Francesca Cormack
Chief Scientist, Cambridge Cognition
Virtual clinical trials (VCTs) are an exciting development in cognitive research. Certain tests needed for clinical or academic studies are taken out of the clinic and brought into participants’ homes.
Digital cognitive assessments are changing how we conduct Alzheimer’s studies. Cognitive tests are used in clinical and research studies to understand a participant’s brain function.
Making clinical trials virtual
Digital cognitive tests can be completed at home on tablets, computers and even smartphones. They can be taken daily or weekly, delivering a more realistic picture of changes over time.
Digital cognitive assessments have been available for over 30 years and are now widely used in healthcare research. However, at first, there was reluctance to adopt them in clinical studies over concerns that older people may prefer a paper version of the test. However, when an Australian study compared digital with paper methods of assessing cognitive health in participants aged 55–96 years, they reported that 54.3% of participants preferred the computerised cognitive assessments.
Important tool for Alzheimer’s research
Drugs targeting Alzheimer’s are thought to be most effective early in the course of the disease when symptoms are very subtle or even absent in standard assessments. Therefore, enrolling people in the earliest stages of Alzheimer’s in trials is a priority to help find a cure. This is where digital assessments offer promise, as they can detect and monitor the earliest stages of the disease. An example is CANTABTM Paired Associates Learning (PAL), which tests episodic memory. In PAL, different images flash up in boxes on the screen. One image then appears in the middle of the screen, and the participant must select the box that conceals the same shape. Research has shown that PAL activates areas of the brain involved early in the course of Alzheimer’s disease.
At-home testing enables greater accessibility as people who find leaving home difficult can still participate in this important aspect of the research process.
Another exciting, new development is the use of voice to understand early cognitive changes. Voice analysis technology such as NeuroVocalixTM uses machine learning techniques to identify subtle changes in speech which may indicate early cognitive decline.
Greater patient benefit
The most exciting thing about virtual clinical trials is the benefit to patients and their carers. At-home testing enables greater accessibility as people who find leaving home difficult can still participate in this important aspect of the research process. It’s wonderful to see the clinical and research world embracing this opportunity for people wishing to participate in Alzheimer’s studies.
