Introducing the tablet-based Oxford Cognitive Screen-Plus (OCS-Plus) as an assessment tool for subtle cognitive impairments

Nele Demeyere,Mihaela D Duta,Sam S Webb,Elise T Milosevich,Kathrin Finke,Hayley Wright,Marleen Haupt,Lea Strobel,Margaret J Moore

doi:10.1038/s41598-021-87287-8

Abstract

Here, we present the Oxford Cognitive Screen-Plus, a computerised tablet-based screen designed to briefly assess domain-general cognition and provide more fine-grained measures of memory and executive function. The OCS-Plus was designed to sensitively screen for cognitive impairments and provide a differentiation between memory and executive deficits. The OCS-Plus contains 10 subtasks and requires on average 24 min to complete. In this study, 320 neurologically healthy ageing participants (age M = 62.66, SD = 13.75) from three sites completed the OCS-Plus. The convergent validity of this assessment was established in comparison to the ACE-R, CERAD and Rey–Osterrieth. Divergent validity was established through comparison with the BDI and tests measuring divergent cognitive domains. Internal consistency of each subtask was evaluated, and test–retest reliability was determined. We established the normative impairment cut-offs for each of the subtasks. Predicted convergent and divergent validity was found, high internal consistency for most measures was also found with the exception of restricted range tasks, as well as strong test–retest reliability, which provided evidence of test stability. Further research demonstrating the use and validity of the OCS-Plus in various clinical populations is required. The OCS-Plus is presented as a standardised cognitive assessment tool, normed and validated in a sample of neurologically healthy participants. The OCS-Plus will be available as an Android App and provides an automated report of domain-general cognitive impairments in executive attention and memory.

Highlights

We present the Oxford Cognitive Screen-Plus, a computerised tablet-based screen designed to briefly assess domain-general cognition and provide more fine-grained measures of memory and executive function
Patients with a language deficit would appear to be impaired on this task, regardless of their underlying attentional capacity. This inability to separate cognitive impairments is problematic for patient populations characterized by language impairments, such as some patients with stroke and dementia[5]
The Oxford Cognitive Screen-Plus (OCS-Plus) aims to avoid undue loading of language requirements by emphasizing visual-oriented assessments. This tablet-based cognitive assessment tool is a follow-up of the paperbased OCS10 and was designed to be inclusive

Summary

Introduction

We present the Oxford Cognitive Screen-Plus, a computerised tablet-based screen designed to briefly assess domain-general cognition and provide more fine-grained measures of memory and executive function. The OCS is a validated and normed standardized paperbased test that provides a domain-specific cognitive profile for stroke survivors It covers five core cognitive domains (attention, language, memory, number and praxis) and includes many aphasia- and neglect-friendly subtasks, i.e., through usage of high frequency words and central presentation of items. The OCS has been shown to be more sensitive to cognitive deficits in acute post-stroke cohorts than both the MoCA and MMSE7,11 While this approach is ideal for acute stroke settings, a more sensitive and detailed assessment is required to detect more subtle domain-general cognitive impairments in this and other populations. This is why we developed the OCS-Plus

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