Validation of a Computerized Cognitive Test Battery for Detection of Dementia and Mild Cognitive Impairment

S, Ye; Huang, Bin; Kim, Sun; Hq, Phi; B, Ko; Cm, Parsey; Rh, Ghomi

doi:10.1101/2020.11.10.20229369

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…The Remote Digital Memory Composite allowed to differentiate individuals with and without PACC5-based MCI-grade impairment with high diagnostic accuracy. This is higher or comparable to several other recently reported unsupervised (Mackin et al, 2018) or in-clinic and supervised digital cognitive assessments (Alden et al, 2021;Groppell et al, 2019;Kalafatis et al, 2021;Ye et al, 2020). Importantly, however, several earlier approaches reported outcomes by comparing MCI patients against samples that exclusively consisted of healthy asymptomatic older adults (Alden et al, 2021;Groppell et al, 2019;Kalafatis et al, 2021;Mackin et al, 2018;Maruff et al, 2013;Ye et al, 2020).…”

Section: Discussionsupporting

confidence: 73%

“…This is higher or comparable to several other recently reported unsupervised (Mackin et al, 2018) or in-clinic and supervised digital cognitive assessments (Alden et al, 2021;Groppell et al, 2019;Kalafatis et al, 2021;Ye et al, 2020). Importantly, however, several earlier approaches reported outcomes by comparing MCI patients against samples that exclusively consisted of healthy asymptomatic older adults (Alden et al, 2021;Groppell et al, 2019;Kalafatis et al, 2021;Mackin et al, 2018;Maruff et al, 2013;Ye et al, 2020). In health care settings, the main challenge is to identify significant impairment within memory complainers.…”

Section: Discussionsupporting

confidence: 68%

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A Remote Digital Memory Composite to Detect Cognitive Impairment in Memory Clinic Samples in Unsupervised Settings using Mobile Devices

Berron

Glanz

Billette³

et al. 2021

Preprint

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INTRODUCTIONMobile app-based unsupervised monitoring of cognition holds the promise to facilitate case-finding in clinical care and the individual detection of cognitive impairment in clinical and research settings. In the context of Alzheimer’s disease, this is particularly relevant for patients who seek medical advice due to memory complaints.OBJECTIVEWe developed a Remote Digital Memory Composite score from an unsupervised remote and mobile cognitive assessment battery focused on episodic memory and long-term recall and assessed its construct validity using a neuropsychological composite score for early cognitive impairment in Alzheimer’s disease, the Preclinical Alzheimer’s Cognitive Composite (PACC5). We also assessed the test-retest reliability of the Remote Digital Memory Composite score across two independent test sessions. Finally, we assessed the diagnostic accuracy of the remote and unsupervised cognitive assessment battery when predicting PACC5-based cognitive impairment in a memory clinic sample and healthy controls.SETTINGThis was an add-on study of the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE) which was also performed in a separate memory clinic-based sample.PARTICIPANTSA total of 102 study participants were included as healthy controls (HC; n=25), cognitively unimpaired first-degree relatives of AD patients (REL; n=7), individuals with subjective cognitive decline (SCD; n= 48) or patients with mild cognitive impairment (MCI; n=22).MEASUREMENTSWe analyzed results from the objects-in-rooms recall (ORR) test, the mnemonic discrimination for objects and scenes (MDT-OS) test and the complex scene recognition (CSR) test implemented on the neotiv digital platform to derive a Remote Digital Memory Composite. Participants used the neotiv mobile app to complete one unsupervised test session every two weeks on their own mobile device in an environment of their choice. We assessed the relationships of the Remote Digital Memory Composite acquired through the mobile app and in-clinic measures of the PACC5 conducted by trained neuropsychologists in the memory clinics participating in the DELCODE study.RESULTS102 participants provided technically complete data for at least one single session of each of the three test paradigms, of which 87 participants provided data from at least two test sessions of each task. The derived Remote Digital Memory Composite score was highly correlated with the PACC5 score across all participants (r=.75, p<0.001), and also in those without complaints (HC and REL, r=.51, p=0.003) and those with complaints separately (SCD and MCI, r=.76, p<0.001). Good test-retest reliability for the Remote Digital Memory Composite score was observed in those with at least two assessments of the three tests. (r=.74; p<.0001). Diagnostic accuracy for discriminating PACC5-based memory impairment from no impairment was high (AUC = 0.9) with a sensitivity of 0.83 and a specificity of 0.74.CONCLUSIONOur results indicate that unsupervised mobile cognitive assessments in a memory clinic setting using the implementation in the neotiv digital platform has high construct validity and results in a good discrimination between cognitively impaired and unimpaired individuals based on the PACC5 score. Thus, it is feasible to complement neuropsychological assessment of episodic memory with unsupervised, remote assessments on mobile devices. This contributes to recent efforts for implementing remotely performed episodic memory assessment for case-finding and monitoring in large research trials and clinical care.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 68%

A Remote Digital Memory Composite to Detect Cognitive Impairment in Memory Clinic Samples in Unsupervised Settings using Mobile Devices

Berron

Glanz

Billette³

et al. 2021

Preprint

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“…We administered BrainCheck, an FDA approved, web-based battery of standardized neuropsychological tests that has been shown to have high sensitivity and specificity for mild or greater cognitive impairment ( Ye et al, 2020 ). BrainCheck requires approximately 15 min to complete and is available in both English and Spanish.…”

