The Mobile Toolbox for remote, self-administered cognitive assessment in older adults: associations with in-clinic cognitive testing and Alzheimer's disease biomarkers

Roos J. Jutten; Jessa. E. Burling; Elliott Slade; Jackson C. Thompson; Jessie Fanglu Fu; Colin Birkenbihl; Michael J. Properzi; Gad A. Marshall; Rebecca E. Amariglio; Kathryn V. Papp; Keith A. Johnson; Julie C. Price; Reisa A. Sperling; Dorene M. Rentz

doi:10.1002/dad2.70160

The Mobile Toolbox for remote, self-administered cognitive assessment in older adults: associations with in-clinic cognitive testing and Alzheimer's disease biomarkers

Roos J. Jutten^*
, Jessa. E. Burling
, Elliott Slade
, Jackson C. Thompson
, Jessie Fanglu Fu
, Colin Birkenbihl
, Michael J. Properzi
, Gad A. Marshall
, Rebecca E. Amariglio
, Kathryn V. Papp
, Keith A. Johnson
, Julie C. Price
, Reisa A. Sperling
, Dorene M. Rentz^*

^*Corresponding author for this work

Neurology

Harvard University

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

INTRODUCTION: Remote, smartphone-based cognitive assessments such as the Mobile Toolbox (MTB) may increase the accessibility of Alzheimer's disease (AD) clinical trials. We examined the feasibility of the MTB among cognitively unimpaired (CU) older adults and investigated its associations with standardized in-clinic cognitive testing and amyloid and tau positron emission tomography imaging. METHODS: A total of 100 CU older adults self-administered the MTB remotely on their personal devices. Linear regression models correcting for demographics investigated associations of MTB fluid and crystallized cognition composites with in-clinic Preclinical Alzheimer's Cognitive Composite-5 (PACC-5) scores, global amyloid-beta burden and tau deposition in the medial-temporal lobe and neocortex. RESULTS: Most participants completed the MTB without requiring assistance (81%) or reminders (61%). MTB fluid cognition scores were positively associated with PACC-5 scores and negatively with tau deposition in the medial-temporal lobe and neocortex. DISCUSSION: These findings suggest that the MTB may provide a feasible approach to capture cognitive processes relevant in preclinical AD. Highlights: The Mobile Toolbox (MTB) is a remote smartphone-based cognitive assessment. We deployed the MTB in CU older adults with Alzheimer's disease (AD) biomarkers. We show how the MTB may facilitate cognitive assessment in preclinical AD research.

Original language	English
Article number	e70160
Journal	Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume	17
Issue number	3
DOIs	https://doi.org/10.1002/dad2.70160
Publication status	Published - 1 Jul 2025

Keywords

Alzheimer's disease
amyloid
cognition
remote assessment
tau

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The-mobile-toolbox-for-remote-self-administered-cognitive-assessment-in-older-adults.pdfFinal published version, 717 KBLicence: CC BY

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Jutten, R. J., Burling, J. E., Slade, E., Thompson, J. C., Fu, J. F., Birkenbihl, C., Properzi, M. J., Marshall, G. A., Amariglio, R. E., Papp, K. V., Johnson, K. A., Price, J. C., Sperling, R. A., & Rentz, D. M. (2025). The Mobile Toolbox for remote, self-administered cognitive assessment in older adults: associations with in-clinic cognitive testing and Alzheimer's disease biomarkers. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, 17(3), Article e70160. https://doi.org/10.1002/dad2.70160

@article{acecd35262164eda9633d6b42a3abe41,

title = "The Mobile Toolbox for remote, self-administered cognitive assessment in older adults: associations with in-clinic cognitive testing and Alzheimer's disease biomarkers",

abstract = "INTRODUCTION: Remote, smartphone-based cognitive assessments such as the Mobile Toolbox (MTB) may increase the accessibility of Alzheimer's disease (AD) clinical trials. We examined the feasibility of the MTB among cognitively unimpaired (CU) older adults and investigated its associations with standardized in-clinic cognitive testing and amyloid and tau positron emission tomography imaging. METHODS: A total of 100 CU older adults self-administered the MTB remotely on their personal devices. Linear regression models correcting for demographics investigated associations of MTB fluid and crystallized cognition composites with in-clinic Preclinical Alzheimer's Cognitive Composite-5 (PACC-5) scores, global amyloid-beta burden and tau deposition in the medial-temporal lobe and neocortex. RESULTS: Most participants completed the MTB without requiring assistance (81\%) or reminders (61\%). MTB fluid cognition scores were positively associated with PACC-5 scores and negatively with tau deposition in the medial-temporal lobe and neocortex. DISCUSSION: These findings suggest that the MTB may provide a feasible approach to capture cognitive processes relevant in preclinical AD. Highlights: The Mobile Toolbox (MTB) is a remote smartphone-based cognitive assessment. We deployed the MTB in CU older adults with Alzheimer's disease (AD) biomarkers. We show how the MTB may facilitate cognitive assessment in preclinical AD research.",

