Comparing Task-Related Stress and Engagement Across Assessments in Older Adults: An Exploratory Study for Cognitive Screening

Aim Declarative neurocognitive assessments (e.g., Montreal Cognitive Assessment, MoCA) may elicit task-related stress and/or low task engagement among older adults. Conversely, performance-based tests may offer a more person-centered alternative. This exploratory study aimed to provide a preliminary comparison of task-related physiological stress and engagement between the MoCA and a performance-based test validated previously against existing measures of cognition.Method Twenty-one older adults were randomized to complete either the MoCA or the performance-based test. Task-related stress was assessed subjectively (STAI-6) and objectively (salivary α-amylase), while task engagement was assessed with electrodermal activity (EDA).Results Neither the performance-based test nor the MoCA induced a significant stress response compared to baseline. However, greater tonic EDA variability was observed during the performance-based test than the MoCA, suggesting more engagement during performance.Discussion These exploratory findings suggest that the performance-based test may be more engaging than traditional neurocognitive assessments, and warrant consideration in clinical settings.