Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017;56(1):249-259.
doi: 10.3233/JAD-160566.

Screening for Mild Cognitive Impairment and Dementia with Automated, Anonymous Online and Telephone Cognitive Self-Tests

Lisa D Van Mierlo  1 , Hans Wouters  1   2 , Sietske A M Sikkes  3   4   5 , Wiesje M Van der Flier  3   5 , Niels D Prins  3   5 , Jonne A E Bremer  3 , Teddy Koene  3 , Hein P J Van Hout  1
Affiliations
Free PMC article

Screening for Mild Cognitive Impairment and Dementia with Automated, Anonymous Online and Telephone Cognitive Self-Tests

Lisa D Van Mierlo et al. J Alzheimers Dis. 2017.
Free PMC article

Abstract

Background: Many older people worry about cognitive decline. Early cognitive screening in an anonymous and easily accessible manner may reassure older people who are unnecessarily worried about normal cognitive aging while it may also expedite help seeking in case of suspicious cognitive decline.

Objective: To develop and validate online and telephone-based automated self-tests of cognitive function.

Methods: We examined the feasibility and validity of the self-tests in a prospective study of 117 participants of whom 34 had subjective cognitive decline (SCD), 30 had mild cognitive impairment (MCI), and 53 had dementia. The ability of these self-tests to accurately distinguish MCI and dementia from SCD was examined with ROC curves. Convergent validity was examined by calculating rank correlations between the self-tests and neuropsychological tests.

Results: Both the online and telephone cognitive self-tests were feasible, because the majority of participants (86% and 80%, respectively) were able to complete them. The online self-test had adequate diagnostic accuracy in the screening for MCI and dementia versus SCD with an Area under the Curve (AUC) of 0.86 (95% CI: 0.78-0.93). The AUC of the MMSE was 0.82 (95% CI: 0.74-0.89). By contrast, the telephone self-test had lower diagnostic accuracy (AUC = 0.75, 95% CI: 0.64-0.86). Both self-tests had good convergent validity as demonstrated by moderate to strong rank correlations with neuropsychological tests.

Conclusion: We demonstrated good diagnostic accuracy and convergent validity for the online self-test of cognitive function. It is therefore a promising tool in the screening for MCI and dementia.

Keywords: Alzheimer’s disease; cognitive screening; online and telephone cognitive self-test; sensitivity; specificity.

PubMed Disclaimer

Figures

Fig.1
Fig.1
Flow chart of inclusion.
Fig.2
Fig.2
Rank correlations (rs) * between online self-tests (horizontal axis) and tests from neuropsychological assessment (vertical axis).
Fig.3
Fig.3
Rank correlations (rs) * between telephone self-tests (horizontal axis) and tests from neuropsychological assessment (vertical axis).
See this image and copyright information in PMC

References

    1. Alzheimer’s Disease International (2015) World Alzheimer report. http://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf, updated 2015. Accessed December 3, 2015.
    1. National Institute for Health and Clinical Excellence (2006) Dementia: Supporting people with dementia and their carers in health and social care. CG42 Dementia: NICE guideline.
    1. Espinosa A, Alegret M, Valero S, Vinyes-Junqué G, Hernández I, Mauleón A, Rosende-Roca M, Ruiz A, López O, Tárraga L, Boada M (2013) A longitudinal follow-up of 550 mild cognitive impairment patients: Evidence for large conversion to dementia rates and detection of major risk factors involved. J Alzheimers Dis 34, 769–780. - PubMed
    1. Commissaris CJ, Ponds RW, Jolles J (1998) Subjective forgetfulness in a normal Dutch population: Possibilities for health education and other interventions. Patient Educ Couns 34, 25–32. - PubMed
    1. van den Dungen P, van Marwijk HW, van der Horst HE, Moll van Charante EP, Macneil Vroomen J, van de Ven PM, van Hout HPJ (2012) The accuracy of family physicians’ dementia diagnoses at different stages of dementia: A systematic review. Int J Geriatr Psychiatry 27, 342–354. - PubMed

Publication types

LinkOut - more resources