Mobile cognitive assessment demonstrates diagnostic equivalence to MMSE and MoCA scales in Alzheimer’s disease screening

TL;DR

A mobile cognitive assessment system was developed and shown to be as effective as traditional tools for screening Alzheimer's disease.

Contribution

The study introduces a mobile-based cognitive assessment system with self-administration and dynamic monitoring capabilities for AD screening.

Findings

mCAS achieved an AUC of 0.884 for MCI discrimination with diagnostic equivalence to MMSE and MoCA.

mCAS showed lower specificity than MoCA for MCI identification (p = 0.027).

The system enables self-administered assessments in non-medical settings.

Abstract

Alzheimer’s disease (AD), the most common neurodegenerative disorder, poses significant challenges for early screening due to the clinical and environmental constraints of traditional neuropsychological assessments.

This study developed a mobile terminal-based cognitive assessment system (mCAS) and prospectively validated its screening efficacy through a diagnostic trial. We recruited 63 memory clinic patients (aged 20–75 years), all of whom independently completed mCAS testing after undergoing standardized MMSE and MoCA evaluations. Through a systematic review of 10 existing mild cognitive impairment (MCI) screening tools, we extracted 25 test items to construct the assessment framework.

Our results demonstrated that, under the optimal Gradient Boosting model, mCAS achieved an area under the curve (AUC) of 0.884 for discriminating MCI while maintaining diagnostic equivalence in sensitivity compared to conventional instruments (p > 0.05 in all pairwise comparisons). Specificity was significantly lower than MoCA only for MCI identification (p = 0.027).

The system’s core innovations include: (1) A multimodal digital assessment framework that overcomes the environmental limitations of conventional scales; (2) Self-administration capability in non-medical settings; and (3) A dynamic cognitive baseline model to facilitate longitudinal monitoring. mCAS provides a convenient screening solution for early AD detection, with significant potential particularly in resource-limited regions. Future multicenter validation and biomarker integration studies are warranted.

Figures