INTRODUCTION: A rapid and reliable neuropsychological protocol is essential for the efficient assessment of neurocognitive constructs related to emergent neurodegenerative diseases. We developed an AI-assisted, digitally administered/scored neuropsychological protocol that can be remotely administered in ~10 min. This protocol assesses the requisite neurocognitive constructs associated with emergent neurodegenerative illnesses. METHODS: The protocol was administered to 77 ambulatory care/memory clinic patients (56.40% women; 88.50% Caucasian). The protocol includes a 6-word version of the Philadelphia (repeatable) Verbal Learning Test [P(r)VLT], three trials of 5 digits backward from the Backwards Digit Span Test (BDST), and the "animal" fluency test. The protocol provides a comprehensive set of traditional "core" measures that are typically obtained through paper-and-pencil tests (i.e., serial list learning, immediate and delayed free recall, recognition hits, percent correct serial order backward digit span, and "animal" fluency output). Additionally, the protocol includes variables that quantify errors and detail the processes used in administering the tests. It also features two separate, norm-referenced summary scores specifically designed to measure executive control and memory. RESULTS: Using four core measures, we used cluster analysis to classify participants into four groups: cognitively unimpaired (CU; n = 23), amnestic mild cognitive impairment (MCI; n = 17), dysexecutive MCI (n = 23), and dementia (n = 14). Subsequent analyses of error and process variables operationally defined key features of amnesia (i.e., rapid forgetting, extra-list intrusions, profligate responding to recognition foils); key features underlying reduced executive abilities (i.e., BDST items and dysexecutive errors); and the strength of the semantic association between successive responses on the "animal" fluency test. Executive and memory index scores effectively distinguished between all four groups. There was over 90% agreement between how cluster analysis of digitally obtained measures classified patients compared to classification using a traditional comprehensive neuropsychological protocol. The correlations between digitally obtained outcome variables and analogous paper/pencil measures were robust. DISCUSSION: The digitally administered protocol demonstrated a capacity to identify patterns of impaired performance and classification similar to those observed with standard paper/pencil neuropsychological tests. The inclusion of both core measures and detailed error/process variables suggests that this protocol can detect subtle, nuanced signs of early emergent neurodegenerative illness efficiently and comprehensively.

Columbia University Medical Center Department of Neurology Cognitive Neuroscience Division Taub Institute and Sergievsky Center New York NY United States

Department of Clinical and Health Psychology University of Florida Gainesville FL United States

Department of Geriatrics and Gerontology New Jersey Institute for Successful Aging Rowan Virtua School of Osteopathic Medicine Glassboro NJ United States

Department of Neurology and Center of Clinical Neuroscience 1st Faculty of Medicine Charles University Prague Czechia

Department of Neurology Harvard Medical School Boston MA United States

Department of Psychiatry and Behavioral Health University of North Dakota School of Medicine and Health Sciences Grand Forks ND United States

Department of Psychology Rowan University Glassboro NJ United States

Hinda and Arthur Marcus Institute for Aging Research and Deanna Sidney Wolk Center for Memory Health Hebrew Senior Life Boston MA United States

Linus Health Boston MA United States

Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral Sciences Rush University Medical Center Chicago IL United States

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