Remote and in‐clinic digital cognitive screening tools outperform the MoCA to distinguish cerebral amyloid status among cognitively healthy older adults

Abstract

INTRODUCTIONWe evaluated the accuracy of remote and in‐person digital tests to distinguish between older adults with and without AD pathological change and used the Montreal Cognitive Assessment (MoCA) as a comparison test.METHODSParticipants were 69 cognitively normal older adults with known beta‐amyloid (Aβ) PET status. Participants completed smartphone‐based assessments 3×/day for 8 days, followed by TabCAT tasks, DCTclock™, and MoCA at an in‐person study visit. We calculated the area under the curve (AUC) to compare task accuracies to distinguish Aβ status.RESULTSAverage performance on the episodic memory (Prices) smartphone task showed the highest accuracy (AUC = 0.77) to distinguish Aβ status. On in‐person measures, accuracy to distinguish Aβ status was greatest for the TabCAT Favorites task (AUC = 0.76), relative to the DCTclockTM (AUC = 0.73) and MoCA (AUC = 0.74).DISCUSSIONAlthough further validation is needed, our results suggest that several digital assessments may be suitable for more widespread cognitive screening application.

Continuous Associations Between Remote Self-Administered Cognitive Measures and Imaging Biomarkers of Alzheimer’s Disease

“…54 Another remote digital assessment -the M2C2 Prices task as part of the NIH Mobile Toolbox -distinguishes A+ versus A-participants better than the MoCA. 52 Our group has previously shown that a one-time administered SLS discriminates between A+ and A-groups, as well as A+T+ and A-T-groups in a predominantly CU sample. 11 Mayo Test Drive & Imaging Biomarkers -20…”

“…31 To date, most of these remote digital assessments rely on multiple assessments, either once per day over several days (e.g., Boston Remote Assessment for Neurocognitive Health; BRANCH), 51 or multiple times per day over several days (e.g., Mobile Monitoring of Cognitive Change; M2C2). 52 Performance on BRANCH has robust associations with the PACC5 as well as associations with cortical amyloid and entorhinal tau deposition, 51 with diminished seven-day practice effects on BRANCH linked to increased levels of amyloid and declines on the PACC5 over one year in CU individuals. 53 Similarly, diminished practice effects on C3 over a three month period have been associated with greater amyloid and tau burden as well as steeper annual decline on the PACC5.…”

Remote and unsupervised digital memory assessments can reliably detect cognitive impairment in Alzheimer's disease

“… 19 , 20 , 21 , 22 , 23 , 24 Furthermore, this work showed that remote and unsupervised assessments can support the identification of mild cognitive impairment (MCI) patients in a memory clinic setting 25 and potentially even β‐amyloid (Aβ) positive but cognitively unimpaired (CU) participants. 19 , 26 , 27 The aim of the present study was to evaluate the feasibility and usability of unsupervised and remote digital memory assessments, their construct validity in reference to traditional neuropsychological assessments, their retest reliability, and their relationship with fluid and imaging biomarkers of AD. To that end, we implemented two non‐verbal visual memory tasks based on recent insights into the functional anatomy of episodic memory, available on the neotiv digital platform ( https://www.neotiv.com/en ), 21 , 24 in a subset of the Swedish BioFINDER‐2 study.…”

Cultural adaptation of the brain health assessment for early detection of cognitive impairment in Southeast Nigeria

“…A shift from paper and pencil to digital cognitive assessment tests is highly advantageous, particularly for Nigeria experiencing rapid demographic aging and widespread cognitive screening (Thompson et al, 2023 ). Digital tests improve efficiency, accuracy, and accessibility, making the assessment process smoother and reducing logistical challenges and the subjective nature of current standardized cognitive assessment methods (Staffaroni et al, 2020 ).…”