Remote clinical cognitive assessment: Validation of mobile interactive cognitive self‐assessment scale

Abstract

AbstractBackgroundThe diagnosis of Alzheimer’s disease relies on trained clinicians and specialized diagnostic tests. Under the circumstances of COVID‐19, the clinical interview is restricted, which caused an additional delay in diagnosis. Emerging demand for remote interactive cognitive assessment aroused for diagnosis and mass screening. We aimed to develop a mobile interactive cognitive self‐ assessment scale (ICSAS)MethodThe ICSAS was created by an expert group applying nominal group techniques and focus groups. Initial examination and iterative rounds were conducted in participants from the community and hospital to optimize the scale. The final version of ICSAS included 4 tasks, covering executive function, logic memory, visual memory, and logic memory recall. Validation was conducted in 387 cognitively impaired participants and 297 participants with normal cognition from the institution. 2034 participants were enrolled from the community.ResultNo significant difference was found in age and sex between cognitively impaired participants and normal controls. Years of education, the score of MMSE and MoCA were higher in normal controls. The Cronbach’s alpha was 0.79 which indicated relative good reliability. The KMO value was 0.76, and the optimal cutoff point was 228.90, leading to the sensitivity of 0.90 and specificity of 0.71. The positive likelihood ratio was 3.10, and the negative likelihood ratio was 0.14, which suggested ICSAS as an ideal scale. 284 participants from the community were predicted to be cognitively impaired, accounting for approximately 15% of participants from the community, which corresponds to the prevalence research.ConclusionOur research developed a remote interactive cognitive self‐assessment scale (ICSAS) which has relatively good reliability and sensitivity. The ICSAS may ease the struggle of remote clinical cognitive assessment brought by the COVID‐19 pandemic. Also, from the long‐term perspective, the application of ICSAS may enhance the feasibility of cognitive assessment, and it may be ideal for mass screening and cognitively impaired patients’ monitoring.