We are very grateful to all APT Webstudy participants during these challenging times, and we hope you will continue to visit the site and complete the assessments every three months. Your performance on the tests may be influenced by the conditions surrounding the COVID-19 pandemic, but our analysis of the data will be adjusted so that we will still be able to accurately track changes over time.

Social distancing restrictions have posed challenges to many of our in-person Trial Ready Cohort (TRC) clinic sites, and so we have reduced our invitations to APT Webstudy participants to visit the sites. As the social distancing restrictions begin to lift, TRC activities will return to normal and our invitations will increase. The safety of participants and site personnel are of the utmost importance to us.

We will continue to update this website with additional information as we continue to navigate the challenges of the pandemic.

The recent tragedies of George Floyd, Ahmaud Arbery and Breonna Taylor demand that we all address the injustice in our society. These terrible events have occurred in the midst of a pandemic which is disproportionately affecting communities of color. These events are symptoms of the unacceptable societal inequalities that contribute to poorer health for people of color in the United States. We must be united in our pursuit of positive change.

The APT Webstudy Team is committed to a culture of equality, inclusiveness and diversity. Racism and other forms of discrimination will not be tolerated in any form. We must intensify our efforts to address inequities in clinical research and work toward positive change in our society.

In our role as Alzheimer’s researchers, we will renew our commitment to unity, collaboration and collective action. We have a moral imperative to eradicate overt and implicit bias, and the conduct of rigorous clinical research demands this. We are committed to diversity in recruiting our study participants, as this is the only way we can find answers which serve the health needs of all people. A more diverse workforce enables us to have the most committed and agile minds focused on our very challenging tasks.

We can and will do better.

Sincerely,

The APT Webstudy Team

APT Webstudy


Accelerating AD Clinical Research


General Questions and Participation

The Alzheimer Prevention Trials (APT) Webstudy is designed to identify people who may have an increased risk for developing Alzheimer’s disease, using the latest technology to monitor their cognitive performance through regular online memory testing. Because the APT Webstudy is an online study, volunteers can participate at their convenience, anywhere they have access to the internet. APT Webstudy participants benefit by:

  • Having their cognitive health assessed over time;
  • Being on the “fast track” for relevant clinical trials to prevent Alzheimer’s;
  • Making an invaluable contribution to advancing Alzheimer’s research, perhaps helping those in the research field find the first Alzheimer’s survivor; and
  • Helping to ensure that future generations do not experience Alzheimer’s and its difficult challenges.

The APT Webstudy is being conducted by the University of Southern California’s Alzheimer’s Therapeutic Research Institute (USC ATRI) and is funded by the National Institute on Aging (NIA). The Webstudy does not require participants to take medication and is not a clinical trial itself; it’s what we call an “observational” study, meaning we look at (or observe) changes over time in measures of memory function.

The APT Webstudy is connected to an in-person study called the Trial Ready Cohort for the Prevention of Alzheimer’s Dementia, or TRC-PAD. TRC-PAD identifies those from the APT Webstudy whom may have a potential increased risk for memory loss caused by Alzheimer’s disease and refers them to a research site nearest them for further evaluation. The purpose of TRC-PAD is to find as many people as possible (also called a “cohort”) who are interested in participating in clinical trials aimed at discovering treatments that will reduce the risk of developing Alzheimer’s dementia. TRC-PAD will help researchers enroll participants into these trials quickly to allow new treatments to be discovered as soon as possible. Volunteers do not have to participant in the TRC-PAD study in order to be part of the online APT Webstudy.

To learn more about TRC-PAD, please visit https://trcpad.org

Please feel free to contact us by email at info@aptwebstudy.org or by phone 1-858-877-3135. Keep in mind we will respond to inquiries during normal business hours: Monday through Friday, 8am to 5pm Pacific Time USA. We will do our best to respond within three business days. We are closed on all major holidays.

APT Webstudy participants take online memory tests every three months, which take about 20 minutes to complete.

To enroll, registration takes about 30 minutes. This first visit will ask you to agree/consent to participate, to answer some questions about your life and medical history, and to complete both the Cognitive Function Index (CFI) survey and the Cogstate memory assessment.

