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OCTAL (Oxford Cognitive Testing Portal): A remote, cross-cultural cognitive assessment detects domain-specific aging and dementia

Zhao, S.; Toniolo, S.; Tang, Q.-Y.; Scholcz, A.; Ganse-Dumrath, A.; Gendarini, C.; Broulidakis, M. J.; Thompson, S.; Manohar, S. G.; Husain, M.

2025-06-24 neurology
10.1101/2025.06.23.25330153 medRxiv
Show abstract

The global rise in dementia necessitates scalable cognitive assessments that can evolve to serve both clinical and research applications. We present the Oxford Cognitive Testing Portal (OCTAL), a remote, browser-based platform providing performance metrics for memory, attention, visuospatial and executive function domains. Four validation studies (N=1,749) confirmed cross-cultural applicability, lifespan sensitivity and clinical utility. Task performance was equivalent in English- and Chinese-speaking younger adults and mapped domain-specific ageing trajectories in mid- to late-adulthood. In a memory-clinic cohort (N=194), a 5-minute OCTAL screen distinguished patients with Alzheimers disease dementia from subjective cognitive decline (AUC = 0.92), matching a standard paper-based test, while a 20-minute subset surpassed this (AUC = 0.98; p = 0.04). Test-retest reliability was very good (ICC [≥] 0.79; N = 118). OCTAL enables remote assessment for large-scale research and screening, with an open, modular architecture that makes it a uniquely sustainable and evolvable tool for the research community.

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