Can Older Adults Self-Administer a Cognitive-Screener at Home? A Pilot Study of the MyCog Mobile App

Stephanie Ruth Young, Northwestern University, Chicago, United States
Elizabeth Dworak, Northwestern University, Chicago, United States
Greg Byrne, Northwestern University, Chicago, United States
Julia Yoshino Benavente, Northwestern University, Chicago, United States
Lihua Yao, Northwestern University, Chicago, United States
Sarah Filec, Northwestern University, Chicago, United States
Maria Varela Diaz, Northwestern University, Chicago, United States
Richard Gershon, Northwestern University, Chicago, United States
Michael Wolf, Northwestern University, Chicago, United States
Cindy Nowinski, Northwestern University, Chicago, United States


Routine cognitive screenings for older adults during primary care visits can facilitate timely referrals to neuropsychologists, help establish a cognitive baseline while older adults are still healthy, monitor cognitive trajectories, and ultimately improve early detection of cognitive dementia. Unfortunately, time constraints present major barriers to cognitive screening in primary care, and less than half of cognitive impairment cases are identified in these settings. A remote cognitive screening smartphone app has the potential to save in-person visit time and replace inadequate or nonexistent screening practices in primary care, particularly for the majority of older adults who are cognitively healthy. To achieve this goal, MyCog Mobile was developed as a cognitive screening app which patients could complete remotely on their own smartphones prior to a primary care visit. The goal of this presentation is to introduce the MyCog Mobile system and describe results from a pilot study of its feasibility, acceptability, and initial psychometric properties. 

Participants and Methods:

A sample of adults 65 years and older self-administered MyCog Mobile remotely on their own smartphones twice 13 to 18 days apart. After their first administration, participants also completed the Simplified System Usability Scale (S-SUS) and provided feedback on their experience. We used the Spearman-Brown split-half formula (rsb) to calculate internal consistency for each of the measures except for MyFaces, for which we found the empirical reliability of the theta scores (ρxx). We examined correlations with education level and test-retest reliability through intraclass correlations (ICCs). 


All participants in the sample (N=51; Mean age = 74.20 years, SD = 6.25) successfully completed each measure and there was no evidence of floor or ceiling effects. Regarding educational attainment, 33.33% completed high school, 19.61% completed some college, 23.53% completed a bachelor’s degree, and 23.53% completed an advanced degree. Internal consistency was adequate or better and test-retest reliability was moderate for all measures, respectively (Table 1). Each test demonstrated moderate correlations with educational attainment except MyPictures. Participants’ ratings on the S-SUS indicated good usability of MyCog Mobile overall (M=73.78, SD = 20.11).  


Table 1. Reliability of the MyCog Mobile Measures 

Measure  Construct Measured  Internal Consistency 

(rsb  or ρxx ) 

Test-Retest Reliability (ICC)  Correlation with Education (ρxx) 
MyFaces  Episodic Memory  .73  .65 .33 
MySorting  Executive Functioning  .90  .69 .45 
MySequences  Working Memory  .91  .70 .36 
MyPictures  Episodic Memory  .81  .62  .06NS 

Note: All correlations significant at p<.001 unless otherwise noted. NS = non-significant (p>.05). 


These preliminary findings suggest that MyCog Mobile can be reliably self-administered by older adults on their own smartphones in a remote setting. Test-retest reliability was moderate across measures, suggesting MyCog Mobile may not be appropriate for frequent re-administration. Three measures demonstrated moderate correlations with education as expected, and education will be considered in future scoring models. Usability ratings indicated a satisfying user experience overall, and free response feedback resulted in actionable design recommendations. We will discuss plans for MyCog Mobile’s construct validation in a clinical sample as well as changes to the app to improve the experience for older adults.

Category: Aging

Keyword 1: aging disorders
Keyword 2: dementia - Alzheimer's disease
Keyword 3: self-monitoring