The Survey for Memory, Attention, and Reaction Time (SMART): Development and Validation of a Brief Web-Based Measure of Cognition for Older Adults

Katherine E. Dorociak, Nora Mattek, Jonathan Lee, Mira I. Leese, Nicole Bouranis, Danish Imtiaz, Bridget M. Doane, John P.K. Bernstein, Jeffrey A. Kaye, Adriana M. Hughes

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


INTRODUCTION: Brief, Web-based, and self-administered cognitive assessments hold promise for early detection of cognitive decline in individuals at risk for dementia. The current study describes the design, implementation, and convergent validity of a fWeb-based cognitive assessment tool, the Survey for Memory, Attention, and Reaction Time (SMART), for older adults.

METHODS: A community-dwelling sample of older adults (n = 69) was included, classified as cognitively intact (n = 44) or diagnosed with mild cognitive impairment (MCI, n = 25). Participants completed the SMART at home using their computer, tablet, or other Internet-connected device. The SMART consists of 4 face-valid cognitive tasks available in the public domain assessing visual memory, attention/processing speed, and executive functioning. Participants also completed a battery of standardized neuropsychological tests, a cognitive screener, and a daily function questionnaire. Primary SMART outcome measures consisted of subtest completion time (CT); secondary meta-metrics included outcomes indirectly assessed or calculated within the SMART (e.g., click count, total CT, time to complete practice items, and time of day the test was completed).

RESULTS: Regarding validity, total SMART CT, which includes time to complete test items, practice items, and directions, had the strongest relationship with global cognition (β = -0.47, p < 0.01). Test item CT was significantly greater for the MCI group (F = 5.20, p = 0.026). Of the SMART tasks, the executive functioning subtests had the strongest relationship with cognitive status as compared to the attention/processing speed and visual memory subtests. The primary outcome measures demonstrated fair to excellent test-retest reliability (intraclass correlation coefficient = 0.50-0.76).

CONCLUSIONS: This study provides preliminary evidence for the use of the SMART protocol as a feasible, reliable, and valid assessment method to monitor cognitive performance in cognitively intact and MCI older adults.

Original languageEnglish (US)
Pages (from-to)740-752
Number of pages13
Issue number6
Early online dateApr 7 2021
StatePublished - Dec 1 2021

Bibliographical note

Funding Information:
This work was supported in part by NIH grant AG058687, Alzheimer’s Disease Research Center grants P30AG008017 and P30AG066518, Roybal Center Grant P30AG024978, the VA Research and Development grant CX001669-0, and the Minneapolis VA Health Care System.

Publisher Copyright:
© 2021


  • Cognition
  • Cognitive screening
  • Computerized testing
  • Mild cognitive impairment
  • Technology


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