Remote and in-clinic digital cognitive screening tools outperform the MoCA to distinguish cerebral amyloid status among cognitively healthy older adults

INTRODUCTION: We evaluated the accuracy of remote and in-person digital tests to distinguish between older adults with and without AD pathological change and used the Montreal Cognitive Assessment (MoCA) as a comparison test.METHODS: Participants were 69 cognitively normal older adults with known beta-amyloid (A beta) PET status. Participants completed smartphone-based assessments 3x/day for 8 days, followed by TabCAT tasks, DCTclock (TM), and MoCA at an in-person study visit. We calculated the area under the curve (AUC) to compare task accuracies to distinguish A beta status.RESULTS: Average performance on the episodic memory (Prices) smartphone task showed the highest accuracy (AUC = 0.77) to distinguish A beta status. On in-person measures, accuracy to distinguish A beta status was greatest for the TabCAT Favorites task (AUC = 0.76), relative to the DCTclock (TM) (AUC = 0.73) and MoCA (AUC = 0.74).DISCUSSION: Although further validation is needed, our results suggest that several digital assessments may be suitable for more widespread cognitive screening application.