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Updated: Jun 10, 2026
Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
Published on: July 24, 2019
Development and Preliminary Validation of ORCA-PD, an Online Rapid Cognitive Assessment for Parkinson Disease: Mixed
Avigail Lithwick Algon1, Sarah Brisman1, Chi-Ying R Lin2
1Department of Occupational Therapy, Gray Faculty of Medical & Health Sciences, Sagol School of Neuroscience, Center for Accessible Neuropsychology, Tel Aviv University, Chaim Levanon St 55, Tel Aviv, 6139001, Israel, 1 0546428833.
Background:
Traditional in-person neuropsychological tests for Parkinson disease (PD) lack accessibility, scalability, and PD specificity. Mobility impairments hinder access to in-person assessments, and long waiting times for expert evaluation limit scalability. Common tools for cognitive screening, such as the Montreal Cognitive Assessment, are generic and not specific to PD.
Objective:
The goal of this study was to address these challenges by leveraging the internet. This study aimed to develop a sensitive tool to detect cognitive impairments in early- to mid-stage PD in an accessible and scalable manner.
Methods:
We developed the Online Rapid Cognitive Assessment for Parkinson's Disease (ORCA-PD), a brief (~15 min), fully self-administered tool, tailored to detect PD-specific impairments remotely. In a cross-sectional study, 112 participants from diverse geographical locations completed the ORCA-PD and a usability questionnaire. Task selection for ORCA-PD was guided by meta-analyses and comprehensive reviews, which demonstrated medium-to-high sensitivity to PD compared to healthy controls.
Results:
Participants from more than 30 geographical locations showed a 93% (135/145) completion rate, with median usability ratings of 4 to 5 (IQRs 0-1) out of 5, indicating strong usability across a diverse sample. The ORCA-PD score significantly correlated with the Montreal Cognitive Assessment score (ρ=0.45, 95% CI 0.21-0.64; P<.001; n=56), supporting convergent validity. The ORCA-PD scores also followed expected significant trends: neurotypical controls scored higher than participants with PD (β=4.18; P=.048) and participants with PD without mild cognitive impairment scored higher than participants with PD with mild cognitive impairment (β=7.22; P=.046), confirming 2 discriminative abilities.
Conclusions:
ORCA-PD demonstrated usability and preliminary validity. ORCA-PD offers an accessible, scalable, and PD-sensitive cognitive screening test that could complement traditional in-person, supervised tools.
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