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

Abstract

INTRODUCTIONRemote unsupervised cognitive assessments have the potential to complement and facilitate cognitive assessment in clinical and research settings.METHODSHere we evaluate the usability, validity and reliability of unsupervised remote memory assessments via mobile devices in individuals without dementia from the Swedish BioFINDER-2 study and explore their prognostic utility regarding future cognitive decline.RESULTSUsability was rated positively; remote memory assessments showed good construct validity with traditional neuropsychological assessments and were significantly associated with tau-PET and downstream MRI measures. Memory performance at baseline was associated with future cognitive decline and prediction of future cognitive decline was further improved by combining remote digital memory assessments with plasma p-tau217. Finally, retest reliability was moderate for a single assessment and good for an aggregate of two sessions.DISCUSSIONOur results demonstrate that unsupervised digital memory assessments might be used for diagnosis and prognosis in Alzheimer’s disease, potentially in combination with plasma biomarkers.