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The Computerized Self Test (CST): An Interactive, Internet Accessible Cognitive Screening Test For Dementia

Article type: Research Article

Authors: Dougherty Jr., John H.a | Cannon, Rex L.a; b; * | Nicholas, Christopher R.a; c | Hall, Lorina | Hare, Feliciaa | Carr, Erikaa; d | Dougherty, Andrewe | Janowitz, Jennifera | Arunthamakun, Justina; f

Affiliations: [a] Cole Neuroscience Center, Memory Disorder Clinic, University of Tennessee Medical Center, Knoxville, TN, USA | [b] Biological Psychology and Neuroscience Laboratory, Department of Psychology, University of Tennessee, Knoxville, TN, USA | [c] Clinical Psychology Program, Department of Psychology, University of Tennessee, Knoxville, TN, USA | [d] Counseling Psychology Program, Department of Psychology, University of Tennessee, Knoxville, TN, USA | [e] Medical Interactive Education, LLC, Knoxville, TN, USA | [f] Neuroscience, Financial Economics, Biology, Vanderbilt University, Nashville, TN, USA

Correspondence: [*] Correspondence to: Rex Cannon, Cole Neuroscience Center, University of Tennessee Medical Center, 1928 Alcoa Highway, Medical Building B, Suite 102, Knoxville, TN 37920, USA. Tel.: +1 865 300 4983; E-mail: rcannon2@utk.edu.

Keywords: Alzheimer's disease, computerized cognitive screening, dementia, mild cognitive impairment

DOI: 10.3233/JAD-2010-1354

Journal: Journal of Alzheimer's Disease, vol. 20, no. 1, pp. 185-195, 2010

Accepted 8 December 2009
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Published: 24 March 2010
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Abstract

The computer self test (CST) is an interactive, internet-based instrument designed to assess functional cognitive domains impaired by Alzheimer's disease (AD) and mild cognitive impairment (MCI). This study consisted of 215 total subjects with a mean age of 75.24. The 84 cognitively impaired patients (excluding patients diagnosed as MCI) met all criteria set forth by NINCDS/ADRDA for the diagnosis of AD. Control participants consisted of 104 age-matched individuals who were cognitively unimpaired. All patients completed the CST prior to other routine neurocognitive procedures. The CST accurately classified 96% of the cognitively impaired individuals as compared to controls, while the Mini-Mental Status Examination (MMSE) accurately classified 71% and the Mini-Cog 69% in the same respect. In addition, the CST accurately classified 91% of the six experimental groups (control, MCI, early AD, mild to moderate, moderate to severe, and severe) as compared to 54% for the MMSE and 48% for the Mini-Cog. In conclusions, the CST demonstrates a high degree of sensitivity and specificity and is capable of accurately identifying cognitive impairment in patients with variable degrees of cognitive abnormality. This interactive internet-based cognitive screening tool may aid in early detection of cognitive impairment in the primary care setting. The ease of use and interpretation may also provide the means to obtain an accurate baseline from which to monitor cognitive changes over time.

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