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Takahashi J, Kawai H, Ejiri M, Fujiwara Y, Hirano H, Sasai H, Obuchi S. Predicting the incidence of mild cognitive impairment with a computer-based cognitive assessment tool in community-dwelling older adults: The Otassha study. PLoS One 2024; 19:e0297433. [PMID: 38271361 PMCID: PMC10810458 DOI: 10.1371/journal.pone.0297433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024] Open
Abstract
This study examined the ability of a computer-based cognitive assessment tool (CompBased-CAT) to predict mild cognitive impairment (MCI) in community-dwelling older adults. A two-year longitudinal study was conducted using data from 2016 to 2018 from the Otassha study cohort of community-dwelling older adults. MCI was defined as a Mini-Mental Status Examination (MMSE) score of <27. The CompBased-CAT was used at baseline, with each subtest score converted into a Z-score. Subsequently, the total Z-scores were calculated. Participants were divided into robust and MCI groups, and all variables were compared using the t-test or χ2 test. Receiver operating characteristic (ROC) curves and logistic regression analyses were conducted, with MCI and total Z-scores as dependent and independent variables, respectively. Among the 455 participants (median age, 72 years; range, 65-89 years; 282 women and 173 men), 32 developed MCI after two years. The participants in the MCI group were significantly older. They had lower maximal gait speed, baseline MMSE scores, subtest Z-scores, and total Z-scores than those in the robust group. The area under the ROC curve was 0.79 (95% confidence interval: 0.70-0.87; P <0.01). The sensitivity was 0.76, and the specificity was 0.75. The logistic regression analysis showed an odds ratio of 1.34 (95% confidence interval: 1.18-1.52; P <0.01). This study showed that CompBased-CAT can detect MCI, which is an early stage of dementia. Thus, CompBased-CAT can be used in future community health checkups and events for older adults.
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Affiliation(s)
- Junta Takahashi
- Exercise Motivation and Physical Function Augmentation Research Team, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Manami Ejiri
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | | | - Hiroyuki Sasai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Cubillos C, Rienzo A. Digital Cognitive Assessment Tests for Older Adults: Systematic Literature Review. JMIR Ment Health 2023; 10:e47487. [PMID: 38064247 PMCID: PMC10746978 DOI: 10.2196/47487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/03/2023] [Accepted: 10/24/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND The global health pandemic has affected the increasing older adult population, especially those with mental illnesses. It is necessary to prevent cases of cognitive impairment in adults early on, and this requires the support of information and communication technologies for evaluating and training cognitive functions. This can be achieved through computer applications designed for cognitive assessment. OBJECTIVE In this review, we aimed to assess the state of the art of the current platforms and digital test applications for cognitive evaluation, with a focus on older adults. METHODS A systematic literature search was conducted on 3 databases (Web of Science, PubMed, and Scopus) to retrieve recent articles on the applications of digital tests for cognitive assessment and analyze them based on the methodology used. Four research questions were considered. Through the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, following the application of inclusion and exclusion criteria, a total of 20 articles were finally reviewed. RESULTS Some gaps and trends were identified regarding the types of digital applications and technologies used, the evaluated effects on cognitive domains, and the psychometric parameters and personal characteristics considered for validation. CONCLUSIONS Computerized tests (similar to paper-and-pencil tests) and test batteries (on computers, tablets, or web platforms) were the predominant types of assessments. Initial studies with simulators, virtual environments, and daily-life activity games were also conducted. Diverse validation methods and psychometric properties were observed; however, there was a lack of evaluations that involved specific populations with diverse education levels, cultures, and degrees of technology acceptance. In addition, these evaluations should consider emotional and usability aspects.
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Affiliation(s)
- Claudio Cubillos
- Escuela de Ingeniería Informática, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Antonio Rienzo
- Escuela de Ingeniería Biomédica, Universidad de Valparaiso, Valparaíso, Chile
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Ding Z, Lee TL, Chan AS. Digital Cognitive Biomarker for Mild Cognitive Impairments and Dementia: A Systematic Review. J Clin Med 2022; 11:jcm11144191. [PMID: 35887956 PMCID: PMC9320101 DOI: 10.3390/jcm11144191] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 01/28/2023] Open
Abstract
The dementia population is increasing as the world’s population is growing older. The current systematic review aims to identify digital cognitive biomarkers from computerized tests for detecting dementia and its risk state of mild cognitive impairment (MCI), and to evaluate the diagnostic performance of digital cognitive biomarkers. A literature search was performed in three databases, and supplemented by a Google search for names of previously identified computerized tests. Computerized tests were categorized into five types, including memory tests, test batteries, other single/multiple cognitive tests, handwriting/drawing tests, and daily living tasks and serious games. Results showed that 78 studies were eligible. Around 90% of the included studies were rated as high quality based on the Newcastle–Ottawa Scale (NOS). Most of the digital cognitive biomarkers achieved comparable or even better diagnostic performance than traditional paper-and-pencil tests. Moderate to large group differences were consistently observed in cognitive outcomes related to memory and executive functions, as well as some novel outcomes measured by handwriting/drawing tests, daily living tasks, and serious games. These outcomes have the potential to be sensitive digital cognitive biomarkers for MCI and dementia. Therefore, digital cognitive biomarkers can be a sensitive and promising clinical tool for detecting MCI and dementia.
