A pilot study of at-home online cognitive screening prior to primary care wellness visits for older adults.

Background: Improved 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. Methods: 32 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 to provide preliminary validation evidence. Completion rates were examined to assess feasibility, and patient acceptability was assessed via survey. Results: Completion 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. Conclusion: Findings provide initial support for the acceptability of self-administered online cognitive screening for older adults in primary care. Completion rates were slightly below a preset benchmark, suggesting that additional support may be needed to facilitate at-home testing in routine care. Further validation research is needed in larger samples including examination of digital measure convergence with clinical diagnoses and additional cognitive testing.