Background: Detection of presymptomatic individuals or those with subtle cognitive changes in midlife may prevent or slow the course of Alzheimer's Disease by identifying candidates for disease‐modifying treatments. Utilizing newer delivery approaches involving digital measures shows promise for cognitive phenotyping, early detection, ease of administration, and scoring, particularly in low‐resource settings. However, the feasibility of these approaches, along with their association with demographics and their effectiveness in detecting fine‐grained aspects of cognitive performance in low‐resource settings, remains unclear. We conducted a pilot study evaluating digital cognitive screening using an iPad‐administered clock drawing test in a diverse South Asian population residing in India.
Methods: Individuals ≥ 50 years old (median: 61.0 years; range: 50‐89 years; female: 56%; education: up to primary schooling: 8%; high school to secondary: 65%; graduation and above: 27.4%) nested within the ongoing population‐based longitudinal Precision‐CARRS study representing socio‐demographically and linguistically diverse adults from Delhi and Chennai in India (n=300; 150/site) were studied. Participants were administered the FDA‐approved, iPad‐based clock drawing test using a commercially available Linus Health Digital Clock (DCTclock) screening tool. The DCTclock summary score, ranging from 0 to 100, was derived through AI analytics and provided various features, including drawing efficiency, information processing, simple motor skills, and visuospatial reasoning. Performance on the traditionally administered paper/pencil version of the Mini‐Cog test incorporating clock drawing and three‐item recall was used to classify participants as cognitively impaired (0‐2 points) or intact (3‐5 points).
Results: DCTclock was administered in ∼3‐4 minutes, and only 0.7% of clocks were unanalyzable due to missing components. Older age and lower education (p<0.0001) were associated with worse DCTclock summary scores. There were no sex differences in performance (p=0.90). Compared to those cognitively intact based on the Mini‐Cog scores (n=252), the impaired group (n=48) performed significantly worse on the DCTclock summary score and spatial reasoning components (Table).
Conclusion: Screening for cognitive status using digital clock measurement is highly feasible and takes a short amount of time to administer in low‐resource settings. The DCTclock provides fine‐grained measures of performance not available on traditional paper/pencil measures, which may prove sensitive to early detection of cognitive impairment.
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http://dx.doi.org/10.1002/alz.086976 | DOI Listing |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11716056 | PMC |
Background: The Defense Automated Neurobehavioral Assessment (DANA) encompasses a suite of standardized neurocognitive screening tools designed for detecting various neurodegenerative diseases and subtle cognitive deficits. This study presents a pilot investigation into digital cognitive screening, utilizing an Android version of the DANA tests, conducted among a diverse South Asian population residing in India.
Methods: The study involved individuals aged over 50 years, nested within the ongoing population‐based longitudinal Precision‐CARRS study, representative of socio‐demographically and linguistically diverse adults from Delhi and Chennai in India.
Alzheimers Dement
December 2024
Emory University School of Medicine, Atlanta, GA, USA
Background: Detection of presymptomatic individuals or those with subtle cognitive changes in midlife may prevent or slow the course of Alzheimer's Disease by identifying candidates for disease‐modifying treatments. Utilizing newer delivery approaches involving digital measures shows promise for cognitive phenotyping, early detection, ease of administration, and scoring, particularly in low‐resource settings. However, the feasibility of these approaches, along with their association with demographics and their effectiveness in detecting fine‐grained aspects of cognitive performance in low‐resource settings, remains unclear.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Federal Center of Brain and Neurotechnologies, FMBA of Russia, Moscow, Russian Federation
Background: The priority problem of modern healthcare is irreversible dementia due to the steady increase in morbidity. Among irreversible dementias, Alzheimer’s disease takes the first place. Most often, only with sufficiently pronounced cognitive disorders, the doctor can diagnose Alzheimer’s disease, although it is obvious that the neurodegenerative process begins even before the clinical manifestations of the disease.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Linus Health, Boston, MA, USA
Background: Maximizing the benefits of disease‐modifying treatments (DMTs) for Alzheimer’s disease (AD) requires early identification of cognitive impairment and abnormal brain amyloid‐beta (Aβ) status. Either one alone is insufficient. Additionally, clinical trials of DMTs are impeded by high screen failure rates and costly prescreening.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA
Background: To estimate the prevalence of cognitive impairment in a population‐based cohort from India and assess the potential modifiable factors of cognitive impairment.
Method: We used the population‐representative data from the longitudinal Precision‐CARRS study from Delhi and Chennai, India. The cohort was recruited in two waves, CARRS‐1 in 2010‐11 and CARRS‐2 in 2015‐16.
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