Longitudinal monitoring of cognitive health can help clinicians assess if an underlying condition is causing cognitive decline and guide timely therapeutic interventions. Many treatable health conditions (e.g., sleep disorders, hypertension, diabetes, heart failure, hypothyroid), deficiencies (e.g., vitamin B12, tryptophan), as well as lack of movement and social interactions can affect memory and thinking. BOCA is available online gratis at Peer Review reports BOCA has the potential to reduce the cost and improve the quality of longitudinal cognitive tracking essential for testing novel interventions designed to reduce or reverse cognitive aging.

The effect of the screen size tested by BOCA administration on a large computer screen and re-administration of the BOCA to the same participant on a smartphone was insignificant (β = 0.82, p = 0.17 positive β indicates greater score on a smartphone).

The practice effect tested by daily BOCA administration over 10 days was insignificant (β = 0.03, p = 0.68). The study revealed strong ( R = 0.94, p < 0.001) test-retest reliability of the total BOCA score one week after participants’ initial administration. BOCA demonstrated strong correlation with Montreal Cognitive Assessment (MoCA) ( R = 0.90, p < 0.001). The Cronbach’s alpha was 0.87 implying good internal consistency. Test scores were significantly different between patients and controls ( p < 0.001) suggesting good discriminative ability. BOCA was administered to patients with cognitive impairment ( n = 50) and age- and education-matched controls ( n = 50). BOCA evaluates eight cognitive domains: 1) Memory/Immediate Recall, 2) Combinatorial Language Comprehension/Prefrontal Synthesis, 3) Visuospatial Reasoning/Mental rotation, 4) Executive function/Clock Test, 5) Attention, 6) Mental math, 7) Orientation, and 8) Memory/Delayed Recall. BOCA uses randomly selected non-repeating tasks to minimize practice effects. The goal of this project was to validate BOCA. We developed a self-administered 10-min at-home test intended for longitudinal cognitive monitoring, Boston Cognitive Assessment or BOCA. Longitudinal cognitive testing is essential for developing novel preventive interventions for dementia and Alzheimer’s disease however, the few available tools have significant practice effect and depend on an external evaluator.

Moca questions cognitive assessment