Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 7, 2019
Date Accepted: Oct 31, 2020
Development of the Electronic Cognitive Screen Technology for the Screening of Older Adults with Dementia and Mild Cognitive Impairment in a Community Setting: A Validation Study.
ABSTRACT
Background:
A digital cognitive test can reportedly serve as a useful, quick and self-administered tool for the screening of cognitive impairment.
Objective:
To evaluate the diagnostic performance of the Electronic Cognitive Screen (EC-Screen) for the identification of cognitive impairment 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 cognitive impairment and healthy controls were recruited from the community. The Hong Kong version of the Montreal Cognitive Assessment (HK-MoCA) was used as a comparison test. A regression derived score of the EC-Screen was calculated by using binomial logistic regression. Receiver operating characteristic (ROC) curves were used to examine the capacity of the EC-Screen to distinguish cognitive impairment from controls. The area under the curve (AUC) with a 95% confidence interval (95% CI) was calculated. The relationship between the EC-Screen and HK-MoCA was evaluated by the Pearson correlation. Subgroup analysis was conducted according to the severity of cognitive impairment, i.e. mild cognitive impairment (MCI), Alzheimer’s Disease (AD).
Results:
A total of 50 cognitively healthy controls, 40 participants with MCI, and 44 participants with AD were included. In differentiating participants with cognitive impairment from controls, the AUC of EC-Screen was determined to be 0.86 (95% CI = 0.80 to 0.93). The optimal sensitivity and specificity were 0.81 and 0.80, respectively. No age or education effects were observed. There was a significant correlation between the EC-Screen and HK-MoCA (r = -0.74).
Conclusions:
The EC-Screen is suggested to be useful as a tool for the screening of cognitive impairment. As the EC-Screen is brief and can be self-administrated, it can be applied in both primary health care and community settings. Clinical Trial: NA
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