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Paterson TSE, Sivajohan B, Gardner S, et al. Accuracy of a Self-Administered Online Cognitive Assessment in Detecting Amnestic Mild Cognitive Impairment. J Gerontol B Psychol Sci Soc Sci. 2021;doi: 10.1093/geronb/gbab097.
Paterson, T. S. E., Sivajohan, B., Gardner, S., Binns, M. A., Stokes, K. A., Freedman, M., Levine, B., & Troyer, A. K. (2021). Accuracy of a Self-Administered Online Cognitive Assessment in Detecting Amnestic Mild Cognitive Impairment. The journals of gerontology. Series B, Psychological sciences and social sciences, . https://doi.org/10.1093/geronb/gbab097
Paterson, Theone S E, et al. "Accuracy of a Self-Administered Online Cognitive Assessment in Detecting Amnestic Mild Cognitive Impairment." The journals of gerontology. Series B, Psychological sciences and social sciences vol. (2021). doi: https://doi.org/10.1093/geronb/gbab097
Paterson TSE, Sivajohan B, Gardner S, Binns MA, Stokes KA, Freedman M, Levine B, Troyer AK. Accuracy of a Self-Administered Online Cognitive Assessment in Detecting Amnestic Mild Cognitive Impairment. J Gerontol B Psychol Sci Soc Sci. 2021 Aug 01; doi: 10.1093/geronb/gbab097. Epub 2021 Aug 01. PMID: 34333629.
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J Gerontol B Psychol Sci Soc Sci. 2021 Aug 01; doi: 10.1093/geronb/gbab097. Epub 2021 Aug 01.

Accuracy of a Self-Administered Online Cognitive Assessment in Detecting Amnestic Mild Cognitive Impairment.

The journals of gerontology. Series B, Psychological sciences and social sciences

Theone S E Paterson, Brintha Sivajohan, Sandra Gardner, Malcolm A Binns, Kathryn A Stokes, Morris Freedman, Brian Levine, Angela K Troyer

Affiliations

  1. Baycrest Health Sciences Centre, Toronto, Ontario, Canada.
  2. Department of Psychology, University of Victoria, British Columbia, Canada.
  3. Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
  4. Rotman Research Institute, Toronto, Ontario, Canada.
  5. Department of Psychology, University of  Toronto, Ontario, Canada.

PMID: 34333629 DOI: 10.1093/geronb/gbab097

Abstract

OBJECTIVES: Our aim was to validate the online Brain Health Assessment (BHA) for detection of amnestic mild cognitive impairment (aMCI) compared to gold-standard neuropsychological assessment. We compared the diagnostic accuracy of the BHA to the Montreal Cognitive Assessment (MoCA).

METHODS: Using a cross-sectional design, community-dwelling older adults completed a neuropsychological assessment, were diagnosed as normal cognition (NC) or aMCI, and completed the BHA and MoCA. Both logistic regression (LR) and penalized logistic regression (PLR) analyses determined BHA and demographic variables predicting aMCI; MoCA variables were similarly modeled. Diagnostic accuracy was compared using area under the receiver operating characteristic curve (ROC AUC) analyses.

RESULTS: Ninety-one participants met inclusion criteria (51 aMCI, 40 NC). PLR modeling for the BHA indicated Face-Name Association, Spatial Working Memory, and age-predicted aMCI (ROC AUC = 0.76; 95% confidence interval [CI]: 0.66-0.86). Optimal cut-points resulted in 21% classified as aMCI (positive), 23% negative, and 56% inconclusive. For the MoCA, digits, abstraction, delayed recall, orientation, and age predicted aMCI (ROC AUC = 0.71; 95% CI: 0.61-0.82). Optimal cut-points resulted in 22% classified positive, 8% negative, and 70% inconclusive (LR results presented within). The BHA model classified fewer participants into the inconclusive category and more as negative for aMCI, compared to the MoCA model (Stuart-Maxwell p = .004).

DISCUSSION: The self-administered BHA provides similar detection of aMCI as a clinician-administered screener (MoCA), with fewer participants classified inconclusively. The BHA has the potential to save practitioners time and decrease unnecessary referrals for a comprehensive assessment to determine the presence of aMCI.

© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America.

Keywords: Cognitive screening; Diagnostic accuracy; Logistic regression; Validity; eHealth

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