The mobile toolbox (MBT): A completely remote platform for cognitive research

Objective: We introduce the Mobile Toolbox Battery (MTB), a library of cognitive assessments for at-home smartphone administration. It is designed for safe, remote, and effective data collection, particularly among older adults. Background: Cognitive Impairment (CI) is estimated to affect more than 16 million people (Centers for Disease Control and Prevention, 2011). About 5.8 million Americans are living with dementia, severe cognitive decline, most often due to Alzheimer's Disease, with a projected increase to 13.8 million people aged 65 and older by 2050 (Alzheimer's Association, 2020). There is a clear need for early detection of cognitive impairment due to neurodegenerative brain disease as well as to differentiate it from more benign, age-associated changes. However, there are currently few sensitive assessment tools to meet this need and fewer yet that can be easily and widely deployed across the lifespan, in different research settings, and with diverse participants. Design/Methods: MTB provides a complete research platform for app creation, study management, and data collection for participants 20-85 years old. Available for both iOS and Android devices, we envision the MTB being used in fully remote or follow-up remote studies. The initial core tests With in MTB were designed to measure comparable cognitive skills to those in the well-established NIH Toolbox Cognition Battery, often utilized for in-person research. Results: We present the Mobile Toolbox research platform and its use in conducting remote assessments measuring the constructs of executive function, language, memory, and processing speed. The suite of assessments includes: Flanker, Face-Name (FNAME), Memory for Sequence (MFS), Picture Sequence Memory (PSM), Vocabulary, Number Match, Spelling, and Dimensional Charge Card Sort (DCCS) tests. Conclusions: Given the COVID-19 global pandemic and its associated stay-at-home orders, it is now more important than ever that researchers have access to well-designed cognitive assessments that can be administered entirely remotely.