^{2

5}, Tempest A van Schaik^{2

5}, Ben Fehnert^{2

5}, James King^{2

5}, Jennifer H Barnett^{1

2

6}

Affiliations

¹ Cambridge Cognition, Cambridge, United Kingdom.
² Cognition Kit, Cambridge, United Kingdom.
³ Takeda Pharmaceuticals USA, Deerfield, IL, United States.
⁴ School of Psychological Science, University of Bristol, Bristol, United Kingdom.
⁵ Ctrl Group, London, United Kingdom.
⁶ Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.

PMID: 31738172
PMCID: PMC6887827
DOI: 10.2196/12814

Abstract

Background: Cognitive symptoms are common in major depressive disorder and may help to identify patients who need treatment or who are not experiencing adequate treatment response. Digital tools providing real-time data assessing cognitive function could help support patient treatment and remediation of cognitive and mood symptoms.

Objective: The aim of this study was to examine feasibility and validity of a wearable high-frequency cognitive and mood assessment app over 6 weeks, corresponding to when antidepressant pharmacotherapy begins to show efficacy.

Methods: A total of 30 patients (aged 19-63 years; 19 women) with mild-to-moderate depression participated in the study. The new Cognition Kit app was delivered via the Apple Watch, providing a high-resolution touch screen display for task presentation and logging responses. Cognition was assessed by the n-back task up to 3 times daily and depressed mood by 3 short questions once daily. Adherence was defined as participants completing at least 1 assessment daily. Selected tests sensitive to depression from the Cambridge Neuropsychological Test Automated Battery and validated questionnaires of depression symptom severity were administered on 3 occasions (weeks 1, 3, and 6). Exploratory analyses examined the relationship between mood and cognitive measures acquired in low- and high-frequency assessment.

Results: Adherence was excellent for mood and cognitive assessments (95% and 96%, respectively), did not deteriorate over time, and was not influenced by depression symptom severity or cognitive function at study onset. Analyses examining the relationship between high-frequency cognitive and mood assessment and validated measures showed good correspondence. Daily mood assessments correlated moderately with validated depression questionnaires (r=0.45-0.69 for total daily mood score), and daily cognitive assessments correlated moderately with validated cognitive tests sensitive to depression (r=0.37-0.50 for mean n-back).

Conclusions: This study supports the feasibility and validity of high-frequency assessment of cognition and mood using wearable devices over an extended period in patients with major depressive disorder.

Keywords: cognition; depression; digital biomarkers; digital phenotyping; ecological momentary assessment; mHealth; mobile apps; mobile health; mood.

©Francesca Cormack, Maggie McCue, Nick Taptiklis, Caroline Skirrow, Emilie Glazer, Elli Panagopoulos, Tempest A van Schaik, Ben Fehnert, James King, Jennifer H Barnett. Originally published in JMIR Mental Health (http://mental.jmir.org), 18.11.2019.