Tracking Cognitive Performance in the General Population and in Patients with Mild Cognitive Impairment with a Self-Applied Computerized Test (Brain on Track)

Ruano, Luís; Severo, Mílton; Sousa, Abel; Ruano, Catarina; Branco, Mariana; Barreto, Rui; Moreira, Sandra; Araújo, Natália; Pinto, Paula; Pais, Joana; Lunet, Nuno; Cruz, Vítor Tedim

doi:10.3233/jad-190631

Cited by 15 publications

(12 citation statements)

References 30 publications

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“…Thirty-three (94%) digital cognitive biomarkers from the test batteries showed good diagnostic performance with sensitivity and specificity higher than 75%, or AUC larger than 0.7. Several test batteries provided excellent diagnostic performance with AUC close to or larger than 0.9, including BHA [ 44 , 65 ], Brain on Track Self-applied Computerized Test (BoT) [ 66 ], and MoCA-CC [ 42 ]. Other single/multiple cognitive tests obtained a sensitivity range of 56.3–84.7%, a specificity range of 53.6–90.5%, and an AUC range of 0.67–0.91.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the test batteries achieved even better diagnostic performance, with sensitivity and specificity larger than 75%, and acceptable AUC larger than 0.8. For screening MCI, BoT [ 66 ] and MoCA-CC [ 42 ] were preferred test batteries. For screening dementia, CST [ 69 ], CCS [ 70 ], CANS-MCI [ 71 ], eSAGE [ 72 ], and Computerized Screening Test Battery [ 73 ] were preferred.…”

Section: Discussionmentioning

confidence: 99%

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Digital Cognitive Biomarker for Mild Cognitive Impairments and Dementia: A Systematic Review

Ding

Lee

Chan

2022

JCM

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The dementia population is increasing as the world’s population is growing older. The current systematic review aims to identify digital cognitive biomarkers from computerized tests for detecting dementia and its risk state of mild cognitive impairment (MCI), and to evaluate the diagnostic performance of digital cognitive biomarkers. A literature search was performed in three databases, and supplemented by a Google search for names of previously identified computerized tests. Computerized tests were categorized into five types, including memory tests, test batteries, other single/multiple cognitive tests, handwriting/drawing tests, and daily living tasks and serious games. Results showed that 78 studies were eligible. Around 90% of the included studies were rated as high quality based on the Newcastle–Ottawa Scale (NOS). Most of the digital cognitive biomarkers achieved comparable or even better diagnostic performance than traditional paper-and-pencil tests. Moderate to large group differences were consistently observed in cognitive outcomes related to memory and executive functions, as well as some novel outcomes measured by handwriting/drawing tests, daily living tasks, and serious games. These outcomes have the potential to be sensitive digital cognitive biomarkers for MCI and dementia. Therefore, digital cognitive biomarkers can be a sensitive and promising clinical tool for detecting MCI and dementia.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Digital Cognitive Biomarker for Mild Cognitive Impairments and Dementia: A Systematic Review

Ding

Lee

Chan

2022

JCM

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“…Second, the number of variations of standard tests is often limited resulting in practice effects [ 6 ]. Therefore, there is a clear need for a self-administered cognitive test that can be repeated periodically and is resistant to practice effects [ 7 ]. Such a test could be performed at home or in the clinic by using randomly selected non-repeating tasks to minimize practice effects.…”

Section: Introductionmentioning

confidence: 99%

Boston cognitive assessment (BOCA) — a comprehensive self-administered smartphone- and computer-based at-home test for longitudinal tracking of cognitive performance

Vyshedskiy

Netson²,

Fridberg

et al. 2022

BMC Neurol

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Longitudinal cognitive testing is essential for developing novel preventive interventions for dementia and Alzheimer’s disease; however, the few available tools have significant practice effect and depend on an external evaluator. We developed a self-administered 10-min at-home test intended for longitudinal cognitive monitoring, Boston Cognitive Assessment or BOCA. The goal of this project was to validate BOCA. BOCA uses randomly selected non-repeating tasks to minimize practice effects. BOCA evaluates eight cognitive domains: 1) Memory/Immediate Recall, 2) Combinatorial Language Comprehension/Prefrontal Synthesis, 3) Visuospatial Reasoning/Mental rotation, 4) Executive function/Clock Test, 5) Attention, 6) Mental math, 7) Orientation, and 8) Memory/Delayed Recall. BOCA was administered to patients with cognitive impairment (n = 50) and age- and education-matched controls (n = 50). Test scores were significantly different between patients and controls (p < 0.001) suggesting good discriminative ability. The Cronbach’s alpha was 0.87 implying good internal consistency. BOCA demonstrated strong correlation with Montreal Cognitive Assessment (MoCA) (R = 0.90, p < 0.001). The study revealed strong (R = 0.94, p < 0.001) test-retest reliability of the total BOCA score one week after participants’ initial administration. The practice effect tested by daily BOCA administration over 10 days was insignificant (β = 0.03, p = 0.68). The effect of the screen size tested by BOCA administration on a large computer screen and re-administration of the BOCA to the same participant on a smartphone was insignificant (β = 0.82, p = 0.17; positive β indicates greater score on a smartphone). BOCA has the potential to reduce the cost and improve the quality of longitudinal cognitive tracking essential for testing novel interventions designed to reduce or reverse cognitive aging. BOCA is available online gratis at www.bocatest.org.

