Usability of the Mayo Test Drive remote self-administered web-based cognitive screening battery in adults aged 35-100 with and without cognitive impairment.

Background: Mayo Test Drive (MTD): Mayo Test Development through Rapid Iteration, Validation and Expansion, is a web-based remote cognitive assessment platform for self-administered neuropsychological measures with previously demonstrated validity and reliability. We examined the usability of MTD and hypothesized that completion rates would be greater than 90%. We explored whether completion and participation rates differed by cognitive status and demographic factors.

Methods: A total of 1,950 Mayo Clinic Study of Aging and Mayo Alzheimer's Disease Research Center participants (97% White, 99% Non-Hispanic) were invited to participate in this ancillary, uncompensated remote study. Most invitees were cognitively unimpaired (CU; n = 1,769; 90.7%) and 9.3% were cognitively impaired (CI; n = 181). Usability was objectively defined as the percentage of participants who completed a session after initiating a session for a given timepoint (i.e. completion rates).

Results: Baseline session completion rates were 98.5% (n = 1199/1217 participants, mean age 71, SD = 12, range 35-100) and were comparable between CU (98.7%) and CI (95.0%) groups (p = .23). Completion rates did not significantly differ by age groups (p > .10) and remained high in individuals 80+ (n = 251, 97.3%). Participation rates were higher in the CU (n = 1142, 65.4%) versus CI (n = 57, 33.1%) group (p < .001); participants were younger and had more years of education (p's < .001). Adherence (i.e. retention) rate for a 7.5-month follow-up session was 89%. Average session duration was 16 min. Most participants used a personal computer (62.7%), followed by a smartphone (22.2%) or tablet (14.8%). Comments entered by 36.4% of participants reflected several themes including acceptability, face validity, usability, and comments informative for session context.

Conclusions: MTD demonstrated high usability as defined by completion rates in this research sample that includes a broad age range, though participation rates are lower in individuals with cognitive impairment. Results support good adherence at follow-up, feasibility through mean session duration, and acceptability based on qualitative analysis of participant comments.