Remote, self-administered, smartphone cognitive testing in a registry-based cohort: Feasibility, reliability, and validity findings

AI Summary

High adherence (82.2%) and favourable usability indicate feasibility of unsupervised smartphone cognitive testing in a registry-based cohort.
Moderate to strong test-retest reliability, rho 0.61 to 0.85, all p < 0.001, across three unsupervised sessions.
Smartphone scores showed expected validity: lower scores associated with older age, lower education, self or informant cognitive concerns, and worse Cogstate performance.

Alzheimers Dement. 2026 Jun;22(6):e71580. doi: 10.1002/alz.71580.

ABSTRACT

BACKGROUND: Remote, smartphone-based cognitive testing may improve access to cognitive assessments for Alzheimer’s disease and related dementias. We evaluated the feasibility, reliability, and validity of unsupervised smartphone-based cognitive tests in a registry-based cohort.

METHODS: Adults without a record of cognitive impairment (N = 1815; ages 18-92) were recruited from the University of California, San Francisco (UCSF) Brain Health Registry to complete three unsupervised smartphone cognitive testing sessions within 2 weeks. Reliability was assessed with correlations between sessions. Linear regression models tested associations of smartphone tasks with demographics, self- and informant-rated cognitive concerns, and web-based cognitive testing (Cogstate Brief Battery).

RESULTS: Adherence was high (82.2%) and usability favorable. Test-retest reliability was moderate to strong (ρ’s = 0.61-0.85, all p’s < 0.001). Lower smartphone scores were associated with older age, lower education, cognitive concerns, and worse Cogstate performance.

DISCUSSION: Findings support the feasibility, reliability, and validity of remote digital assessments in adults without a record of cognitive impairment.

PMID:42273832 | DOI:10.1002/alz.71580

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