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Updated: Jul 1, 2026

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease

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Published on: October 13, 2016

Remote cognitive tests predict neurodegenerative biomarkers in the Insight 46 cohort.

Martina Del Giovane^1,2, Valentina Giunchiglia^1,3,4, Ziyuan Cai^1,3

¹Imperial College London, Department of Brain Sciences. Burlington Danes, The Hammersmith Hospital, London, UK.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association

|February 12, 2025

Summary

Remote cognitive tests can detect early Alzheimer's disease changes. Slower memory task responses and lower accuracy predict amyloid positivity and brain atrophy, correlating with standard tests.

Keywords:

Alzheimer's disease Insight 46 amyloid biomarkers computerized cognitive testing dementia memory neurodegeneration

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Published on: January 24, 2020

Area of Science:

Neuroscience
Biomarkers
Cognitive Assessment

Background:

Alzheimer's disease (AD) biomarkers identify pathology before symptoms, enabling early intervention.
Remote cognitive testing offers a scalable method for detecting subtle cognitive changes.
This study investigates the link between neurodegenerative biomarkers and cognitive function in healthy individuals.

Purpose of the Study:

To explore the relationship between neurodegenerative biomarkers and cognitive performance in cognitively normal individuals.
To assess the utility of remote computerized cognitive tasks in identifying early AD-related changes.
To determine if remote cognitive testing correlates with standard neuropsychological assessments.

Main Methods:

255 participants in the Insight 46 study completed 13 remote computerized Cognitron tasks.
Amyloid load, white matter hyperintensity volume (WMHV), and brain/hippocampal volumes were measured.
Cognitron task performance was analyzed against biomarker data and standard neuropsychological tests.

Main Results:

Slower response times on a delayed recognition task predicted amyloid positivity and increased WMHV.
Reduced accuracy on memory and spatial span tasks correlated with longitudinal brain atrophy rates.
Cognitron task performance showed significant correlation with standard cognitive tests.

Conclusions:

Remote computerized cognitive testing effectively correlates with traditional supervised assessments.
These remote tasks show potential for studying early cognitive alterations associated with neurodegeneration.
Online cognitive testing can aid in identifying early memory deficits indicative of AD.