The Mobile Toolbox for remote, self-administered cognitive assessment in older adults: associations with in-clinic cognitive testing and Alzheimer's disease biomarkers.

Remote, smartphone-based cognitive assessments such as the Mobile Toolbox (MTB) may increase the accessibility of Alzheimer's disease (AD) clinical trials. We examined the feasibility of the MTB among cognitively unimpaired (CU) older adults and investigated its associations with standardized in-clinic cognitive testing and amyloid and tau positron emission tomography imaging. A total of 100 CU older adults self-administered the MTB remotely on their personal devices. Linear regression models correcting for demographics investigated associations of MTB fluid and crystallized cognition composites with in-clinic Preclinical Alzheimer's Cognitive Composite-5 (PACC-5) scores, global amyloid-beta burden and tau deposition in the medial-temporal lobe and neocortex. Most participants completed the MTB without requiring assistance (81%) or reminders (61%). MTB fluid cognition scores were positively associated with PACC-5 scores and negatively with tau deposition in the medial-temporal lobe and neocortex. These findings suggest that the MTB may provide a feasible approach to capture cognitive processes relevant in preclinical AD. The Mobile Toolbox (MTB) is a remote smartphone-based cognitive assessment.We deployed the MTB in CU older adults with Alzheimer's disease (AD) biomarkers.We show how the MTB may facilitate cognitive assessment in preclinical AD research.