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A pilot comparison of remote versus in-clinic digital cognitive assessments for older adults in primary care settings.

Thompson, L.; Eaton, C.; Prieto, S.; Lawrence, M.; Czech, S.; Rosenbaum, J.; Anthony, D.; Chandran, R.; Kelly, L.; Ngo, I.; Goldberg, A.; Gillooly, C.; Roque, N.; Andrews, H.; Elwy, R.; Jones, R.; Rentz, D.

2025-08-21 geriatric medicine
10.1101/2025.08.19.25333983 medRxiv
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BACKGROUNDImproved methods of cognitive testing are urgently needed for primary care settings faced with a growing older adult population and higher rates of dementia. We tested the feasibility and acceptability of a novel online cognitive test that can be completed at home prior to an annual exam. METHODS32 older adults completed testing at home on personal devices 1-4 weeks prior to an annual exam with their primary care provider. Additional cognitive screening was completed in-clinic for validation. Completion rates were examined to assess feasibility, and patient acceptability was assessed via survey. RESULTSCompletion rate was 78.5% for at-home testing online. Participants reported that they generally preferred at-home over in-clinic testing. At-home test performance was moderately correlated with the standard Montreal Cognitive Assessment completed in clinic. CONCLUSIONFindings support the acceptability of self-administered online cognitive screening in older adults. Completion rates were slightly below expectation, suggesting that additional support may be needed to facilitate at-home testing in routine care.

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