Comparison of an Electronic and Paper-based Montreal Cognitive Assessment Tool

Snowdon, Anne; Hussein, Abdulkadir; Kent, Robert G.; Pino, Lou; Hachinski, Vladimir

doi:10.1097/wad.0000000000000069

Cited by 21 publications

(16 citation statements)

References 12 publications

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“…There have recently been digital translations of traditional brief pen and paper cognitive tests [57, 76]. It is clear from these attempts that the digital translation needs to be separately validated from the pen and paper version [57].…”

Section: Discussionmentioning

confidence: 99%

Digitally translated Self-Administered Gerocognitive Examination (eSAGE): relationship with its validated paper version, neuropsychological evaluations, and clinical assessments

et al. 2017

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BackgroundThe original paper Self-Administered Gerocognitive Examination (SAGE) is a valid and reliable cognitive assessment tool used to identify individuals with mild cognitive impairment (MCI) or early dementia. We evaluated identical test questions in a digital format (eSAGE) made for tablet use with the goals of calibrating it against SAGE and establishing its association with other neuropsychological tests and clinical assessments of cognitive impairment.MethodsSubjects aged 50 and over who had taken SAGE were recruited from community and clinic settings. Subjects were randomly selected to participate in a clinical evaluation including neuropsychological evaluations. SAGE and eSAGE were administered using a crossover design. Subjects were identified as dementia, MCI, or normal based on standard clinical criteria. Associations were investigated using Spearman correlations, linear regression, and sensitivity and specificity measures.ResultsOf the 426 subjects screened, 66 completed the evaluation. eSAGE score correlation to a battery of neuropsychological tests was 0.73 (p < 0.0001) with no significant difference between the paper and digital format. Spearman correlation of SAGE versus eSAGE was 0.88 (p < 0.0001), and they are related by the formula: eSAGE score = –1.05 + 0.99 × SAGE score. Since the slope is very close to 1 (p = 0.86) there is strong evidence that the scaling is identical between eSAGE and SAGE, with no scale bias. Overall, eSAGE scores are lower by an average of 1.21 and the decrease is statistically significant (p < 0.0001). For those subjects familiar with smartphones or tablets (one measure of digital proficiency), eSAGE scores are lower by an average of 0.83 points (p = 0.029). With a score 16 and higher being classified as normal, eSAGE had 90% specificity and 71% sensitivity in detecting those with cognitive impairment from normal subjects.ConclusionsTablet-based eSAGE shows a strong association with the validated paper SAGE and a neuropsychological battery. It shows no scale bias compared to SAGE. Both have the advantage of self-administration, brevity, four interchangeable forms, and high sensitivity and specificity in detecting cognitive impairment from normal subjects. Their potential widespread availability will be a major factor in overcoming the many obstacles in identifying early cognitive changes.Trial registrationClinicalTrials.gov, NCT02544074. Registered on 18 March 2015.

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Section: Discussionmentioning

confidence: 99%

Digitally translated Self-Administered Gerocognitive Examination (eSAGE): relationship with its validated paper version, neuropsychological evaluations, and clinical assessments

et al. 2017

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“…Three studies belong to this category: one from Canada, one from France, and one from Australia (see Table ).…”

Section: Resultsmentioning

confidence: 99%

“…The Canadian study assessed the comparison of the paper-based Montreal Cognitive Assessment (MoCA) and the electronic version (eMoCA). 23 Participants were randomly assigned to 2 groups. A demographic questionnaire was built into the eMoCA tool.…”

Section: One Frommentioning

confidence: 99%

Diagnosis of cognitive decline and dementia in rural areas — A scoping review

Barth

Nickel

Kolominsky-Rabas

2018

Int J Geriat Psychiatry

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“…Mezurio has been used in the PREVENT Dementia study and the UK Alzheimer's Society GameChanger Study (53) The "Novel Assessment of Nutrition and Ageing" (NANA) touchscreen interface has been tested in 40 neurotypical elderly (mean age: 72 years) care home residents where it was deployed daily (55). Cognitive NANA data produced comparable validity and reliability to standard clinical measures, such as the MMSE, Symbol Digit Modalities Test and Digit Scan tests (55).Winterlight (https://winterlightlabs.com/) is a tablet-based cognitive assessment designed to detect cognitive impairment (56) by examining linguistic markers (57) 8 . MCS scores also correlated (mean r 2 = .57) with MoCA scores.…”

Section: Device-basedmentioning

confidence: 99%

“…Telephone Interview for Cognitive Status (TICS) (7)] or remote versions of standardized assessment scales (e.g. eMontreal Cognitive Assessment [eMOCA (8)], telephone-Mini Mental State Examination [tMMSE (9)]. Finally, fully automated systems and related scalable digital technologies exist to measure cognition and function.…”

Section: Introductionmentioning

confidence: 99%

Implementing Remote Memory Clinics to Enhance Clinical Care During and After COVID-19

et al. 2020

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Social isolation is likely to be recommended for older adults due to COVID-19, with ongoing reduced clinical contact suggested for this population. This has increased the need for remote memory clinics, we therefore review the literature, current practices and guidelines on organizing such remote memory clinics, focusing on assessment of cognition, function and other relevant measurements, proposing a novel pathway based on three levels of complexity: simple telephone or video-based interviews and testing using available tests (Level 1), digitized and validated methods based on standard pen-and-paper tests and scales (Level 2), and finally fully digitized cognitive batteries and remote measurement technologies (RMTs, Level 3). Pros and cons of these strategies are discussed. Remotely collected data negates the need for frail patients or carers to commute to clinic and offers valuable insights into progression over time, as well as treatment responses to therapeutic interventions, providing a more realistic and contextualized environment for data-collection. Notwithstanding several challenges related to internet access, computer skills, limited evidence base and regulatory and data protection issues, digital biomarkers collected remotely have significant potential for diagnosis and symptom management in older adults and we propose a framework and pathway for how technologies can be implemented to support remote memory clinics. These platforms are also well-placed for administration of digital cognitive training and other interventions. The individual, societal and public/private costs of COVID-19 are high and will continue to rise for some time but the challenges the pandemic has placed on memory services also provides an opportunity to embrace novel approaches. Remote memory clinics' financial, logistical, clinical and practical benefits have been highlighted by COVID-19, supporting their use to not only be maintained when social distancing legislation is lifted but to be devoted extra resources and attention to fully potentiate this valuable arm of clinical assessment and care.

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Comparison of an Electronic and Paper-based Montreal Cognitive Assessment Tool

Cited by 21 publications

References 12 publications

Digitally translated Self-Administered Gerocognitive Examination (eSAGE): relationship with its validated paper version, neuropsychological evaluations, and clinical assessments

Digitally translated Self-Administered Gerocognitive Examination (eSAGE): relationship with its validated paper version, neuropsychological evaluations, and clinical assessments

Diagnosis of cognitive decline and dementia in rural areas — A scoping review

Implementing Remote Memory Clinics to Enhance Clinical Care During and After COVID-19

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