If we notice any changes in your memory and thinking performance overtime, we may invite you to a clinic located closest to you for further evaluation and screening for the in-person TRC-PAD Study. Please see question #1 above for more information on TRC-PAD and the APT Webstudy, or you can also visit the TRC-PAD website at https://trcpad.org . Based upon this, you may then be matched to an Alzheimer's prevention trial if you are eligible.

The APT Webstudy is not designed for individuals who have already been diagnosed with Alzheimer's disease dementia or any form of dementia. Enrollees in the APT Webstudy should be at least 50 years old and healthy.

Yes! We invite people all over the world to join! Please just keep in mind that all clinical sites will be located in the United States. These sites are part of TRC-PAD to conduct further evaluation of those APT Webstudy participants invited for in-person visits. Please see question #1 above for more information on TRC-PAD and the APT Webstudy, or you can also visit the TRC-PAD website at https://trcpad.org . If this isn't a deal breaker for you, please join us! You will still have access to everything in the APT Webstudy, including your scores from the assessments you take. Attending any in-person clinic visits someone may be invited to is not a requirement to be part of the APT Webstudy. If you end up choosing to join, note that the zip code field at registration is not required so you may skip this question.

Email communications are delivered based upon the last language you used to view the APT Webstudy while you were logged in. To change your preferred language, please log into your APT Webstudy account. Once logged on, you will be able to change between languages (English or Spanish) by using the toggle in the top right corner of the screen as shown below.

Picture of language selection in menu bar

Once you are registered and have completed one full round of assessments, you should see the menu pictured below whenever you log into your account.

Picture of menu options: My Memory, My Life, Dashboard, About APT

Because we want to track your memory and thinking performance over time, "My Memory" will be where you go every three months to take the necessary tests. It will also tell you the date when you are next able to take them. We'll send you an email to remind you when it's time. Sometimes these types of emails will automatically get sent to junk and/or spam folders, so please be sure to check there.

Next, "My Life" is where you will find the answers to some of the personal questions we asked when you registered for the APT Webstudy. If something ever changes, you can make edits here.

"My Dashboard" contains a lot of information. Your test scores will be posted here, but you'll also be able to update your profile, manage your consent to participate, view your Summary Report, and you can even refer a friend to participate in the APT Webstudy.

"About APT" houses resources, updates to studies connected to the APT Webstudy, and an archive of the APT Webstudy Quarterly Review. This page will help keep you updated on all that’s happening with the Webstudy.

Lastly, on the top right of the screen you will see a blue icon with a person in it. By clicking on the blue icon, you can go to your "Profile" and to Account Settings which is where you can change the email associated with your account and/or your password, among other actions.

You can stop participation in the APT Webstudy at any time by withdrawing your consent. To do this, log into your APT Webstudy account. From there, you would:

  • Select "My Dashboard" from the menu of choices
  • Select "Manage Consent" on the left side of the screen
  • Select "I no longer agree to participate". If you select this, you will no longer receive emails from the APT Webstudy.

*Note: if you are in the middle of your first visit, you'll need to navigate back to the consent section by clicking on the yellow thumbs up at the top of the screen (in the navigation pane) as shown below. Then select "Check to revoke my study consent". This will immediately revoke your own consent and you will no longer receive emails from the APT Webstudy.

Picture of walkthrough: targeting navigation to consent view


Technical Issues

The best way to retrieve a forgotten Username or password is to navigate to the "Log In" page (https://www.aptwebstudy.org/accounts/login/). Here, you should see a "Forgot Password or Username?" option, as shown on the screen below. Click on that and it will take you to a page that will ask for you to enter the email address you used to register for the APT Webstudy. We will send you an email containing your Username, as well as an option to reset your password. Please make sure to check spam/junk folders if not finding the email in your Inbox.

**If you are still having trouble signing in, and you have a Google (Gmail) email account, please see Question #10 below.

Picture of Login Page: Forgot Password or Username option

If you have a Google (Gmail) account, we offer account creation and any future logins through a "Log in with Google" option. This procedure automatically connects your APT Webstudy account with your Gmail (Google) email account. If you chose this option at registration, you may have noticed a "weird" Username in the confirmation emails you receive from us.

