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

Dhanam, S.; Sanderson-Cimino, M.; Taylor, J. C.; Paolillo, E. W.; Fregly, R.; Kwang, W.; Maruff, P.; Wise, A.; Heuer, H. W.; Forsberg, L. K.; Kramer, J. H.; Boeve, B. F.; Rosen, H. J.; Mackin, R. S.; Weiner, M. W.; Nosheny, R. L.; Boxer, A. L.; Staffaroni, A. M.; Brain Health Registry,

2025-10-30 neurology
10.1101/2025.10.28.25338686 medRxiv
Show abstract

BackgroundRemote, smartphone-based cognitive testing may improve access to cognitive assessments for Alzheimers disease and related dementias. We evaluated the feasibility, reliability, and validity of unsupervised smartphone-based cognitive tests in a registry-based cohort. MethodsAdults without a record of cognitive impairment (N=1,815; ages 18-92) were recruited from the UCSF Brain Health Registry to complete unsupervised ALLFTD-mApp cognitive tasks three times over two weeks. Reliability was assessed with correlations between sessions. Linear regression models tested associations of ALLFTD-mApp tasks with demographics, self- and informant-rated cognitive concerns (Everyday Cognition Surveys; ECog), and web-based cognitive testing (CogState Brief Battery; CBB). ResultsAdherence was high (82.2%) and usability favorable. Test-retest reliability was moderate to strong ({rho}s = 0.61-0.85, all ps < .001). Lower ALLFTD-mApp scores were associated with older age, lower education, cognitive concerns, and worse CBB performance. ConclusionFindings support the feasibility, reliability, and validity of the ALLFTD-mApp in adults without a record of cognitive impairment.

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