Digital Cognitive Tests: How AI Tools Could Transform Alzheimer’s Diagnosis and Care

While Alzheimer’s diagnostics have advanced in recent decades — evolving from spinal taps to amyloid PET scans and now blood tests — cognitive testing has largely remained the same.

The Mini-Mental State Exam (MMSE), developed in 1975, and the Montreal Cognitive Assessment (MoCA), released in 1996, are still the most common tools. But they have drawbacks:

• They take time to administer.
• They must be done in person.
• They can miss early changes, especially in non-white or culturally diverse populations.

That’s where a new generation of digital cognitive tests comes in. More than 20 digital tools are being developed worldwide, many using artificial intelligence to provide faster, more sensitive assessments, streamlining the referral to a dementia specialist for diagnosis.

Why traditional cognitive tests fall short

Traditional tests like MMSE and MoCA remain useful but are limited in several ways:

• Accessibility: Not all patients can easily travel to a clinic for in-person testing.
• Cultural bias: Some questions may not translate across languages or cultural contexts.
• Sensitivity: They may miss subtle early-stage changes in cognition.

For people worried about Alzheimer’s or mild cognitive impairment, these gaps can delay diagnosis and care.

AI-powered digital cognitive tests: the new frontier

Researchers and companies are working to bring cognitive testing into the 21st century. Below are some of the technologies in the works.

Cognivue Clarity

• Reach: 4,000 devices are currently in U.S. clinics.
• Scale: About 100,000 patients complete the test each year.
• Future potential: The company’s CARM algorithm helps predict whether a patient has beta-amyloid plaques, guiding referrals for Alzheimer’s biomarker testing.

Cognivue Clarity, an FDA-cleared digital cognitive test, resembles a retro arcade game. 

Patients use a rotating joystick to complete 10 tasks that assess memory, motor control, and visual attention in 10 minutes. For example, a person might need to use the joystick to follow moving dots on the screen. The test uses AI to adapt the difficulty of each task based on your performance.

There are now 4,000 devices across clinics in the U.S., and 100,000 patients take the test each year, a spokesperson told Being Patient. The company has also developed an algorithm called CARM that could tell doctors if a patient has beta-amyloid plaques, streamlining patients for Alzheimer’s biomarker testing and diagnosis. 

Dr. James Galvin, chief scientific officer at Cognivue told Being Patient that the company minimized bias by making sure Clarity works in a diverse population.

Linus Health

Boston-based Linus Health offers three AI-powered digital cognitive tests that take between two and eight minutes to complete:

• DCTclock: A digitized version of a century-old clock-drawing test, enhanced with AI.
• Digital Clock and Recall: Combines clock drawing with a short memory test; studies suggest it may detect mild cognitive impairment earlier than MMSE.
• Core Cognitive Evaluation: Multiple tasks plus a lifestyle questionnaire, which not only measures cognition but also flags risk factors like diet and offers personalized tips.
  

“The tests have been shown not only to reflect a person’s current performance but also to reliably indicate their future risk,” Dr. John Showalter, chief operating officer of Linus Health, told Being Patient. 

Linus Health’s tools are used in large-scale research studies and in clinical care for tens of thousands of patients.

Altoida

Altoida is developing a digital test app that uses augmented reality, the same technology behind Pokémon Go. 

Patients complete real-world–like tasks through a smartphone app, such as:

• Navigating a simulated home fire to pull the alarm.
• Finding virtual documents in an office setting.

The app captures 350,000 datapoints on speech, movement, and cognition in just 10–12 minutes. And studies show it may be able to spot cognitive impairment sooner than traditional tests. “If you look at your camera on your phone, you will capture whatever is in front of you, and the augmented reality will add a series of elements into that and force you to interact with it,” Emmanuel Streel, vice president of medical affairs at the company, told Being Patient.

Altoida’s tool is already being used in clinical trials and is awaiting FDA clearance.

How digital tools could change Alzheimer’s diagnosis

Experts say digital cognitive tests could eventually function like routine blood work:

• Patients could complete them at home each year.
• Results could be tracked over time and flagged for changes.
• Doctors would spend less time testing and more time discussing care.

“If I want to do that with a classical approach, it takes me three hours per patient,” Streel at Altoida said. Digital cognitive tests can get to that level of detail in minutes.

But will they replace the classic approach completely? Others say no.

Sophie M. van der Landen, a researcher at Amsterdam University Medical Center, is helping validate some of these tools. “I don’t think in upcoming years, digital cognitive tests will replace the extensive cognitive testing that we do now,” she told Being Patient. Instead she thinks these tools could be used as triage tools before an appointment, flagging patients who need specialist memory clinic evaluation.

Challenges ahead for digital cognitive testing

Despite their promise, digital tools face real-world challenges:

• Usability: Some apps, especially AR-based ones, can be difficult for older adults to navigate.
• Compliance: Patients may not consistently complete at-home tests.
• Lack of guidelines: No universal standards exist yet for when and how doctors should use these tools.

Work is underway to change that. David Berron of the German Center for Neurodegenerative Diseases, co-founder of Neotiv, is part of an effort to develop international guidelines through the Global CEO Initiative and an EU-funded working group.

Importantly, experts caution that digital tools cannot yet diagnose Alzheimer’s on their own. But by making assessments more accessible, they could shorten the path to diagnosis and improve monitoring once patients are in care.

“They have the potential to revolutionize care,” said DZNE researcher Sarah Polk, “but only if they are easy to use and integrated into real-world clinical practice.”

What’s next for AI cognitive test apps?

Digital cognitive tests are not replacements for neurologists or gold-standard biomarker tests. But as AI and digital health advance, they may become essential tools for early Alzheimer’s detection, faster referrals, and better long-term monitoring.

FAQs about digital cognitive tests

What are digital cognitive tests?

They are smartphone, tablet, or computer-based tools that measure memory, attention, and other cognitive skills, often using AI.

Are they FDA-approved?

A few, like Cognivue Clarity, are FDA-cleared, while others are still in research or regulatory review.

Can they diagnose Alzheimer’s disease?

No. They are designed to flag potential impairment and help doctors decide who needs further evaluation.

Who might benefit from them?

Older adults at risk of dementia, people with mild memory concerns, or patients already in clinical monitoring.