title: Embedded Online Questionnaire Measures Are Sensitive to Identifying Mild Cognitive Impairment.
abstract: Early changes in cognitively demanding daily activities occur between normal cognition and the development of mild cognitive impairment (MCI). These real-world functional changes as early signals of cognitive change form a prime target for meaningful early detection of dementia. We examined whether passive aspects of responding to a remotely monitored weekly online questionnaire discriminated between older adults with and without MCI.
  
  
  
  Participants were 83 independent, community-dwelling older adults enrolled in a longitudinal study of in-home monitoring technologies, which included completion of a short weekly online questionnaire of health and life events.
  
  
  
  In longitudinal analyses, time to complete the online questionnaire decreased over 1 year in both MCI and cognitively intact participants (P<0.01). MCI and intact participants did not differ in the time of day they submitted their questionnaires initially; however, over the course of 1 year MCI participants began to submit their questionnaires progressively later in the day and they needed greater assistance from staff as compared with intact participants (P<0.05). The online questionnaire performance measures were significantly correlated to conventional cognitive test scores (P<0.05) across the spectrum of normal cognition to MCI.
  
  
  
  Ambiently assessed, passive performance measures embedded within an online questionnaire are able to discriminate between normal cognition and MCI. Remote monitoring of cognitively demanding routine daily activities is a promising approach for ecologically valid real-world cognitive assessment.
authors.affiliation: Departments of *Neurology‡Biomedical Engineering†Oregon Center for Aging and Technology, Oregon Health & Science University, Portland, OR.
authors.forename: Adriana
authors.initials: A
authors.lastname: Seelye
authors.forename: Nora
authors.initials: N
authors.lastname: Mattek
authors.forename: Diane B
authors.initials: DB
authors.lastname: Howieson
authors.forename: Daniel
authors.initials: D
authors.lastname: Austin
authors.forename: Katherine
authors.initials: K
authors.lastname: Wild
authors.forename: Hiroko H
authors.initials: HH
authors.lastname: Dodge
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kaye
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis; D042241:Early Diagnosis; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D020407:Internet; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires