Shanghai Cognitive Screening: A Mobile Cognitive Assessment Tool Using Voice Recognition to Detect Mild Cognitive Impairment and Dementia in the Community
Affiliations: [a] Department of Gerontology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| [b] Center for Brain Science, Shanghai BestCovered Limited, Shanghai, China
Correspondence:
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*Correspondence to: Qihao Guo, Department of Gerontology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China. Tel./Fax: +86 021 24056072; E-mail: qhguo@sjtu.edu.cn and Huanhuan Xia, Center for Brain Science, Shanghai BestCovered Limited, Shanghai 200082, China. Tel./Fax: +86 021 65688077; E-mail: joyce@bestcovered.com.
Note: [1] These authors contributed equally to this work.
Abstract: Background:A rapid digital instrument is needed to facilitate community-based screening of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in China. Objective:We developed a voice recognition-based cognitive assessment (Shanghai Cognitive Screening, SCS) on mobile devices and evaluated its diagnostic performance. Methods:Participants (N = 251) including healthy controls (N = 98), subjective cognitive decline (SCD, N = 42), MCI (N = 80), and mild AD (N = 31) were recruited from the memory clinic at Shanghai Sixth People’s Hospital. The SCS is fully self-administered, takes about six minutes and measures the function of visual memory, language, and executive function. Participants were instructed to complete SCS tests, gold-standard neuropsychological tests and standardized structural 3T brain MRI. Results:The Cronbach’s alpha was 0.910 of the overall scale, indicating high internal consistency. The SCS total score had an AUC of 0.921 to detect AD (sensitivity = 0.903, specificity = 0.945, positive predictive value = 0.700, negative predictive value = 0.986, likelihood ratio = 16.42, number needed for screening utility = 0.639), and an AUC of 0.838 to detect MCI (sensitivity = 0.793, specificity = 0.671, positive predictive value = 0.657, negative predictive value = 0.803, likelihood ratio = 2.41, number needed for screening utility = 0.944). The subtests demonstrated moderate to high correlations with the gold-standard tests from their respective cognitive domains. The SCS total score and its memory scores all correlated positively with relative volumes of the whole hippocampus and almost all subregions, after controlling for age, sex, and education. Conclusion:The SCS has good diagnostic accuracy for detecting MCI and AD dementia and has the potential to facilitate large-scale screening in the general community.
