Validity and usability for digital cognitive assessment tools to screen for mild cognitive impairment: a randomized...

Area of Science:

• Gerontology
• Digital Health
• Cognitive Science

Background:

• Assessing the feasibility of digital cognitive screening tools in primary health care (PHC) is crucial for detecting cognitive impairments.
• Challenges persist, especially for populations with lower educational attainment.

Purpose of the Study:

• To evaluate the validity and usability of digital cognitive screening tests within PHC settings.
• To compare digital versus paper-based cognitive assessments.

Main Methods:

• A randomized crossover study involved 47 older adults (≥65 years) comparing paper-based (Mini-Mental State Examination, Clock Drawing Test) and digital versions.
• Validity assessed via correlation, AUC, sensitivity, and specificity; usability via questionnaires, preferences, and duration.
• Regression analyses explored usability's impact on scores, controlling for demographics and cognitive status.

Main Results:

• Digital tests demonstrated moderate correlations and superior Area Under the Curve (AUC) performance compared to paper versions (e.g., eMMSE AUC 0.82 vs. MMSE AUC 0.65).
• Older participants provided positive usability feedback but preferred paper formats; electronic MMSE completion time was longer (7.11 min vs. 6.21 min).
• Digital test scores were minimally influenced by attitudes but significantly affected by assessment duration.

Conclusions:

• Digital cognitive tests are valid and feasible for PHC settings.
• Implementation hurdles exist, particularly concerning usability and adaptability for individuals with lower education levels.
• Further refinement is needed to optimize digital tools for diverse populations in primary care.