Public Health.

Background: Game-based Cognitive Assessment - 3-minute Version (G3) is a self-administrated mobile screening tool for detecting early cognitive impairments among Chinses community-dwelling older adults. Released as a WeChat and Alipay mini-programs, G3 offers a convenient and cost-free means for individuals to evaluate their cognitive functions online. This study aimed to investigate the cognitive performance of older adults in the Shanghai community with G3. Additionally, a comparison was made between the cognitive performance of older adults who participated in the screening offline and those who proactively participated online.

Method: Between June and October 2023, an offline cognitive screening with G3 tests was performed in Xiaodongmen subdistrict of Shanghai. And G3 results of 3344 participants aged 55-89 years old were enrolled for restrictive analysis. Simultaneously, G3 online assessment records between January and December 2022 completed by 64535 individuals aged 55-89 years old from various regions of China, were reviewed and compared to the offline screening results.

Result: Among older adults aged 55 to 89 in Xiaodongmen communities, the average G3 score (mean ± stand deviation) was 56.82±12.47. Furthermore, the mean G3 score for males and females was 57.23±12.29 (n = 1569) and 56.46±12.61(n = 1775), respectively, both of which exhibited a trend of cognitive decline with increasing age (Figure 1). Moreover, older adults with a high school education or higher demonstrated significantly better cognitive performance compared to those without (p<0.05, Figure 2). When comparing the online self-administrated G3 results of age-matched older adults, both cohorts displayed a similar trend of cognitive decline with increasing age. However, the average G3 score obtained from Xiaodongmen subdistrict was statistically lower than that of the online assessments (p<0.05, Figure 3).

Conclusion: This study characterized the cognitive function among older adults in Shanghai and enhanced the feasibility of G3 tool for large-scale cognitive screening in Chinese communities. Nonetheless, due to the notable disparity between online and offline screening results, further investigations are warranted to explore the underlying mechanisms.