The Validity of a Smartphone-Based Application for Assessing Cognitive Function in the Elderly

Background/Objectives: The early detection of individuals at risk of cognitive impairment is a clinical imperative. With the recent advancement of digital devices, smartphone application-based cognitive assessment is considered a promising tool for cognitive screening and monitoring inside and outside the clinic. This study examined whether a smartphone-based cognitive assessment, Brain OK, was valid for evaluating cognitive performance and identifying people at risk of cognitive impairment. Methods: We recruited 88 study participants aged over 60. They completed two cognitive tests with the Montreal Cognitive Assessment (MoCA), a validated paper-and-pencil cognitive screening tool, and Brain OK, a smartphone-based cognitive testing application. To examine convergent validity, we conducted analyses of Spearman correlations between MoCA and BrainOK, a Bland-Atman plot with regression analysis, and the area under the curve (AUC). Results: There was a significant positive association between Brain OK and the MoCA total score, with a coefficient of 0.9044 (SE = 0.057, t = 15.750, p < 0.001). The Bland-Altman plot represented a reasonable level of agreement between the two tests. We conducted the AUC analysis of Brain OK to compare the cognitively normal and impaired groups. The AUC value for the Brain OK score of 13.5 was the highest at 0.941. The sensitivity and specificity were 0.958 and 0.925, respectively. Conclusions: The smartphone app-based Brain OK test was feasible for assessing cognitive function and acceptable for identifying subjects with cognitive impairment. The results suggest Brain OK complements traditional in-person cognitive assessments and may help enhance cognitive health dialogue between doctors and patients.