Digital Screening for Cognitive Impairment – A Proof of Concept Study

Abstract

Background: Due to an ageing demographic and rapid increase of cognitive impairment and dementia, combined with potential disease-modifying drugs and other interventions in the pipeline, there is a need for the development of accurate, accessible and efficient cognitive screening instruments, focused on early-stage detection of neurodegenerative disorders. Objective: In this proof of concept report, we examine the validity of a newly developed digital cognitive test, the Geras Solutions Cognitive Test (GCST) and compare its accuracy against the Montreal Cognitive Assessment (MoCA). Methods: 106 patients, referred to the memory clinic, Karolinska University Hospital, due to memory complaints were included. All patients were assessed for presence of neurodegenerative disorder in accordance with standard investigative procedures. 66% were diagnosed with subjective cognitive impairment (SCI), 25% with mild cognitive impairment (MCI) and 9% fulfilled criteria for dementia. All patients were administered both MoCA and GSCT. Descriptive statistics and specificity, sensitivity and ROC curves were established for both test. Results: Mean score differed significantly between all diagnostic subgroups for both GSCT and MoCA (p<0.05). GSCT total test time differed significantly between all diagnostic subgroups (p<0.05). Overall, MoCA showed a sensitivity of 0.88 and specificity of 0.54 at a cut-off of <=26 while GSCT displayed 0.91 and 0.55 in sensitivity and specificity respectively at a cut-off of <=45. Conclusion: This report suggests that GSCT is a viable cognitive screening instrument for both MCI and dementia.

A voice recognition-based digital cognitive screener for dementia detection in the community: Development and validation study

“…Findings from our study showed that the DCS performed at least as well as other previous digital cognitive screening tools. For example, two recently developed digital cognitive tests which took more than 10 min to administrate showed AUCs of 0.87 and 0.91, respectively, for discriminating between demented and cognitively intact participants (10,24) while the AUC of that in our study was 0.95. Moreover, the DCS can provide several additional advantages.…”

“…However, most of the presently available cognitive tests are touch screen-based, which requires operation from individual participant. This has resulted in lower test acceptance and performance due to computer illiteracy among older adults who are less familiar with operating digital devices (10,11). Furthermore, even though mobile platforms can collect new data streams and achieve a high measurement accuracy, they are usually expensive to track longitudinal behavioral/cognitive changes, such as sensor data through wearables (12, 13).…”

Intercepting Dementia: Awareness and Innovation as Key Tools

“…Tech companies have been showing a growing interest toward the generation of “smart” devices for physiological monitoring and assessment of cognitive functions, both heavily affected in dementia-related disorders. The emerging technologies that hold great promise in the prognosis of neurodegenerative disorders cover a wide spectrum of applications, ranging from the development of wearable devices, such as fitness trackers, smartwatches, and mobile apps, to artificial intelligence platforms, VR, and game-based systems, purposely designed for early diagnosing, monitoring and treating dementia symptoms (Zygouris et al, 2017 ; Mandryk and Birk, 2019 ; Piau et al, 2019 ; Bloniecki et al, 2021 ; Gielis et al, 2021 ; Majnarić et al, 2021 ). Overall, digital tools provide a constant and extensive amount of data reflecting an individual’s health status.…”

“…Beyond that, several user interfaces have been recently implemented to administer basic cognitive tests-such as the Montreal Cognitive Assessment (MoCA; Nasreddine et al, 2005 ), one of the most common screening methods used for the detection of MCI and AD, and normally conducted using “pen and paper”—in a computerized version that showed promising results to date (Berg et al, 2018 ). Another example indicating the expansion and contribution of new appliances in monitoring brain health is given by Bloniecki and coworkers, who developed a novel digital test to assess cognitive performance and validated its accuracy against the MoCA test (Bloniecki et al, 2021 ). These short examinations are reliable in distinguishing individuals with advanced cognitive impairment, but unable to detect earlier stages of deficit and insufficient to quantify subtle subjective cognitive complaints.…”

“…The introduction of digital tests, wearable devices, and VR systems offer the unprecedented opportunity to constantly track physiological parameters and cerebral functions, which can supply a substantial amount of data potentially underlying subtle anomalies occurring in the transitional phases of the pathology. Ultimately, allowing a faster and more accurate personal follow-up (Westerberg et al, 2010 ; Chester and Rudolph, 2011 ; Zygouris et al, 2017 ; Berg et al, 2018 ; Lucke et al, 2019 ; Mandryk and Birk, 2019 ; Piau et al, 2019 ; Zhavoronkov et al, 2019 ; Bloniecki et al, 2021 ; Gielis et al, 2021 ; Majnarić et al, 2021 ).…”