BACKGROUND:
Digital health technologies offer promising solutions for remote cognitive assessment in Frontotemporal Dementia (FTD). As part of the FTD Prevention Initiative, we compared two digital tools: the Genetic FTD Initiative (GENFI) Ignite iPad app (UCL) and the ALLFTD smartphone app (UCSF). We aimed to compare executive function measures across both platforms to validate these tools and identify the most suitable approach for early detection of cognitive change in FTD.
METHODS:
47 presymptomatic participants (mean age = 49.0 ± 1.8 years; 22 males) from UCL and UCSF completed both apps within four weeks. Each assessed executive function using analogous tasks: Stroop Ink Naming Test (inhibitory control), Wisconsin Card Sorting Test (set-shifting), Flanker Test (inhibitory control), and N-Back Test (working memory). Pearson correlations compared performance across platforms. Participants provided usability and feasibility feedback via online survey.
RESULTS:
Performance was significantly correlated across apps for Stroop (r = 0.67, p < 0.001), Wisconsin Card Sorting (r = 0.54, p < 0.001), Flanker (r = 0.63, p < 0.001), and N-Back tests (r = 0.33, p = 0.035). Participants rated both apps favorably, with no clear preference between smartphones (46.2%) and tablets (46.2%). Regarding usability, 23% reported the ALLFTD screen as somewhat small, while all found the Ignite screen satisfactory or ideal. However, 15% found Ignite sessions too long compared to 38% for ALLFTD, suggesting differences in perceived task burden.
CONCLUSION:
These findings support the validity and feasibility of digital executive function assessments across independent platforms. Comparable performance between Ignite and ALLFTD indicates that remote cognitive testing can reliably capture FTD-relevant measures. Both tools proved practical and acceptable for at-home use, though screen size remains a consideration. Session duration is already being adjusted to improve usability. Ongoing work will further optimize and align digital tools for large-scale remote FTD trials and monitoring.