Feasibility of digital multidomain cognitive testing in mild cognitive impairment and dementia assessment in primary care.

Abstract

Background: Primary care plays a central role in identifying and monitoring mild cognitive impairment (MCI), Alzheimer's disease and other dementias, yet access to suitable cognitive assessment tools remains limited.

Objective: To evaluate the feasibility, acceptability, usability and preliminary clinical validity of a digital multidomain cognitive test battery in routine primary care neurocognitive assessments.

Methods: A total of 77 patients undergoing neurocognitive assessment across eight Swedish primary care centers were recruited and grouped by final diagnosis: 26 subjective cognitive impairment (SCI), 28 MCI, and 23 dementia. Participants completed a digital cognitive test battery consisting of eight traditional tests administered on the Mindmore platform via touchscreen tablets and supervised by occupational therapists (OTs). Clinicians were blinded to test results. Cognitive performance was compared across diagnostic groups and against normative data. Patient and OT experiences were collected using structured surveys.

Results: Cognitive performance declined progressively from SCI to MCI to dementia on all tests. The battery yielded a detailed cognitive profile spanning 10 main test results across five cognitive domains. All included patients completed the test battery, they reported clear instructions, and 58% preferred tablet-based over paper-based testing. OTs considered the battery appropriately challenging in this population, provided some assistance in 69% of cases, and expected the battery to yield reliable results.

Conclusions: These findings support the feasibility of integrating multidomain digital cognitive testing in primary health care with limited clinician burden. This is a promising approach for increasing availability of standardized detailed cognitive assessments at early levels of care.