{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:10:58Z","timestamp":1790251858714,"version":"4.1.0"},"posted":{"date-parts":[[2026,9,21]]},"group-title":"Neurology","reference-count":65,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"award":["U19 AG063911"],"award-info":[{"award-number":["U19 AG063911"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01 AG077557"],"award-info":[{"award-number":["R01 AG077557"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["P01 AG019724"],"award-info":[{"award-number":["P01 AG019724"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["P30 AG062422"],"award-info":[{"award-number":["P30 AG062422"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01 AG038791"],"award-info":[{"award-number":["R01 AG038791"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["K23 AG084883"],"award-info":[{"award-number":["K23 AG084883"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["P30 AG062677"],"award-info":[{"award-number":["P30 AG062677"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"id":[{"id":"https:\/\/ror.org\/03wkk5p21","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Bluefield Project to Cure FTD"},{"id":[{"id":"https:\/\/ror.org\/003q4qk22","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Tau Consortium"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,21]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Frontotemporal lobar degeneration (FTLD) is a devastating disease that commonly results in early onset dementia, yet its rarity and heterogeneity limit large-scale research and clinical trials. Remote monitoring via low-burden digital health tools may overcome these barriers. We evaluated clinical utility of passive smartphone monitoring in FTLD using a multi-domain mobile assessment platform.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants were 567 adults (53% clinically normal, 21% prodromal FTLD, 26% symptomatic FTLD) who completed an in-person study visit and downloaded the ALLFTD Mobile App on their personal smartphones. The app delivered unsupervised cognitive tests and passively collected continuous data on battery percentage (proxy for smartphone use) and step count. Longitudinal follow-up included smartphone monitoring and annual in-person study visits. Primary analyses examined associations between passive smartphone features and markers of disease severity at baseline and longitudinally, and tested whether passive features added incremental value beyond app-based cognitive testing.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Passive smartphone features were feasible to collect and showed excellent reliability with &lt;2 weeks of monitoring (ICCs&gt;0.9). Features capturing smartphone use and movement demonstrated sensitivity to gold-standard clinical measures of disease severity both at baseline and longitudinally. A classification model combining passive features, the app-based cognitive composite score, and demographics detected longitudinal functional decline (AUC=0.89); passive features alone (AUC=0.84) performed comparably to a cognitive screener (AUC=0.85).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Passive smartphone monitoring is a valid, zero-burden measure of disease severity and progression in FTLD that adds modest incremental value beyond app-based cognitive testing. Findings support its use as a scalable digital endpoint in longitudinal FTLD research.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.18.26363439","type":"posted-content","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:40:24Z","timestamp":1790037624000},"source":"Crossref","is-referenced-by-count":0,"title":["Smartphone Passive Digital Phenotyping in Frontotemporal Lobar Degeneration"],"prefix":"10.64898","author":[{"given":"Emily W","family":"Paolillo","sequence":"first","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreya","family":"Dhanam","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack Carson","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sanderson-Cimino","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Fregly","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowan","family":"Saloner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin B","family":"Casaletto","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel H","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce L","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W","family":"Seeley","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Gorno-Tempini","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"Ljubenkov","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio C","family":"Rojas","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzee","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Sturm","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Appleby","sequence":"additional","affiliation":[{"name":"Department of Neurology, Case Western Reserve University, Cleveland, OH, 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ece","family":"Bayram","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Colorado Anschutz, Aurora, CO, 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Neurology, Indiana University, Indianapolis, IN, 46202, 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University, Providence, RI, 02906, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Irwin","sequence":"additional","affiliation":[{"name":"Department of Neurology and Penn Frontotemporal Degeneration Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kejal","family":"Kantarci","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Neuroradiology, Mayo Clinic, Rochester, Rochester, MN, 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin Y","family":"Kwan","sequence":"additional","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian R","family":"Mackenzie","sequence":"additional","affiliation":[{"name":"Department of Pathology, 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Carmela","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Neurology, Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, M5S 3H2, CAN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan J","family":"Traynor","sequence":"additional","affiliation":[{"name":"National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, MGH, Charlestown, MA, 02129, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kornak","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter K","family":"Kremers","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Rochester, MN, 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah K","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, Rochester, MN, 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary W","family":"Heuer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley F","family":"Boeve","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, Rochester, MN, 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard J","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam L","family":"Boxer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M","family":"Staffaroni","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, 94158, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"issue":"7","key":"2026092404550453000_2026.09.18.26363439v1.1","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1038\/s43587-023-00438-6","article-title":"\u2018Proactive aging\u2019is a new research approach for a new era","volume":"3","year":"2023","journal-title":"Nature Aging"},{"key":"2026092404550453000_2026.09.18.26363439v1.2","unstructured":"United Nations Department of Economic and Social Affairs. 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