Remote monitoring of cognition holds the promise to facilitate case-finding in clinical care and the individual detection of cognitive impairment in clinical and research settings. In the context of Alzheimer’s disease, this is particularly relevant for patients who seek medical advice due to memory problems. Here, we develop a remote digital memory composite (RDMC) score from an unsupervised remote cognitive assessment battery focused on episodic memory and long-term recall and assess its construct validity, retest reliability, and diagnostic accuracy when predicting MCI-grade impairment in a memory clinic sample and healthy controls. A total of 199 participants were recruited from three cohorts and included as healthy controls (n = 97), individuals with subjective cognitive decline (n = 59), or patients with mild cognitive impairment (n = 43). Participants performed cognitive assessments in a fully remote and unsupervised setting via a smartphone app. The derived RDMC score is significantly correlated with the PACC5 score across participants and demonstrates good retest reliability. Diagnostic accuracy for discriminating memory impairment from no impairment is high (cross-validated AUC = 0.83, 95% CI [0.66, 0.99]) with a sensitivity of 0.82 and a specificity of 0.72. Thus, unsupervised remote cognitive assessments implemented in the neotiv digital platform show good discrimination between cognitively impaired and unimpaired individuals, further demonstrating that it is feasible to complement the neuropsychological assessment of episodic memory with unsupervised and remote assessments on mobile devices. This contributes to recent efforts to implement remote assessment of episodic memory for case-finding and monitoring in large research studies and clinical care.

认知的远程监测有望促进临床护理中的病例发现以及临床和研究环境中认知障碍的个体检测。在阿尔茨海默病的背景下，这对于因记忆问题而寻求医疗建议的患者尤其重要。在这里，我们通过无监督的远程认知评估电池开发了远程数字记忆综合（RDMC）分数，重点关注情景记忆和长期回忆，并在预测记忆中的 MCI 级损伤时评估其构建有效性、重新测试可靠性和诊断准确性临床样本和健康对照。从三个队列中总共招募了 199 名参与者，包括健康对照组 ( n  = 97)、主观认知能力下降的个体 ( n  = 59) 或轻度认知障碍患者 ( n  = 43)。参与者通过智能手机应用程序在完全远程和无人监督的环境中进行认知评估。得出的 RDMC 分数与参与者的 PACC5 分数显着相关，并表现出良好的重测可靠性。区分记忆障碍和无记忆障碍的诊断准确性很高（交叉验证的 AUC = 0.83，95% CI [0.66，0.99]），敏感性为 0.82，特异性为 0.72。因此，neotiv 数字平台中实施的无监督远程认知评估显示出认知受损和未受损个体之间的良好区分，进一步证明通过移动设备上的无监督远程评估来补充情景记忆的神经心理学评估是可行的。这有助于最近在大型研究和临床护理中实施情景记忆远程评估以进行病例发现和监测的努力。