{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:13:27Z","timestamp":1792782807364,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","id":[{"id":"https:\/\/ror.org\/001w7jn25","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With growing prevalence of mild cognitive impairment and dementia, online self-administered pre-screening tests hold the promise to more objectively identify individuals who stand to benefit from prioritized access to supervised cognitive testing and in-depth neurological evaluation, while reducing the burden of unnecessary tests for physicians and the health care system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to quantify practice effects in same-day and mid-term test-retest applications of the XpressO cognitive pre-screening test, to develop novel methods to stratify practice effects in the absence of ground truth, to quantify the discrimination power in retests, and to incorporate information from practice effects to improve the discrimination power for retests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>We performed a retrospective observational study to analyse data from a large, self-enrolled online cohort. We created descriptive statistics for test-retest comparisons of all relevant performance metrics, developed an unsupervised machine learning approach to impute the cognitive status of participants, and used this to compare the discrimination power in the initial test-retests on the same day or after a gap of two weeks or more.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant practice effects were found in a self-enrolled online population, in same-day retests and after several weeks, with differentially larger effects observed for presumably cognitively impaired participants. Practice effects reduced the discrimination power of the original test score in the retests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Whenever participants can perform unlimited, uncontrolled, and unsupervised practice sessions, increased task variation is desirable for future cognitive pre-screening tests. Quantified practice effects contain independent, additional predictive information regarding the cognitive status of online participants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-026-09333-5","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:58:53Z","timestamp":1787018333000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantification of practice effects in a self-administered online cognitive pre-screening test"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1201-343X","authenticated-orcid":false,"given":"Hans-Aloys","family":"Wischmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"Huijbers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murray","family":"Gillies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziad","family":"Nasreddine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"issue":"8","key":"9333_CR1","doi-asserted-by":"publisher","first-page":"afac173","DOI":"10.1093\/ageing\/afac173","volume":"51","author":"W Bai","year":"2022","unstructured":"Bai W, Chen P, Cai H, Zhang Q, Su Z, Cheung T et al (2022) Worldwide prevalence of mild cognitive impairment among community dwellers aged 50 years and older: a meta-analysis and systematic review of epidemiology studies. Age Ageing 51(8):afac173. https:\/\/doi.org\/10.1093\/ageing\/afac173","journal-title":"Age Ageing"},{"issue":"12","key":"9333_CR2","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1002\/alz.12362","volume":"17","author":"KB Rajan","year":"2021","unstructured":"Rajan KB, Weuve J, Barnes LL, McAninch EA, Wilson RS, Evans DA (2021) Population estimate of people with clinical Alzheimer\u2019s disease and mild cognitive impairment in the United States (2020\u20132060). Alzheimers Dement 17(12):1966\u20131975. https:\/\/doi.org\/10.1002\/alz.12362","journal-title":"Alzheimers Dement"},{"issue":"10","key":"9333_CR3","doi-asserted-by":"publisher","first-page":"e6158","DOI":"10.1002\/gps.6158","volume":"39","author":"C Giebel","year":"2024","unstructured":"Giebel C, Silva-Ribeiro W, Watson J, Volkmer A, Chirico I, Diaz A et al (2024) A Systematic Review on the Evidence of Misdiagnosis in Dementia and Its Impact on Accessing Dementia Care. Int J Geriatr Psychiatry 39(10):e6158. https:\/\/doi.org\/10.1002\/gps.6158","journal-title":"Int J Geriatr Psychiatry"},{"issue":"S3","key":"9333_CR4","doi-asserted-by":"publisher","first-page":"e089046","DOI":"10.1002\/alz.089046","volume":"20","author":"SE Polk","year":"2024","unstructured":"Polk SE, \u00d6hman F, Hassenstab JJ, K\u00f6nig A, Papp KV, Sch\u00f6ll M et al (2024) Current advances in remote and unsupervised digital cognitive assessment in preclinical Alzheimer\u2019s disease. Alzheimers Dement 20(S3):e089046. https:\/\/doi.org\/10.1002\/alz.089046","journal-title":"Alzheimers Dement"},{"key":"9333_CR5","doi-asserted-by":"publisher","unstructured":"Carver RB, Fredheim NAG, Mowinckel AM, Ebmeier KP, Friedman BB, Rosness TA et al (2022) People\u2019s interest in brain health testing: Findings from an international, online cross-sectional survey. Front Public Health 10\u20132022. https:\/\/doi.org\/10.3389\/fpubh.2022.998302","DOI":"10.3389\/fpubh.2022.998302"},{"issue":"8","key":"9333_CR6","doi-asserted-by":"publisher","first-page":"2516","DOI":"10.1111\/jgs.18902","volume":"72","author":"S Klil-Drori","year":"2024","unstructured":"Klil-Drori S, Bodenstein KCS, K S, L. G, J. G YC et al (2024) Montreal Cognitive Assessment (MoCA) XpressO: validation of a digital self-administered cognitive