If you chose this method at registration, you may notice having trouble signing in the "regular" way utilizing a Username and password. When you try logging in the "regular" way, you will most likely have the system tell you one or the other is incorrect.

In any case, please visit the login page (https://www.aptwebstudy.org/accounts/login/) and all you will need to do is click on blue "Log in with Google" button as shown below. The system might ask you to choose which account your Google (Gmail) account is. Once you click on the correct account, the system should automatically sign you in under your Google (Gmail) account if you are already signed into it. If it prompts you for a password, enter the password associated with your Google (Gmail) account.

Picture of Sign Up Page


CFI and Cogstate Questions

Yes, it is important that the same device (i.e. computer, tablet) be used each time you retake the Cogstate assessment for the APT Webstudy. This is to ensure that any changes in performance are indicative of genuine change and not simply a result of devices potentially having different processing times.

If you close the browser before you complete either assessment, it will not be saved, and you will need to restart from the beginning.

You can use any computer or tablet, as long as its connected to the internet and meets the following minimum capabilities requirements: 2gb RAM of memory, 1024x768 screen resolution, and sound capability. For now, the Cogstate can only be taken using tablets (in landscape mode) or computers (laptops or desktops). All other activities in the APT Webstudy can be done using your smart phone.

The Cogstate assessment must be taken on a device that meets certain minimum capabilities, including screen resolution. This is so that the test is displayed and runs properly. If you are getting a message saying that your device doesn’t meet the minimum screen resolution of 1024x768, you will need to try to change the display screen resolution. Use the links below for more information on how to change the screen resolution of Apple Macs and Microsoft Windows:

Windows 7
https://support.microsoft.com/en-us/help/14108/windows-7-change-screen-resolution

Windows 10
https://support.microsoft.com/en-us/help/4026956/windows-10-change-screen-resolution

Macs
https://support.apple.com/guide/mac-help/change-your-displays-resolution-mchl86d72b76/mac

You can also try the suggestions provided in the response to Question #15. Another option is to log into your APT Webstudy account using a different device (i.e. laptop, PC).

There might be two issues here. First make sure that the web screen/window you are working on is maximized to its fullest. If it's not maximized, the system may think you are using a small device like a phone, thus giving the mobile or resolution message. You can maximize screens by selecting the icon directly to the left of the "X" in the top right corner of your browser window like below:

Picture of how icon to maximize screen size.

Another issue here might be the size of the screen font. If the screen is zoomed in too far, so that your font size is large, the system may think you are using a small device like a phone, thus giving the mobile or resolution message. Try zooming out of your screen a little to reduce the font size.

If using a tablet, make sure you're holding it in landscape mode.

We apologize that none of our suggested remedies have helped. It may mean that your system does not support the Cogstate assessment software at this time. The Cogstate assessment must be taken on devices that meet certain technological requirements to run properly. Until your system can be supported, you may skip the Cogstate assessment and we will inform you when software upgrades occur, so that you can attempt the Cogstate assessment in the future.

Even without being able to complete the Cogstate assessment at this time, you can still participate in the APT Webstudy. You should know that by doing so, you are still making a significant contribution to Alzheimer’s research and for that, we are greatly appreciative. Not being able to complete the Cogstate assessment will not preclude you from continuing to participate in the APT Webstudy and contributing what you can.

To "skip" the Cogstate assessment, please follow the subsequent directions. When you get the resolution and/or mobile device message, you can click on the "Skip Assessment" button as highlighted below.

Picture of Cogstate Screen Resolution Message.

That should take you to a thank you page where you can then click on the "Home" button, which will take you to the main menu as shown below.

Picture of menu options: My Memory, My Life, Dashboard, About APT

There, "My Dashboard" will contain your CFI score (and any future scores), while "My Memory" is where you will go to retake the assessments every three months. "My Life" contains other information you inputted into the system and "About APT" contains general information about Alzheimer's disease research, and much more.

Be sure to watch the Cogstate tutorial video found on the Cogstate introductory page. This will help guide you through the Cogstate assessment. Please see screenshot below of what you should see for the introduction page to Cogstate- the video play button is found on the screen where the finger and keyboard are. Also, as a guide through each of the Cogstate sections, you will be presented with an introduction to each, will be allowed a short practice round, and then will be taken to the actual scored assessment.

