@Article{info:doi/10.2196/67298,
author="Hooyman, Andrew
and Huentelman, Matt J
and De Both, Matt
and Ryan, Lee
and Duff, Kevin
and Schaefer, Sydney Y",
title="Relationship Between Within-Session Digital Motor Skill Acquisition and Alzheimer Disease Risk Factors Among the MindCrowd Cohort: Cross-Sectional Descriptive Study",
journal="JMIR Aging",
year="2025",
month="Apr",
day="24",
volume="8",
pages="e67298",
keywords="digital health technology; web-based assessment; aging; APOE; motor skills; sensitivity; risk factors; adults; older adults",
abstract="Background: Previous research has shown that in-lab motor skill acquisition (supervised by an experimenter) is sensitive to biomarkers of Alzheimer disease (AD). However, remote unsupervised screening of AD risk through a skill-based task via the web has the potential to sample a wider and more diverse pool of individuals at scale. Objective: The purpose of this study was to examine a web-based motor skill game (``Super G'') and its sensitivity to risk factors of AD (eg, age, sex, APOE $\epsilon$4 carrier status, and verbal learning deficits). Methods: Emails were sent to 662 previous MindCrowd participants who had agreed to be contacted for future research and have their APOE $\epsilon$4 carrier status recorded and those who were at least 45 years of age or older. Participants who chose to participate were redirected to the Super G site where they completed the Super G task using their personal computer remotely and unsupervised. Once completed, different Super G variables were derived. Linear and logistic multivariable regression was used to examine the relationship between available AD risk factors (age, sex, APOE $\epsilon$4 carrier status, and verbal learning) and distinct Super G performance metrics. Results: Fifty-four participants ({\textasciitilde}8{\%} response rate) from the MindCrowd web-based cohort (mean age of 62.39 years; 39 females; and 23 APOE $\epsilon$4 carriers) completed 75 trials of Super G. Results show that Super G performance was significantly associated with each of the targeted risk factors. Specifically, slower Super G response time was associated with being an APOE $\epsilon$4 carrier (odds ratio 0.12, 95{\%} CI 0.02-0.44; P=.006), greater Super G time in target (TinT) was associated with being male (odds ratio 32.03, 95{\%} CI 3.74-1192,61; P=.01), and lower Super G TinT was associated with greater age ($\beta$ −3.97, 95{\%} CI −6.64 to −1.30; P=.005). Furthermore, a sex-by-TinT interaction demonstrated a differential relationship between Super G TinT and verbal learning depending on sex ($\beta$male:TinT 6.77, 95{\%} CI 0.34-13.19; P=.04). Conclusions: This experiment demonstrated that this web-based game, Super G, has the potential to be a skill-based digital biomarker for screening of AD risk on a large scale with relatively limited resources. ",
issn="2561-7605",
doi="10.2196/67298",
url="https://aging.jmir.org/2025/1/e67298",
url="https://doi.org/10.2196/67298"
}