keywords = "Alzheimer's disease, amyloid, cognition, remote assessment, tau",

author = "Jutten, \{Roos J.\} and Burling, \{Jessa. E.\} and Elliott Slade and Thompson, \{Jackson C.\} and Fu, \{Jessie Fanglu\} and Colin Birkenbihl and Properzi, \{Michael J.\} and Marshall, \{Gad A.\} and Amariglio, \{Rebecca E.\} and Papp, \{Kathryn V.\} and Johnson, \{Keith A.\} and Price, \{Julie C.\} and Sperling, \{Reisa A.\} and Rentz, \{Dorene M.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Alzheimer's \& Dementia: Diagnosis, Assessment \& Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.",

year = "2025",

month = jul,

day = "1",

doi = "10.1002/dad2.70160",

language = "English",

volume = "17",

journal = "Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring",

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Jutten, RJ, Burling, JE, Slade, E, Thompson, JC, Fu, JF, Birkenbihl, C, Properzi, MJ, Marshall, GA, Amariglio, RE, Papp, KV, Johnson, KA, Price, JC, Sperling, RA & Rentz, DM 2025, 'The Mobile Toolbox for remote, self-administered cognitive assessment in older adults: associations with in-clinic cognitive testing and Alzheimer's disease biomarkers', Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, vol. 17, no. 3, e70160. https://doi.org/10.1002/dad2.70160

The Mobile Toolbox for remote, self-administered cognitive assessment in older adults: associations with in-clinic cognitive testing and Alzheimer's disease biomarkers. / Jutten, Roos J.; Burling, Jessa. E.; Slade, Elliott et al.
In: Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, Vol. 17, No. 3, e70160, 01.07.2025.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The Mobile Toolbox for remote, self-administered cognitive assessment in older adults

T2 - associations with in-clinic cognitive testing and Alzheimer's disease biomarkers

AU - Jutten, Roos J.

AU - Burling, Jessa. E.

AU - Slade, Elliott

AU - Thompson, Jackson C.

AU - Fu, Jessie Fanglu

AU - Birkenbihl, Colin

AU - Properzi, Michael J.

AU - Marshall, Gad A.

AU - Amariglio, Rebecca E.

AU - Papp, Kathryn V.

AU - Johnson, Keith A.

AU - Price, Julie C.

AU - Sperling, Reisa A.

AU - Rentz, Dorene M.

PY - 2025/7/1

Y1 - 2025/7/1

N2 - INTRODUCTION: Remote, smartphone-based cognitive assessments such as the Mobile Toolbox (MTB) may increase the accessibility of Alzheimer's disease (AD) clinical trials. We examined the feasibility of the MTB among cognitively unimpaired (CU) older adults and investigated its associations with standardized in-clinic cognitive testing and amyloid and tau positron emission tomography imaging. METHODS: A total of 100 CU older adults self-administered the MTB remotely on their personal devices. Linear regression models correcting for demographics investigated associations of MTB fluid and crystallized cognition composites with in-clinic Preclinical Alzheimer's Cognitive Composite-5 (PACC-5) scores, global amyloid-beta burden and tau deposition in the medial-temporal lobe and neocortex. RESULTS: Most participants completed the MTB without requiring assistance (81%) or reminders (61%). MTB fluid cognition scores were positively associated with PACC-5 scores and negatively with tau deposition in the medial-temporal lobe and neocortex. DISCUSSION: These findings suggest that the MTB may provide a feasible approach to capture cognitive processes relevant in preclinical AD. Highlights: The Mobile Toolbox (MTB) is a remote smartphone-based cognitive assessment. We deployed the MTB in CU older adults with Alzheimer's disease (AD) biomarkers. We show how the MTB may facilitate cognitive assessment in preclinical AD research.

AB - INTRODUCTION: Remote, smartphone-based cognitive assessments such as the Mobile Toolbox (MTB) may increase the accessibility of Alzheimer's disease (AD) clinical trials. We examined the feasibility of the MTB among cognitively unimpaired (CU) older adults and investigated its associations with standardized in-clinic cognitive testing and amyloid and tau positron emission tomography imaging. METHODS: A total of 100 CU older adults self-administered the MTB remotely on their personal devices. Linear regression models correcting for demographics investigated associations of MTB fluid and crystallized cognition composites with in-clinic Preclinical Alzheimer's Cognitive Composite-5 (PACC-5) scores, global amyloid-beta burden and tau deposition in the medial-temporal lobe and neocortex. RESULTS: Most participants completed the MTB without requiring assistance (81%) or reminders (61%). MTB fluid cognition scores were positively associated with PACC-5 scores and negatively with tau deposition in the medial-temporal lobe and neocortex. DISCUSSION: These findings suggest that the MTB may provide a feasible approach to capture cognitive processes relevant in preclinical AD. Highlights: The Mobile Toolbox (MTB) is a remote smartphone-based cognitive assessment. We deployed the MTB in CU older adults with Alzheimer's disease (AD) biomarkers. We show how the MTB may facilitate cognitive assessment in preclinical AD research.

KW - Alzheimer's disease

KW - amyloid

KW - cognition

KW - remote assessment

KW - tau

UR - https://www.scopus.com/pages/publications/105013773869

U2 - 10.1002/dad2.70160

DO - 10.1002/dad2.70160

M3 - Article

C2 - 40836942

SN - 2352-8729

VL - 17

JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

IS - 3

M1 - e70160

ER -

The Mobile Toolbox for remote, self-administered cognitive assessment in older adults: associations with in-clinic cognitive testing and Alzheimer's disease biomarkers

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