The digital mobile assessment of cognition as a quick comprehensive cognitive test for primary care

Abstract

AbstractBackgroundThe uniform standardized neuro‐cognitive test is a challenge for the primary care physician due to time constraints, interpretation, and clinical use in the daily practice for dementia care.MethodThe DMAC was given to 318 patients presenting with memory loss in the disease group and 33 patients in the control group. The DMAC was given between 35‐55 minutes after the pre‐screening test. Each domain test was bundled to give a comprehensive average score of each domain in percentage: as the person’s ability to recruit neurons in the neural circuit to perform the cognitive task. The test was given individually. The domains tested include visual, auditory, delayed recall, attention, executive, number recall, disinhibition, and working memory.ResultsStatistical analysis with a series of t‐Tests showed the diseased group (n‐318) had significantly lower scores than the control group (c‐33) with confidence interval of 95% in the following domains: visual (p < 0.001), auditory (p < 0.001), delayed recall ( p < 0.001), disinhibition (p < 0.001), attention (p < 0.001), executive function (p < 0.001), numerical recall ( p < 0.001), and working memory (p < 0.001). The average sensitivity of the DMAC across these eight domains was 84.75% while the average specificity was 59.56%.DiscussionNeuropsychological test batteries have limitations as it takes 4 to 6 hours, which is not possible for the dementia group due to a short attention span and score interpretation is a challenge due to t‐score and z‐score reporting and selection bias of test battery. In an effort to create a comprehensive, reliable, and simple test for cognitive evaluation by a primary care physician under a controlled environment, we have created a digital mobile cognitive assessment test (DMAC) for memory loss patients with 8 common domains with simple interpretation and guidance to cognitive therapy within one software package. The DMAC has an inbuilt prescreening questionnaire to eliminate and standardize the patient selection.ConclusionThe DMAC is an ideal cognitive test in an outpatient primary care setting as the results are also translated into cognitive therapy & training in simple digital media.