Section: Methodsmentioning

confidence: 99%

Cognitive Impairment in Non-critical, Mild-to-Moderate COVID-19 Survivors

et al. 2022

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ImportancePrevious studies of post-acute COVID-19 syndrome have focused on critical cases with severe disease. However, most cases are mild to moderate in disease severity.ObjectiveWe aimed to examine cognitive outcomes in cases of non-critical, mild-to-moderate COVID-19. Design, Setting, and Participants: In this cross-sectional study, we enrolled 72 adults aged 22 to 65 years in Central Texas who had non-critical, mild-to-moderate COVID-19 infection between 13 January 2021 and 20 April 2021.Main Outcomes and MeasuresWe remotely administered cognitive-behavioral testing to determine the frequency of cognitive impairment and examine demographic, clinical, and psychosocial contributors to impairment.ResultsThe frequency of objective cognitive impairment was 40%. The largest number of participants (24%) showed impairment on a measure of executive functioning. Attention and processing speed was more impaired in males (OR = 1.5, 95%CI = 0.23–2.9). Males endorsed lower adherence to social distancing guidelines (U = 590, p = 0.01), which was in turn associated with cognitive impairment across participants (r = −0.30, p = 0.01). Younger age was correlated with impairment (r = −0.26, p = 0.03) but was also associated with racial/ethnic minority status (r = −0.31, p = 0.01) and increased psychological symptoms (p < 0.04). Greater number of COVID-19 symptoms was correlated with lower subjective cognitive function (r = −0.38, p = 0.001) as well as psychosocial function (r > 0.24, p < 0.05). Moderate COVID-19 severity was associated with attention/processing speed impairment (r = 0.27, p = 0.03), increased pain (r = 0.31, p = 0.01), and higher number of COVID-19 symptoms (r = 0.32, p = 0.01).Conclusion and RelevanceMild or moderate COVID-19 infection may be associated with cognitive impairments, especially in the domain of executive functioning. A subgroup of younger individuals may be more vulnerable to cognitive and psychosocial effects of COVID-19.HighlightsQuestion: How frequent is cognitive impairment among non-critical, mild-to-moderate COVID-19 survivors?FindingsIn this cross-sectional study of 72 adults, 40% demonstrated cognitive impairment, particularly in executive function.MeaningNeurologic sequelae, such as cognitive impairment, may be common following COVID-19 infection.

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“…Considering this, only the Phototest has been already validated for the detection of cognitive impairment in the illiterate [ 36 ]. Whilst the features described in this paragraph did not impact the analysis presented in this preliminary study, because all the participants analyzed were able to undertake the three cognitive tests, if we consider the potential implementation of the tests as an online service, which seems to be the course to follow in dementia screening [ 47 – 50 ], the RSVP may represent a more appropriate candidate based on its computerized and auto-scored nature. This implementation could potentially allow the users to access the test from home, with the assistance of their caregivers if needed.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the feasibility of cognitive impairment detection in Alzheimer’s disease screening using a computerized visual dynamic test

Pérez-Valero

Gutierrez

López-Gordo

et al. 2023

J NeuroEngineering Rehabil

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Background Alzheimer’s disease (AD) is a neurodegenerative disease without known cure. However, early medical treatment can help control its progression and postpone intellectual decay. Since AD is preceded by a period of cognitive deterioration, the effective assessment of cognitive capabilities is crucial to develop reliable screening procedures. For this purpose, cognitive tests are extensively used to evaluate cognitive areas such as language, attention, or memory. Methods In this work, we analyzed the potential of a visual dynamics evaluation, the rapid serial visual presentation task (RSVP), for the detection of cognitive impairment in AD. We compared this evaluation with two of the most extended brief cognitive tests applied in Spain: the Clock-drawing test (CDT) and the Phototest. For this purpose, we assessed a group of patients (mild AD and mild cognitive impairment) and controls, and we evaluated the ability of the three tests for the discrimination of the two groups. Results The preliminary results obtained suggest the RSVP performance is statistically higher for the controls than for the patients (p-value = 0.013). Furthermore, we obtained promising classification results for this test (mean accuracy of 0.91 with 95% confidence interval 0.72, 0.97). Conclusions Since the RSVP is a computerized, auto-scored, and potentially self-administered brief test, it could contribute to speeding-up cognitive impairment screening and to reducing the associated costs. Furthermore, this evaluation could be combined with other tests to augment the efficiency of cognitive impairment screening protocols and to potentially monitor patients under medical treatment.

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Validation of a Computerized Cognitive Test Battery for Detection of Dementia and Mild Cognitive Impairment

Cited by 8 publications

References 31 publications

A Remote Digital Memory Composite to Detect Cognitive Impairment in Memory Clinic Samples in Unsupervised Settings using Mobile Devices

A Remote Digital Memory Composite to Detect Cognitive Impairment in Memory Clinic Samples in Unsupervised Settings using Mobile Devices

Cognitive Impairment in Non-critical, Mild-to-Moderate COVID-19 Survivors

Evaluating the feasibility of cognitive impairment detection in Alzheimer’s disease screening using a computerized visual dynamic test

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