JMIR Publications

ABSTRACT

Background:

Dementia poses a significant public health challenge. Early detection is crucial for timely intervention but remains difficult in community settings, as many existing cognitive screening tools are either insufficiently sensitive to subtle decline or too burdensome for widespread use.

Objective:

This study aimed to develop and validate a novel combined audiovisual-semantic digital tool for rapid and acceptable community-based screening of cognitive decline in older adults.

Methods:

A total of 156 older adults completed six progressively complex task variants, shifting from unimodal to multimodal stimuli and from basic to superordinate semantic categorization. Performance was measured using reaction time, accuracy, false alarms, and inverse efficiency. Diagnostic utility was assessed via logistic regression and ROC analysis, while qualitative interviews evaluated acceptability.

Results:

Task outcomes showed significant declines across the cognitive continuum from no cognitive impairment (NCI) to mild cognitive impairment (MCI) to dementia (p < 0.001). The integrated audiovisual-semantic condition at the basic categorization level reliably differentiated cognitive groups and achieved higher AUC values for distinguishing NCI from cognitive impairment, and MCI from dementia, compared to basic-level tasks. Incorporating semantic processing enhanced diagnostic discrimination. Participant feedback was highly positive, with 48.7% describing the tasks as "fun/interesting."

Conclusions:

The audiovisual-semantic integrated digital tool is a valid, well-accepted, and time-efficient instrument for cognitive screening in older adults. Its design, which increases cognitive load through multimodal and semantic integration, improves sensitivity to early decline, supporting its potential for practical community application.