Mobile technologies are becoming ubiquitous in the world, changing the way we communicate and provide patient care and services. Some of the most compelling benefits of mobile technologies are in the areas of disease prevention, health management, and care delivery. For all the advances that are occurring in mobile health, its full potential for older adults is only starting to emerge. Yet, existing mobile health applications have design flaws that may limit usability by older adults. The aim of this paper is to review barriers and identify knowledge gaps where more research is needed to improve the accessibility of mobile health use in aging populations. The same observations might apply to those who are not elderly, including individuals suffering from severe mental or medical illnesses.

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Objectives: This study describes the performance of the Multilingual Naming Test (MINT) by Chinese American older adults who are monolingual Chinese speakers. An attempt was also made to identify items that could introduce bias and warrant attention in future investigation. Methods: The MINT was administered to 67 monolingual Chinese older adults as part of the standard dementia evaluation at the Alzheimer’s Disease Research Center (ADRC) at the Icahn School of Medicine at Mount Sinai (ISMMS), New York, USA. A diagnosis of normal cognition (n = 38), mild cognitive impairment (n = 12), and dementia (n = 17) was assigned to all participants at clinical consensus conferences using criterion sheets developed at the ADRC at ISMMS. Results: MINT scores were negatively correlated with age and positively correlated with education, showing sensitivity to demographic factors. One item, butterfly, showed no variations in responses across diagnostic groups. Inclusion of responses from different regions of China changed the answers from “incorrect” to “correct” on 20 items. The last five items, porthole, anvil, mortar, pestle, and axle, yielded a high nonresponse rate, with more than 70% of participants responding with “I don’t know.” Four items, funnel, witch, seesaw, and wig, were not ordered with respect to item difficulty in the Chinese language. Two items, gauge and witch, were identified as culturally biased for the monolingual group. Conclusions: Our study highlights the cultural and linguistic differences that might influence the test performance. Future studies are needed to revise the MINT using more universally recognized items of similar word frequency across different cultural and linguistic groups.

In March 2020, the novel coronavirus (COVID-19) became a global pandemic that would cause most in-person visits for clinical studies to be put on pause. Coupled with protective stay at home guidelines, clinical research at the Icahn School of Medicine at Mount Sinai Alzheimer’s Disease Research Center (ISMMS ADRC) needed to quickly adapt to remain operational and maintain our cohort of research participants. Data collected by the ISMMS ADRC as well as from other National Institute on Aging (NIA) Alzheimer Disease centers, follows the guidance of the National Alzheimer Coordinating Center (NACC). However, at the start of this pandemic, NACC had no alternative data collection mechanisms that could accommodate these safety guidelines. To stay in touch with our cohort and to ensure continued data collection under different stages of quarantine, the ISMMS ADRC redeployed their work force to continue their observational study via telehealth assessment. On the basis of this experience and that of other centers, NACC was able to create a data collection process to accommodate remote assessment in mid-August. Here we review our experience in filling the gap during this period of isolation and describe the adaptations for clinical research, which informed the national dialog for conducting dementia research in the age of COVID-19 and beyond.

Background To compare rates of amyloid positivity in non‐Hispanic whites with diverse cohorts including Hispanic, Black, Asian, and other research participants. Methods Participants were enrolled in the ADRC, completed the Unified Data Set (UDS) and underwent amyloid imaging (2011‐2019). Racial and ethnic origin was self‐reported. Referral source and study enrollment were recorded. Amyloid images received a clinical read by a neuro‐radiologist who was blinded to patient characteristics used to determine amyloid status, regardless of study‐specific amyloid determination. Results 191 cases who had received amyloid imaging were identified. 113 were non‐Hispanic white and 78 were minorities (36 non‐Hispanic Black, 28 Hispanic, 6 Asian, 8 other). Aside from the most common referral source from physicians (42%) for participants in both white and minority groups (42%), referral sources differed between white and minority participants. Amyloid imaging was performed using Amyvid (florbetapir F18 injection, n=94) and Neuraceq (florbetaben F18, n=97, 50.8%) tracers but usage differed between white and minority groups. Participant characteristics were: mean age 68.1 (SD=10.8) at time of scan, 52.9% male, mean CDR Sum of Boxes 0.8 (SD=1.3), 57.9% had no Apolipoprotein e4 alleles. Differences in these measures were not statistically significant between white and minority groups. Education (16.7±2.5 vs. 15.0±3.3) and cognitive composite scores (5.0±1.8 vs. 4.5±1.4) were higher in white compared to minority group (both p<0.01). Amyloid positivity was 27.4% (31/113) in whites, significantly higher than 9.0% (7/78) among minorities (p=0.002). Both groups demonstrated increasing amyloid positivity with age with whites ranging from 11.8% in those younger than 70, 34.0% in those age 70‐79, to 66.7 % in those 80 or older, and ranging from 4.7%, 14.3%, 14.3% in minorities in the same age groups, respectively. Results from analysis restricted to those with a UDS determined diagnosis of normal cognition, aMCI or AD remained the same. Conclusions In this relatively small convenience sample from diverse sources of recruitment and differential use of tracers for imaging studies we confirm previous impressions of lower rates of amyloid positivity in aging minority cohorts despite poorer cognitive performance. Both white and minority cohorts demonstrated age related increase in the presence of brain amyloid positivity.