Abstract

 

Background: Managing finances constitutes an Instrumental Activity of Daily Living that often declines with cognitive impairment. The Banking App was developed as a brief digital assessment that simulates a real-world financial task (money withdrawal) to objectively measure functional performance, and has demonstrated the ability to discriminate stages of cognitive impairment. In RADAR-AD (https://www.radar-ad.org/), the app differentiated healthy controls (HC) and individuals with preclinical Alzheimer’s disease (AD) from those with prodromal and mild AD (DOI: 10.1186/s13195-025-01675-0). These findings guided further refinement within PREDICTOM (https://www.predictom.eu/), including the addition of difficulty levels while preserving the core task (Figure 1). A feasibility study was conducted prior to enrolling 4,000 PREDICTOM participants, to assess user acceptability and whether discrimination between stages was retained.

Methods: Thirty participants were recruited through the Greek Association of Alzheimer’s Disease and Related Disorders, including 9 HC, 16 individuals with mild cognitive impairment (MCI), and 5 individuals with MCI and stress/depressive symptoms. Participants completed the app-based test, followed by a questionnaire. Analysis focused on participant feedback (demographics, Likert-scale, and open-ended responses). Statistical analysis on app performance data included one-way ANOVA and between-group t-tests.

Results: The Banking App was well accepted, with usability highest in HC and lower in participants with MCI or MCI with stress/depression (Table 1A). Importantly, all participants completed the test independently. Welch’s one-way ANOVA showed significant group differences for most app features (p ≤ 0.05), and pairwise t-tests indicated longer task completion times with greater cognitive impairment and significant differences across both established and new features (Table 1B, Figure 2).

 

Conclusion: The updated Banking App is a feasible, user-friendly tool usable by healthy older adults and individuals with MCI, with the new features effectively discriminating between groups. Ongoing analyses within PREDICTOM will investigate combinations of the Banking App features to further improve identification of individuals at higher and lower risk of developing dementia.