Such a test could be performed at home or in the clinic by using randomly selected non-repeating tasks to minimize practice effects. Therefore, there is a clear need for a self-administered cognitive test that can be repeated periodically and is resistant to practice effects. Second, the number of variations of standard tests is often limited resulting in practice effects. While this approach has a high sensitivity and specificity for the detection of dementia, it is time and resource intensive. First, they ubiquitously rely on trained professionals. Standard cognitive assessments are not suited for weekly/monthly cognitive evaluations. In addition, longitudinal monitoring is essential for testing novel interventions designed to reduce or reverse cognitive aging. 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. Trail making requires cognitive flexibility generated through the dorsolateral and medial prefrontal cortices.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.At the end of the second trial, inform the subject that (s)he will be asked to recall these words again by saying, “ I will ask you to recall those words again at the end of the test.” Try to remember and tell me as many words as you can, including words you said the first time.” Put a check in the allocated space for each word the subject recalls after the second trial. When the subject indicates that (s)he has finished (has recalled all words), or can recall no more words, read the list a second time with the following instructions: “ I am going to read the same list for a second time. It doesn’t matter in what order you say them.” Mark a check in the allocated space for each word the subject produces on this first trial. When I am through, tell me as many words as you can remember. I am going to read a list of words that you will have to remember now and later on. Read a list of 5 words at a rate of 1 word per second, giving the following instructions: “ This is a memory test.
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