ArticlemedRxiv : the preprint server for health sciences2025
A scoping review of remote and unsupervised digital cognitive assessments in preclinical Alzheimer's disease.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Characterizing subtle cognitive changes in preclinical Alzheimer's disease (AD) is difficult using traditional neuropsychological assessments. Remote and unsupervised digital assessments can improve scalability, measurement reliability, and ecological validity, enabling the capture of subtle changes. We evaluate such tools for use in preclinical AD, or cognitively unimpaired individuals with abnormal levels of AD pathology. We screened 1,904 reports for studies remotely assessing cognition in preclinical AD samples. Twenty-three tools were identified and their usability, reliability, and validity, including construct and criterion validity based on in-person neuropsychological and Aβ/tau measures, was reported. We present a necessary update to a rapidly evolving field, following our previous review (Öhman et al., 2021) and address open questions of feasibility and reliability of remote testing in older adults. Future applications of such tools are discussed, including longitudinal monitoring of cognition, scalable case finding, and individualized prognostics in both clinical trials and healthcare contexts.
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