A Rapid, Mobile Neurocognitive Screening Test to Aid in Identifying Cognitive Impairment and Dementia (BrainCheck): Cohort Study

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Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The U.S. population over the age of 65 is expected to double by the year 2050. Concordantly, the incidence of dementia is projected to increase. The subclinical stage of dementia begins years before signs and symptoms appear. Early detection of cognitive impairment and/or cognitive decline may allow for interventions to slow its progression. Furthermore, early detection may allow for implementation of care plans that may affect the quality of life of those affected and their caregivers Objective: We sought to determine the accuracy and validity of BrainCheck Memory as a diagnostic aid for age-related cognitive impairment, as compared against other commonly used neurocognitive screening tests -the SLUMS test, the MMSE, and the MoCA - and against physician diagnosis. Methods: We tested 583 volunteers over the age of 49 from various community centers and living facilities in Houston, TX. The volunteers were divided into five cohorts: a normative population, and four comparison groups for SLUMS, MMSE, MoCA, and physician diagnosis. Each comparison group completed their respective assessment and BrainCheck Memory. Results: 398 subjects were included in the normative population. 84 participants were in the SLUMS cohort, 51 in the MMSE cohort, 35 in the MoCA cohort, and 18 in the physician cohort. BrainCheck Memory assessments were significantly correlated to the SLUMS, with coefficients ranging from 0.5 to 0.7. Correlation coefficients for the MMSE and BrainCheck and the MoCA and BrainCheck were also significant. Of the 18 subjects evaluated by a physician, nine were healthy, six were moderately impaired, and three were severely impaired. A significant difference was found between the severely/moderately impaired and the healthy (p=.02). We derived a BrainCheck Memory composite score that showed stronger correlations with the standard assessments as compared to the individual BrainCheck assessments. ROC curve analysis of this composite score found a sensitivity of 81% and a specificity of 94%. Conclusions: BrainCheck Memory provides a sensitive and specific metric for age-related cognitive impairment in older adults, with the advantages of a mobile, digital, and easy-to-use test. Clinical Trial: Video Games to Track Cognitive Health. Clinical Trials.gov identifier: NCT03608722. https://clinicaltrials.gov/ct2/show/NCT03608722?term=braincheck&rank=1

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