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“…Some studies found that drawing time or drawing process can be a predictive factor for cognitive impairment [31,32]. In the last decade, some multidomain digital cognitive tests have been investigated, including Brain on Track [13] and Computerized Cognitive Screen [33]. These digital cognitive tests assess memory, attention, processing speed, and executive functions, and the administration time is around 20 to 25 minutes.…”

Section: Principal Findingsmentioning

confidence: 99%

“…Moreover, the calculation of the cutoff scores in paper-and-pencil cognitive tests cannot take behavioral data such as response time into account. Furthermore, "practice effects" occur with repeated applications, which could undermine the usefulness of the tests for measuring either the treatment response or the monitoring of disease progression [12,13]. In addition, older adults may not be motivated to seek out or undergo cognitive assessment with health care professionals, or they may have difficulties in accessing health care services.…”

Section: Introductionmentioning

confidence: 99%

Electronic Cognitive Screen Technology for Screening Older Adults With Dementia and Mild Cognitive Impairment in a Community Setting: Development and Validation Study (Preprint)

Chan¹,

Wong²,

Yiu³

et al. 2019

Preprint

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BACKGROUND A digital cognitive test can be a useful and quick tool for the screening of cognitive impairment. Previous studies have shown that the diagnostic performance of digital cognitive tests is comparable with that of conventional paper-and-pencil tests. However, the use of commercially available digital cognitive tests is not common in Hong Kong, which may be due to the high cost of the tests and the language barrier. Thus, we developed a brief and user-friendly digital cognitive test called the Electronic Cognitive Screen (EC-Screen) for the detection of mild cognitive impairment (MCI) and dementia of older adults. OBJECTIVE The aim of this study was to evaluate the performance of the EC-Screen for the detection of MCI and dementia in older adults. METHODS The EC-Screen is a brief digital cognitive test that has been adapted from the Rapid Cognitive Screen test. The EC-Screen uses a cloud-based platform and runs on a tablet. Participants with MCI, dementia, and cognitively healthy controls were recruited from research clinics and the community. The outcomes were the performance of the EC-Screen in distinguishing participants with MCI and dementia from controls, and in distinguishing participants with dementia from those with MCI and controls. The cohort was randomly split into derivation and validation cohorts based on the participants’ disease group. In the derivation cohort, the regression-derived score of the EC-Screen was calculated using binomial logistic regression. Two predictive models were produced. The first model was used to distinguish participants with MCI and dementia from controls, and the second model was used to distinguish participants with dementia from those with MCI and controls. Receiver operating characteristic curves were constructed and the areas under the curves (AUCs) were calculated. The performances of the two predictive models were tested using the validation cohorts. The relationship between the EC-Screen and paper-and-pencil Montreal Cognitive Assessment-Hong Kong version (HK-MoCA) was evaluated by the Pearson correlation coefficient. RESULTS A total of 126 controls, 54 participants with MCI, and 63 participants with dementia were included in the study. In differentiating participants with MCI and dementia from controls, the AUC of the EC-Screen in the derivation and validation cohorts was 0.87 and 0.84, respectively. The optimal sensitivity and specificity in the derivation cohorts were 0.81 and 0.80, respectively. In differentiating participants with dementia from those with MCI and controls, the AUC of the derivation and validation cohorts was 0.90 and 0.88, respectively. The optimal sensitivity and specificity in the derivation cohort were 0.83 and 0.83, respectively. There was a significant correlation between the EC-Screen and HK-MoCA (<i>r</i>=–0.67, <i>P</i><.001). CONCLUSIONS The EC-Screen is suggested to be a promising tool for the detection of MCI and dementia. This test can be self-administered or assisted by a nonprofessional staff or family member. Therefore, the EC-Screen can be a useful tool for case finding in primary health care and community settings.

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Tracking Cognitive Performance in the General Population and in Patients with Mild Cognitive Impairment with a Self-Applied Computerized Test (Brain on Track)

Cited by 15 publications

References 30 publications

Digital Cognitive Biomarker for Mild Cognitive Impairments and Dementia: A Systematic Review

Digital Cognitive Biomarker for Mild Cognitive Impairments and Dementia: A Systematic Review

Boston cognitive assessment (BOCA) — a comprehensive self-administered smartphone- and computer-based at-home test for longitudinal tracking of cognitive performance

Electronic Cognitive Screen Technology for Screening Older Adults With Dementia and Mild Cognitive Impairment in a Community Setting: Development and Validation Study (Preprint)

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