Focus groups on digital cognitive assessment in the context of Alzheimer's disease

Introduction: Digital cognitive assessments (DCAs) may facilitate early recognition of cognitive decline in the context of Alzheimer's disease (AD). While DCAs are increasingly emerging, they are often not used in practice. We assessed facilitators and barriers of using DCAs according to older individuals and patients. Methods: In five focus groups, we presented three different DCAs to older individuals with unimpaired cognition (n = 14), subjective cognitive decline (n = 11) and mild cognitive impairment with biomarker-confirmed AD (n = 4) and their caregivers (n = 2). Participants discussed facilitators and barriers that could influence the use of DCAs. Focus groups were recorded, and transcripts were analysed using thematic analysis. Results: Three main themes were identified: (1) test motivation (‘Do I want to know my brain health?’), facilitated by early disease recognition, while impeded by fear of dementia; (2) digital test suitability (‘Do I want to use a digital test?’), enabling at-home testing, while lacking personal contact; and (3) digital test characteristics (‘What makes a digital test a good test for me?’), where user-friendliness was emphasized as a key facilitator to overcome digital incompetence. Discussion: Participants recognized the added value of DCAs, and multiple factors were identified as facilitators and barriers for their use. Similar factors could be a barrier for one, yet facilitated others, underlining the need for a personalized approach. Strategies to minimize barriers and exploit facilitators would ultimately foster implementation.