Abstract
The purpose of this study was to compare a new digitized cognitive test battery, Minnemera, with its correspondent traditional paper-based cognitive tests. Eighty-one healthy adults between the ages of 21 and 85 participated in the study. Participants performed the two different test versions (traditional paper-based and digitized) with an interval of four weeks between the tests. Test presentation (the order of the test versions presented) was counterbalanced in order to control for any possible test learning effects. The digitized tests were constructed so that there were only minor differences when compared to the traditional paper-based tests. Test results from the paper-based and digitized versions of the cognitive screening were compared within individuals by means of a correlation analysis and equivalence tests. The effects of demographic variables (age, gender and level of education) and test presentation were explored for each test measure and each test version through linear regression models. For each test measure, a significant correlation between traditional and digitized version was observed ranging between r = 0.34 and r = 0.67 with a median of r = 0.53 (corresponding to a large effect size). Score equivalence was observed for five out of six tests. In line with previous traditional cognitive studies, age was found to be the most prominent predictor of performance in all digitized tests, with younger participants performing better than older adults. Gender was the second strongest predictor, where women outperformed men in tests measuring verbal memory; men performed better than women in tests with a strong visual component. Finally, the educational level of the test subjects had an effect on executive functions, with a higher educational level linked to a better inhibition response and working memory span. This study suggests that the tests in the Minnemera cognitive screening battery are acceptably comparable to the traditional paper-based counterparts.
Highlights
Effective cognitive screening is needed in healthcare to be able to ascertain whether a patient needs further cognitive investigation
With the global aging population (Winblad et al, 2016) and with dementia medicines in clinical trials, there is a need for cognitive screening that is more sensitive to subtle cognitive impairment, which is costeffective (Müller et al, 2017) and which can be made available to more patients who experience subjective cognitive decline
The tests were digitized, closely copying traditional paper-based tests and introducing the least amount of modifications, which was especially successful for Rey Auditory Verbal Learning Test (RAVLT), Corsi, Trail Making Test (TMT), and BNT
Summary
Effective cognitive screening is needed in healthcare to be able to ascertain whether a patient needs further cognitive investigation. Used short cognitive screening instruments in case of suspicion of dementia are the Mini-Mental State Examination (MMSE; Folstein et al, 1975) and Clock Drawing Test (Shulman and Feinstein, 2003). These instruments are, coarse measurements of cognitive functioning and do not capture subtle cognitive impairment (Hooijer et al, 1992). With the global aging population (Winblad et al, 2016) and with dementia medicines in clinical trials, there is a need for cognitive screening that is more sensitive to subtle cognitive impairment, which is costeffective (Müller et al, 2017) and which can be made available to more patients who experience subjective cognitive decline. Digitized cognitive screening has been proposed as a method to track clients’ health status and support health workers in decision making (World Health Organization [WHO], 2019)
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