An Effective Test (EOmciSS) for Screening Older Adults With Mild Cognitive Impairment in a Community Setting:...

Area of Science:

• Gerontology
• Cognitive Science
• Digital Health

Background:

• Early detection of mild cognitive impairment (MCI) is crucial for timely diagnosis and intervention.
• The Efficient Online MCI Screening System (EOmciSS) was developed as a novel, self-paced digital screening tool.
• EOmciSS is designed for community-dwelling older adults, usable on tablets or smartphones in various settings.

Purpose of the Study:

• To evaluate the validity and reliability of the EOmciSS for identifying individuals at risk of MCI.
• To assess the psychometric properties of the EOmciSS, including item difficulty, discriminative index, internal consistency, and construct validity.
• To test the discriminative ability of EOmciSS between individuals with MCI and normal cognitive function (NCF) using cross-validation.

Main Methods:

• 827 participants completed the EOmciSS alongside other MCI screening tests.
• Psychometric properties such as subscale item difficulty, discriminative index, internal consistency (Cronbach's α), and construct validity were analyzed.
• Cross-validation was employed to assess between-group discrimination between MCI and NCF groups.

Main Results:

• The EOmciSS structure involved 3 accuracy factors and 1 reaction time factor.
• Key accuracy factors (e.g., trail making, clock drawing, cube copying, delayed recall) and reaction time factors showed good difficulty and discriminative indices.
• The system achieved high accuracy in classifying MCI versus NCF (AUC=0.912), with 84.9% sensitivity and 85.1% specificity. Depressive symptoms significantly influenced performance, while age, education, and device proficiency did not.
• Internal consistency varied (Cronbach's α: .41–.96), with specific item factors proving significant predictors for MCI classification.

Conclusions:

• EOmciSS is a valid and reliable tool for detecting older adults at significant risk of MCI.
• The system demonstrates superior sensitivity and specificity compared to existing digital screening tools.
• The user-friendly, online, self-paced format facilitates use by older adults or caregivers in diverse settings.
• Incorporating assessment of depressive symptoms is recommended for future MCI screening systems due to their impact on performance.