A new home‐based cognitive test using phone calls in mild cognitive impairment

Abstract

AbstractBackgroundMild cognitive impairment (MCI) is a risk group of dementia. Despite of plethora of hospital‐based neuropsychological tests, assessment tools that can be performed at home to detect cognitive progression are lacking. We thought that a home‐based cognitive test (HCT) is useful for regular cognitive monitoring without visiting the hospital. Our study aimed to validate the HCT by assessing relationships with existing hospital‐based neuropsychological tests scores.MethodThis pilot study was conducted in a university‐affiliated dementia clinic from July 2019 to December 2021. We had developed a new HCT that can be examined using phone calls without visiting the hospital. The newly developed HCT is composed of 20 questions (score ranges 0‐30), a higher score indicates better general cognition. Participants with MCI were enrolled and underwent regular HCT during 6 months. Brain MRI, plasma amyloid, baseline and endpoint neuropsychological tests, and assessment for clinical progression were performed. Associations between HCT scores and in‐person neuropsychological tests were investigated. We additionally assessed whether the HCT scores are correlated with Alzheimer’s disease (AD)‐related biomarkers including plasma amyloid values and regional brain volumes. To assess relevance, partial correlation coefficient adjusted by age, sex, and education was performed.ResultHCT had good intraclass correlation coefficient values (test‐retest Cronbach’s alpha 0.839 & inter‐rater reliability Cronbach’s alpha 0.627). Totally 38 participants were enrolled and 32 completed the endpoint evaluations at 6 months. Seven participants progressed to mild dementia. Baseline HCT score showed good correlations with Mini‐Mental State Examination (MMSE) score, verbal memory delayed recall scores, and stroop test scores after adjustment for age, sex, and education. However, HCT scores did not show significant associations with AD‐biomarkers. MCI with higher risk of progression (APOE4 carrier or positivity in plasma amyloid values) showed numerical trends of faster HCT declines compared with MCI with lower risk of progression, although it did not reach statistical significance (p>0.05).ConclusionWe demonstrated good reliability and correlations of the newly developed HCT with existing in‐person neuropsychological tests. It also showed good applicability on the elderly with MCI. Hence, HCT could be a promising and alternative option to monitor cognitive declines without visiting the hospital.