Test taking location and practice effects as factors contributing to scores on remotely administered neurocognitive performance tests in a sample of older adults.

Our goals were to evaluate the association of test taking location (clinic, home) with remotely administered, unsupervised computerized test performance in older adults and to examine practice effects for these tests. Additionally, we evaluated the association of computerized test performance with performance on traditional neuropsychological tests. Participants were 923 older adults who completed four remotely administered NeuroCognitive Performance Tests (NCPT; Lumos Labs, Inc.) twice over 14 days. Clinic performance was better than home performance for one NCPT (Trail Making Test B; p < 0.001). Practice effects were observed on all four NCPT measures (p < 0.001 for all). The four NCPTs showed stability over 14 days across the two testing locations (r = 0.24 to 0.47). NCPT performance was associated with a traditional neuropsychological test measuring the same cognitive construct (Trail Making Test B, r = 0.59 in clinic, 0.35 at home). NCPTs show promise for evaluating cognition in older adults remotely. Reducing variability in NCPT performance related to testing location and practice effects represents two possible avenues for improving their utility for detection of cognitive decline in older adults.