Ask HN: How do you remotely monitor cognitive performance in the eldery?

Disclaimer: I'm not qualified in any particular way for this.

First, some basic tests that neurologists try routinely can be done remotely on a video call. A couple of these can be:

- drawing a clock/watch. On a piece of paper, which they can then show to you on the screen, without, obviously, looking at a real clock. The goal is to have a round clock, with 1 to 12 numbers and the hands pointing the current time. Signs of problems can include difficulty placing the hands or the numbers correctly, or even just not managing to do an approximately round shape. Rarer signs can appear in the order in which things are drawn.

- counting backwards out loud from 30 down to 0 in steps of 3. (30, 27, 24, 21...). You'll have to look for various "obvious" difficulties with getting the correct numbers and more subtle ones like the effort it takes to do it.

But these are very obvious tests and, as RobinHirst11 says, you'll probably get a better evaluation through "normal" conversation. I'd suggest a longer conversation going through various subjects. While at it, try to ask things like the current date and weekday, and a few basic things on their daily lives like what they ate/had for breakfast today or yesterday. Also go through a number of subjects, particularly ones that involve different groups of people (different sides of the family, groups of friends -theirs and yours-, neighbours, etc) and different situations and dates.

Some clear signs may be repetition -asking the same questions- or difficulty keeping track of a story/actors. But more subtle ones can be seen through "going back" or "mixing". Mixing is just that, confusing the people or actions in different stories you've been talking about. "Going back" is just that, going back to previous stories after that part of the conversation has ended -like you may be now talking about your cousin this Christmas and in an unrelated, unexpected way, they ask about something you mentioned before about your car, or whatever-.

Regular video calls with your parent doing casual activities like crosswords can help spot early issues like repeated stories or word-finding trouble. Setting up autopay and monitoring their spending (with permission) helps track financial management. Building connections with neighbors gives you local eyes, while smart home devices can track daily routines. Watch for changes in how they handle tasks, personal care, or social activities. Keep everything feeling natural rather than like a test.

I'm curious what action would be driven by seeing these signs? Do they feel they need assistance to handle their daily life, or is this just for yourself to know whether they are headed that direction? Actually, for either answer, I'd suggest talking directly to them about how they want to be monitored. Most elderly people are acutely aware that they are elderly and what struggles they are having. Open dialogue about it can resolve concerns about it fairly reasonably.

i think you need to chill and just let them live their old life.

you're trying to quantify something that's qualitative on them. checking on them and hanging out with them in person when you got the time is already enough.

let them fade on their own pace, stop trying to control it.

Our doctor asks us to count backwards in steps of 7 from 100! Seems a bit too tricky to me.

1. Caregiving happens hands on and one person at a time. No app is going to make it efficient. Only convenient in the box checking sense.

2. What would you do if you saw cognitive decline?

3. Why not do that now?

4. Meaningful assessments come from professionals.

Good luck.