[Performance Comparison of Cognitive Screening Tools in Community-Dwelling Older Adults: The Correlation and...

In line with the current rapid pace of population aging in Taiwan, the population of individuals living with dementia has risen significantly. However, the early identification of dementia onset in community settings remains insufficient. Although the Montreal Cognitive Assessment (MoCA) has demonstrated good reliability and validity, its applicability in large-scale community screening settings is limited by administration time and manpower requirements. Therefore, more-accessible screening tools for dementia are urgently needed.

This study was designed to examine the feasibility of applying the game-based intelligent cognitive assessment CogMate™ on older adults in community settings and to evaluate the correlation and comparative discriminative validity of this tool with the MoCA.

A cross-sectional study design with convenience sampling was employed. Two hundred and fifty community-dwelling adults aged 65 years and older in Taichung City were recruited as participants. The participants completed a demographic questionnaire, the MoCA, and CogMate™. The collected data were analyzed using descriptive statistics, Pearson correlation coefficients, intraclass correlation coefficients, and receiver operating characteristic (ROC) curve analysis.

After adjusting for age and educational level, based on a cutoff score of 23, 53.6% of the participants were classified as having suspected cognitive impairment based on MoCA total score. The MoCA total score was found to correlate significantly and positively with the CogMate™ total score (r = .612, p < .001), with an intraclass correlation coefficient of .601. The CogMate™ total score demonstrated good discriminative performance for detecting abnormal MoCA results, with an area under the receiver operating characteristic curve (AUC) of .813.

CogMate™ demonstrated levels of consistency and validity similar to the MoCA, supporting its potential use as an early cognitive screening and referral tool in community settings. CogMate™ may serve as a complementary or alternative tool to the MoCA in community-based cognitive assessment.