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. 2025 Jan 3;15(1):92.
doi: 10.3390/diagnostics15010092.

The Validity of a Smartphone-Based Application for Assessing Cognitive Function in the Elderly

Jin-Young Min  1 , Duri Kim  1 , Hana Jang  1 , Hyunjoo Kim  1 , Soojin Kim  1 , Seungbo Lee  2 , Yae-Eun Seo  2 , Ye-Jin Kim  2 , Jong-Yoon Kim  2 , Kyoung-Bok Min  3
Affiliations

The Validity of a Smartphone-Based Application for Assessing Cognitive Function in the Elderly

Jin-Young Min et al. Diagnostics (Basel). .

Abstract

Background/Objectives: The early detection of individuals at risk of cognitive impairment is a clinical imperative. With the recent advancement of digital devices, smartphone application-based cognitive assessment is considered a promising tool for cognitive screening and monitoring inside and outside the clinic. This study examined whether a smartphone-based cognitive assessment, Brain OK, was valid for evaluating cognitive performance and identifying people at risk of cognitive impairment. Methods: We recruited 88 study participants aged over 60. They completed two cognitive tests with the Montreal Cognitive Assessment (MoCA), a validated paper-and-pencil cognitive screening tool, and Brain OK, a smartphone-based cognitive testing application. To examine convergent validity, we conducted analyses of Spearman correlations between MoCA and BrainOK, a Bland-Atman plot with regression analysis, and the area under the curve (AUC). Results: There was a significant positive association between Brain OK and the MoCA total score, with a coefficient of 0.9044 (SE = 0.057, t = 15.750, p < 0.001). The Bland-Altman plot represented a reasonable level of agreement between the two tests. We conducted the AUC analysis of Brain OK to compare the cognitively normal and impaired groups. The AUC value for the Brain OK score of 13.5 was the highest at 0.941. The sensitivity and specificity were 0.958 and 0.925, respectively. Conclusions: The smartphone app-based Brain OK test was feasible for assessing cognitive function and acceptable for identifying subjects with cognitive impairment. The results suggest Brain OK complements traditional in-person cognitive assessments and may help enhance cognitive health dialogue between doctors and patients.

Keywords: cognitive assessment; cognitive impairment; digitalized tool; feasibility; validation.

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Conflict of interest statement

Jong-yoon Kim is the founder and CEO of Beluga Crop. Three other authors (Seungbo Lee, Yae-eun Seo, and Ye-jin Kim) are affiliated with Beluga Crop. and were involved in the development of the smartphone-based cognitive assessment tool Brain OK. Specifically, their roles included selecting and designing test items based on a comprehensive review of the existing literature and implementing the tool’s software framework. However, to ensure objectivity and minimize potential bias, none of the Beluga-affiliated authors participated in data collection, data analysis, or result interpretation in the current study. Their contributions were limited to tool development, while the research design, data acquisition, statistical analysis, and manuscript preparation were conducted independently by the other authors.

Figures

Figure 1
Figure 1
Correlation heatmap of subdomains between Brain OK and MoCA.
Figure 2
Figure 2
Correlation scatter plot (A) and Bland–Altman plot (B) for Brain OK vs. MoCA. Each blue dot represents an individual data point, reflecting observed values for the two variables. The red line indicates the linear regression line, demonstrating the overall trend between the two scores.
Figure 3
Figure 3
The ROC curve for the Brain OK total score in the comparison between the normal control and MCI groups (A) and description (B).
Figure 3
Figure 3
The ROC curve for the Brain OK total score in the comparison between the normal control and MCI groups (A) and description (B).
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