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.