Related Experiment Video
Updated: Jun 7, 2026
Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients
Published on: December 16, 2022
A GAMLSS approach to digital dementia screening and profiling using a two-step cognitive self-assessment tool in
Jing Nie1, Ling Li1, Jianfeng Luo2
1Department of Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Shanghai, China.
Purpose:
To develop clinically actionable, education-stratified normative reference ranges for the two-step cognitive self-assessment (TCSA) tool, addressing China's urgent need for scalable cognitive screening in its rapidly aging population.
Methods:
Using generalised additive models for location, scale and shape (GAMLSS) on a cohort of 40 588 community-dwelling adults (50-100 years), we developed reference curves for core cognition (primary tasks), multi-cognition domains (secondary tasks) and processing speed (TCSA-Response Time, TCSA-RT). Individuals with self-reported dementia or functional dependence assessed via activities of daily living scale were excluded.
Results:
Smoothed percentile curves were established. A health equity gap manifested through 89% greater cognitive decline variability in low-education groups (σ intercept = -0.089 vs. -0.168). Education reduced annual decline by 8.7% (-0.042 vs. -0.046 points/year) while elevating baseline cognition (μ = 1.99).
Conclusions:
As the first large-scale normative framework in China's diverse aging population, it enables precision public health through education-specific screening thresholds for the digital TCSA tool.
