Feasibility and usefulness of cognitive monitoring using a new home-based cognitive test in mild cognitive impairment: A prospective single arm study

Abstract

Background: The risk of dementia is increased in subjects with mild cognitive impairment (MCI). Despite the plethora of in-person cognitive tests, those that can be administered over the phone are lacking. We hypothesized that a home-based cognitive test (HCT) using phone calls would be feasible and useful in non-demented older adults. We aimed to assess feasibility and validity of a new HCT as an optional cognitive monitoring tool without visiting hospitals. Methods: Our study was conducted in a prospective design during 24 months. We developed a new HCT consisting of 20 questions (score range 0–30). Participants with MCI (n = 38) were consecutively enrolled and underwent annual follow-ups during 24 months. Associations between HCT scores and in-person cognitive scores and Alzheimer’s disease (AD) biomarkers were evaluated. In addition, HCT scores in MCI participants were cross-sectionally compared with age-matched cognitively normal (n = 30) and mild AD dementia (n = 17) participants for discriminative ability of the HCT. Results: HCT had good intra-class reliability (test-retest Cronbach’s alpha 0.839). HCT scores were correlated with the Mini-Mental State Examination (MMSE), verbal memory delayed recall, and Stroop test scores but not associated with AD biomarkers. HCT scores significantly differed among cognitively normal, MCI, and mild dementia participants, indicating its discriminative ability. Finally, 32 MCI participants completed annual follow-up evaluations, and 8 progressed to dementia. Baseline HCT scores in dementia progressors were lower than those in non-progressors (p = 0.001). Conclusion: The feasibility and usefulness of the HCT were demonstrated in older adults with MCI. HCT could be an alternative option to monitor cognitive decline in early stages without dementia.