Personalized Digital Training for COGnitive FITness in Mild Cognitive Impairment

The Patient Activation Measure (PAM) is a validated and highly reliable scale designed to assess a person's level of activation, defined as their ability to manage their own health and actively participate in care. The PAM identifies four progressive levels of activation: (1) awareness of the importance of one's role in managing health, (2) acquisition of the knowledge and confidence to take action, (3) initiation of health-related behaviors, and (4) consistent maintenance of those behaviors even under stress (Hibbard et al., 2004).

The MoCA is a brief cognitive screening tool used to detect mild cognitive impairment. It assesses multiple domains, including attention and concentration, executive functions, memory, language, visuoconstructional skills, abstract reasoning, calculation, and orientation. The test takes approximately 10 minutes to administer and has a maximum score of 30 points; scores of 26 or above are generally considered within the normal range. Tasks include the Trail Making Test, complex figure copying, object naming, word and sentence repetition, attention and verbal fluency tests, abstraction, and orientation questions. Each item is scored according to standardized criteria, allowing for reliable evaluation of a participant's cognitive performance.

The CRIq is a psychometric tool designed to assess the cumulative cognitive reserve developed across the lifespan. It evaluates three main domains: education, working activity, and leisure time, and provides an overall composite score of an individual's cognitive reserve. The CRIq is widely used in clinical and neuropsychological research to investigate the protective role of cognitive reserve in age-related cognitive decline and neurodegenerative diseases. Due to its simplicity, reliability, and validity, it is considered a useful tool in both clinical and epidemiological settings.

The WHODAS 2.0 is a standardized, cross-culturally applicable instrument developed by the World Health Organization to assess health and disability in the general adult population and in clinical settings. WHODAS 2.0 assesses functioning across six key domains: cognition, mobility, self-care, social interaction, daily activities, and participation in society. Grounded in the framework of the International Classification of Functioning, Disability and Health (ICF), it measures health and disability as a continuum, regardless of the underlying medical condition. WHODAS 2.0 is available in two main versions-a 36-item full form and a 12-item short form-administered via interview, self-report, or proxy. It provides a composite score reflecting the functional impact of different health conditions and supports monitoring and planning of healthcare interventions.

The EQ-5D-5L is a standardized and quick-to-administer instrument designed to assess health-related quality of life (HRQL) from the patient's perspective. It evaluates five key dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is rated across five severity levels, generating up to 3,125 unique health states and providing a detailed picture of an individual's health status. The EQ-5D-5L also includes a visual analogue scale (VAS) ranging from 0 (the worst imaginable health state) to 100 (the best imaginable health state), allowing patients to provide a global rating of their perceived health. Due to its simplicity and versatility, it is widely used in clinical practice, economic evaluations, and epidemiological research, enabling comparisons across conditions and populations.

The STAI-Y is a widely used psychometric instrument for assessing anxiety in adults and older adults. It includes two 20-item subscales that distinguish between state anxiety (S-Anxiety), a temporary emotional condition in response to situational stress, and trait anxiety (T-Anxiety), a stable tendency to perceive situations as threatening. The STAI-Y has been validated in older Italian populations, demonstrating high internal consistency and strong psychometric properties. Normative data are available for this population, supporting its use in clinical and research settings to identify anxiety levels that may negatively affect overall health, cognitive functioning, and quality of life in older adults.

The BDI is a 21-item self-report questionnaire designed to assess the presence and severity of depressive symptoms and attitudes. Originally developed by Beck in 1961, it takes approximately 10 minutes to complete and requires a basic reading level. The BDI demonstrates high internal consistency and robust psychometric properties across both psychiatric and general populations. It is one of the most widely used tools in clinical and research settings to screen for depression and monitor symptom severity over time.

The MBI-C is a specialized instrument designed to assess emergent neuropsychiatric symptoms in individuals aged 50 years and older, which may precede cognitive decline or dementia. It includes 34 items grouped into five domains: decreased motivation, emotional dysregulation, impulse control difficulties, socially inappropriate behaviour, and abnormal thoughts or perceptions. The MBI-C captures behavioural changes that persist for at least 6 months and represent a meaningful deviation from the individual's previous baseline. It can be completed by the patient, a knowledgeable informant, or a clinician. The tool is valuable for the early detection of dementia-related syndromes and for monitoring symptom progression over time.

The SUS is a widely used psychometric tool for evaluating users' perceived ease of use of a product, interface, or service. It consists of 10 items rated on a 5-point Likert scale (ranging from "strongly disagree" to "strongly agree") and yields a single composite score that reflects the overall perceived usability of the system.

TAM is a widely used psychometric framework for explaining and predicting user acceptance and usage of new technologies. It focuses on two key constructs: perceived usefulness and perceived ease of use, both of which influence users' attitudes toward the technology and their intention to use it. TAM has been validated in multiple settings and has demonstrated strong reliability and utility in forecasting the adoption of new technologies in workplace, healthcare, and educational contexts.