Tablet-based Cognitive Assessment Tool (TabCAT) in a multisite study of early-onset Alzheimer's disease

INTRODUCTION: Brief digital cognitive measures may be a valuable and scalable alternative to traditional tests for improving early detection and disease monitoring in patients with early-onset Alzheimer's disease (EOAD). METHODS: We examined the convergent, diagnostic, and neuroanatomical validity of Tablet-based Cognitive Assessment Tool (TabCAT) tests in the multisite Longitudinal Early-Onset Alzheimer's Disease Study. Four hundred seventy-five participants from 16 sites (83 cognitively unimpaired participants, 146 individuals diagnosed with mild cognitive impairment [MCI], and 246 with mild dementia) underwent TabCAT testing, including two executive/attentional tasks (Match and Flanker) and two visuospatial tasks (Line Length and Line Orientation). RESULTS: TabCAT tests showed good convergent validity with traditional pen-and-paper tests. Match was the most accurate TabCAT test in differentiating among clinical groups (controls vs. MCI vs. dementia) and predicting amyloid positron emission tomography (PET) positivity in clinically impaired participants. TabCAT tests were associated with regional tau PET patterns. DISCUSSION: TabCAT digital measures have promise for frontline identification of patients with EOAD. Highlights: Four hundred seventy-five participants from 16 US sites underwent tablet-based cognitive assessment. Digital tests assessed executive function and visuospatial abilities. Digital tests correlated with traditional pen-and-paper cognitive tests. Match (test of executive function) differentiated clinical groups. Digital tests were associated with amyloid positron emission tomography (PET) status and regional tau PET patterns.