Technology and Dementia Preconference.

Background: There is an urgent need for neuropsychological screening tests that are easily deployed and reliable. We have developed a digital neuropsychological screening protocol that is administered on a tablet, automatically scored using artificial intelligence, and requires approximately 10 minutes to administer. This tablet-administered protocol assesses the requisite neurocognitive constructs associated with emergent neurodegenerative illness METHOD: The digital protocol was administered to 77 ambulatory care/ memory clinic patients (Table1). The protocol is comprised of a 6-word version of the Philadelphia (repeatable) Verbal Learning Test [P(r)VLT], three trials of 5 digits backward (BDST), and the 'animal' fluency test. The protocol provides a panel of six traditional measures as would be obtained using paper/ pencil tests and manual scoring of (P[r]VLT free recall/ recognition hits, backward digit span, 'animal' fluency output); a variety of outcome measures quantifying errors and the process used to bring tests to fruition; and two separate, norm-referenced summary scores measuring executive control and memory.

Result: Cluster analysis using the panel of 6 traditional measures classified participants into normal (nl = 23), amnestic MCI (aMCI = 17), dysexecutive MCI (dMCI = 23), and dementia (dementia = 23) groups. Subsequent analyses of error and process variables operationally defined key features associated with amnesia including rapid forgetting such as (P[r]VLT immediate free recall trial 2 vs. delay free recall (aMCI & dementia < dMCI & nl; p< 0.001), the production of extra-list intrusion errors (dementia > nl; p< 0.002); profligate responding to recognition foils (aMCI & dementia > dMCI & nl; p< 0.001); key features underlying reduced executive measures (i.e., BDST perseveration/ related errors (dMCI & dementia > aMCI & nl, < 0.050); and the strength of semantic association from successive 'animal' fluency responses (nl & dMCI > dementia; p< 0.028). The novel executive and memory index scores dissociated all four groups from each other (p< 0.014).

Conclusion: This digitally administered and scored protocol yields patterns of impaired performance similar to paper/ pencil tests. The availability of both traditional and error/ process measures suggests that subtle, nuanced indications of early emergent illness may be identified in a fast, efficient, yet comprehensive way.