prescreening tool. J Am Geriatr Soc 72(8):2516\u20132522","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"9333_CR7","doi-asserted-by":"publisher","first-page":"662","DOI":"10.3758\/PBR.15.3.662","volume":"15","author":"MK Goode","year":"2008","unstructured":"Goode MK, Geraci L, Roediger HL (2008) Superiority of variable to repeated practice in transfer on anagram solution. Psychon Bull Rev 15(3):662\u2013666. https:\/\/doi.org\/10.3758\/PBR.15.3.662","journal-title":"Psychon Bull Rev"},{"key":"9333_CR8","unstructured":"Cherry K (2019) What Are Practice Effects? [Internet]. Dec 16 [cited 2025 Dec 21]. Available from: https:\/\/www.explorepsychology.com\/practice-effects\/"},{"key":"9333_CR9","doi-asserted-by":"publisher","unstructured":"Huijbers W, Wischmann HA, Gruber J, Pistoia K, Krieger J, Gillies M et al (2026 Jan) Real-world evidence from 50,000 online participants using MoCA-XpressO for cognitive prescreening. Sci Rep 13. https:\/\/doi.org\/10.1038\/s41598-026-35640-0","DOI":"10.1038\/s41598-026-35640-0"},{"issue":"2","key":"9333_CR10","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1007\/s11634-019-00373-8","volume":"14","author":"K Murphy","year":"2020","unstructured":"Murphy K, Murphy TB (2020) Gaussian Parsimonious Clustering Models with Covariates and a Noise Component. Adv Data Anal Classif 14(2):293\u2013325. https:\/\/doi.org\/10.1007\/s11634-019-00373-8","journal-title":"Adv Data Anal Classif"},{"key":"9333_CR11","unstructured":"Murphy K, Murphy TB, MoEClust (2025) Gaussian Parsimonious Clustering Models with Covariates and a Noise Component [Internet]. Available from: https:\/\/cran.r-project.org\/package=MoEClust"},{"key":"9333_CR12","doi-asserted-by":"crossref","unstructured":"Wood SN (2017) Generalized Additive Models: An Introduction with R, 2nd edn. Chapman and Hall\/CRC","DOI":"10.1201\/9781315370279"},{"issue":"1","key":"9333_CR13","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1467-9868.2010.00749.x","volume":"73","author":"SN Wood","year":"2011","unstructured":"Wood SN (2011) Fast stable restricted maximum likelihood and marginal likelihood estimation of semiparametric generalized linear models. J R Stat Soc B 73(1):3\u201336. https:\/\/doi.org\/10.1111\/j.1467-9868.2010.00749.x","journal-title":"J R Stat Soc B"},{"key":"9333_CR14","volume-title":"Unesco Institute for Statistics, Eurostat. ISCED 2011 operational manual. Paris Cedex","author":"Organisation for Economic Co-Operation and Development","year":"2015","unstructured":"Organisation for Economic Co-Operation and Development (2015) Unesco Institute for Statistics, Eurostat. ISCED 2011 operational manual. Paris Cedex. Organization for Economic Co-operation and Development (OECD), France"},{"issue":"3","key":"9333_CR15","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1212\/WNL.0000000000004826","volume":"90","author":"RC Petersen","year":"2018","unstructured":"Petersen RC, Lopez O, Armstrong MJ, Getchius TSD, Ganguli M, Gloss D (2018) Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 90(3):126\u2013135","journal-title":"Neurology"},{"key":"9333_CR16","doi-asserted-by":"publisher","unstructured":"Aarsland D, Sunde AL, Tovar-Rios DA, Leuzy A, Fladby T, Zetterberg H et al (2025 Dec) Prevalence of Alzheimer\u2019s disease pathology in the community. Nature 17. https:\/\/doi.org\/10.1038\/s41586-025-09841-y","DOI":"10.1038\/s41586-025-09841-y"},{"issue":"1","key":"9333_CR17","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/1471-2202-11-118","volume":"11","author":"C Bartels","year":"2010","unstructured":"Bartels C, Wegrzyn M, Wiedl A, Ackermann V, Ehrenreich H (2010) Practice effects in healthy adults: A longitudinal study on frequent repetitive cognitive testing. BMC Neurosci 11(1):118. https:\/\/doi.org\/10.1186\/1471-2202-11-118","journal-title":"BMC Neurosci"},{"issue":"6","key":"9333_CR18","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1080\/13854046.2015.1087596","volume":"29","author":"SA Cooley","year":"2015","unstructured":"Cooley SA, Heaps JM, Bolzenius JD, Salminen LE, Baker LM, Scott SE et al (2015) Longitudinal Change in Performance on the Montreal Cognitive Assessment in Older Adults. Clin Neuropsychol 29(6):824\u2013835 .1087596 PubMed PMID: 26373627","journal-title":"Clin Neuropsychol"},{"key":"9333_CR19","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.intell.2018.01.003","volume":"67","author":"J Scharfen","year":"2018","unstructured":"Scharfen J, Peters JM, Holling H (2018) Retest effects in cognitive ability tests: A meta-analysis. Intelligence 67:44\u201366. https:\/\/doi.org\/10.1016\/j.intell.2018.01.003","journal-title":"Intelligence"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-026-09333-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-026-09333-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-026-09333-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:34:22Z","timestamp":1791826462000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-026-09333-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["9333"],"URL":"https:\/\/doi.org\/10.1007\/s10072-026-09333-5","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]},"assertion":[{"value":"17 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Hans-Aloys Wischmann worked for Philips in various healthcare research and innovation management functions, up to April 2021, in roles unrelated to this work. Except for Hans-Aloys Wischmann, all authors are employees, consultants, or owner (Ziad Nasreddine) of MoCA Cognition.","order":1,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"713"}}