As a quick point though, the tutorial will show that there are keys on your computer keyboard to use to designate "yes" or "no" answers, so will the practice rounds of each subtest. If you are on a tablet, there will be actual "yes" or "no" buttons on the screen to touch with your fingers. Please keep in mind that practice rounds are separate from the scored tests and that the "yes" and "no" answer prompts will not appear during the scored tests.

Picture of Cogstate test.

Cogstate scores will be processed within about a week of completing the assessment, and you will receive notification when your scores are available by email. You will be able to find both your CFI and Cogstate scores under "My Dashboard" once you sign into your APT Webstudy account.

Both assessments are research tools being evaluated for their ability to predict individuals at risk for developing Alzheimer's in the future. A change in score over time is thought to be most useful in identifying individuals who may be at increased risk for developing Alzheimer's in the future. Below are links to published manuscripts on the development of these research tools:

The CFI scores range from 0 to 15. CFI scoring is such that zero is normal and increasing scores over time may indicate a possible decline in subjective cognitive function. A progressively worsening score, a few points increased over each testing session, may reflect worsening function.

If your Cogstate score falls between -10 to +10, it is considered normal. Cogstate scoring is such that zero could be considered as performing in the average range for that subtest compared to people of similar age. When you hover over a specific timepoint dot, you should see all four subtest scores. A negative score on the test means that your performance was lower than average, and a positive score means your performance was higher than average. Higher positive scores (for instance, 0.2 becoming 0.5) may indicate slightly better performance and higher negative scores (for instance, -0.4 becoming -0.8) may indicate slightly worsening performance.

Under "My Dashboard", where your scores are posted, you will see different colors on the Cogstate graph. These indicate individual scores associated with the Cogstate subtests (i.e. Detection, Identification, One Card Learning, One Back). Below is a little more explanation of the Cogstate subtests:

  • The Detection subtest: measures processing speed. The on-screen instructions ask: "Has the card turned over?". A playing card is presented face down in the center of the screen. The card flips over so it is face up. As soon as the card flips over the participant should indicate "Yes".
  • The Identification subtest: measures attention. The on-screen instructions ask: "Is the card red?". A playing card is presented face down in the center of the screen. The card flips over so it is face up. As soon as it flips over the participant must decide whether the card is red or not. If it is red the participant should indicate "Yes", and if it is not red the participant should indicate "No".
  • The One Card Learning subtest: measures visual memory. The on-screen instructions ask: "Have you seen this card before in this test?". A playing card is presented face up in the center of the screen and the participant must decide whether they have seen the card before in this subtest. If the card has been seen before the participant should indicate "Yes", and if it hasn’t been seen before the participant should indicate "No".
  • The One Back subtest: measures working memory. The on-screen instructions ask: "Is the previous card the same?". A playing card is presented face up in the center of the screen. The participant must decide whether the card is the same as the previous card. If the card is the same the participant should indicate "Yes", and if it is not the same the participant should indicate "No".

**Please note that a single CFI and/or Cogstate score at any given time is not thought to have as much clinical meaning as a change in score over time. As you progress in the APT Webstudy, we will be able to track changes which we believe will be useful in predicting individuals at increased risk for developing Alzheimer’s disease. A change in score over time is thought to have a predictive value that would be confirmed by in-clinic evaluation. Of course, should you have concerns about your memory, you should consult with your personal physician.**

The goal of the APT Webstudy is to track a person’s memory and thinking performance overtime. While we can’t delete any of your tests, one bad score will not completely skew your overall status that we see. We’ll be looking at all of your scores, so we’ll notice if one just doesn’t seem right especially if it was your first time taking the assessments.

First, log in to your APT Webstudy account. You should then see a menu of options as shown below.

Picture of Cogstate test.

Next, navigate to "My Memory", in which you should see something similar to what’s shown below. If it’s time to take your next set of CFI and/or Cogstate assessments, they will be "unlocked" and you should be able to click on the blue "Take CFI Assessment" or "Take Cogstate Assessment" button(s). If it is not quite time yet, you should see the date of the next availability to retake.

Picture of Cogstate test.