Practice Effects on Repeated Self-Administered Digital Cognitive Assessments in Cognitively Intact Older Adults from the Framingham Heart Study: Longitudinal Observational Study

Background

Remote, self-administered digital assessments provide scalable approaches for monitoring cognition in older adults. Practice effects (PEs), once viewed as measurement noise, are increasingly recognized as potential markers of cognitive decline. As disease-modifying therapies for neurodegenerative conditions emerge, longitudinal digital assessments may capture subtle cognitive changes. Although the majority of PE studies have focused on memory tasks, it is critical to determine whether PEs occur in other domains. Clarifying the potential presence of PEs across multiple time points on the Food and Drug Administration-cleared Defense Automated Neurocognitive Assessment (DANA) platform remains critical for determining whether PEs can serve as a measure of cognitive decline longitudinally.