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Affiliation(s)
- Zihan Ding
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; (Z.D.); (T.-l.L.)
| | - Tsz-lok Lee
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; (Z.D.); (T.-l.L.)
| | - Agnes S. Chan
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; (Z.D.); (T.-l.L.)
- Research Centre for Neuropsychological Well-Being, The Chinese University of Hong Kong, Hong Kong, China
- Correspondence: ; Tel.: +852-3943-6654
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Abe T, Kitamura A, Yamashita M, Kim H, Obuchi SP, Ishizaki T, Fujiwara Y, Awata S, Toba K. Simple screening models for cognitive impairment in community settings: The
IRIDE
Cohort Study. Geriatr Gerontol Int 2022; 22:292-297. [PMID: 35187789 PMCID: PMC9306945 DOI: 10.1111/ggi.14360] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/23/2021] [Accepted: 01/27/2022] [Indexed: 01/23/2023]
Abstract
Aim Community settings often need simple screening, rather than detailed tests, to identify cognitive impairment. This study aimed to develop models to screen older adults with cognitive impairment. Methods This study used data from the Integrated Research Initiative for Living Well with Dementia Cohort Study and included 5830 older adults. Individuals were considered cognitively impaired if their Mini‐Mental State Examination score was less than 24. Three screening models were developed: the simple model (age, sex, and education), the base model comprising 13 candidate variables available in the questionnaire, and the enhanced model, where grip strength and gait speed were added to the base model. We performed binary logistic regression analysis with stepwise backward elimination (P < 0.1 for retention in the model) to develop each model. Then, we calculated integer scores from coefficients to develop score‐based models. The area under the receiver operating characteristic curve (AUC) was used to evaluate discrimination. Results Participants with cognitive impairment accounted for 4.0% (n = 233) of the total. The score‐based simple model comprised three variables (AUC = 0.72, sensitivity: 72%, specificity: 61%). The score‐based base model included nine variables (AUC = 0.76, sensitivity: 70%, specificity: 67%). The score‐based enhanced model comprised eight variables, including grip strength and gait speed (AUC = 0.79, sensitivity: 73%, specificity: 70%). Conclusions This study developed three screening models with acceptable discriminant validity for cognitive impairment. These models comprised simple questionnaire‐based items and common physical performance measurements. These models could enable screening of older adults suspected of cognitive impairment without the need to conduct cognitive tests in community settings. Geriatr Gerontol Int 2022; 22: 292–297.
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Affiliation(s)
- Takumi Abe
- Integrated Research Initiative for Living Well with Dementia Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Mari Yamashita
- Integrated Research Initiative for Living Well with Dementia Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Shuichi P. Obuchi
- Human Care Research Team Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Tatsuro Ishizaki
- Human Care Research Team Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Yoshinori Fujiwara
- Integrated Research Initiative for Living Well with Dementia Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well with Dementia Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Kenji Toba
- Integrated Research Initiative for Living Well with Dementia Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology Tokyo Japan
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Liu YCG, Lan SJ, Hirano H, Lin LM, Hori K, Lin CS, Zwetchkenbaum S, Minakuchi S, Teng AYT. Update and review of the gerodontology prospective for 2020's: Linking the interactions of oral (hypo)-functions to health vs. systemic diseases. J Dent Sci 2020; 16:757-773. [PMID: 33854730 PMCID: PMC8025188 DOI: 10.1016/j.jds.2020.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/03/2020] [Indexed: 02/07/2023] Open
Abstract
New lines of evidence suggest that the oral-systemic medical links and oral hypo-function are progressively transcending beyond the traditional clinical signs and symptoms of oral diseases. Research into the dysbiotic microbiome, host immune/inflammatory regulations and patho-physiologic changes and subsequent adaptations through the oral-systemic measures under ageism points to pathways leading to mastication deficiency, dysphagia, signature brain activities for (neuro)-cognition circuitries, dementia and certain cancers of the digestive system as well. Therefore, the coming era of oral health-linked systemic disorders will likely reshape the future of diagnostics in oral geriatrics, treatment modalities and professional therapies in clinical disciplines. In parallel to these highlights, a recent international symposium was jointly held by the International Association of Gerontology and Geriatrics (IAGG), Japanese Society of Gerodontology (JSG), the representative of USA and Taiwan Academy of Geriatric Dentistry (TAGD) on Oct 25th, 2019. Herein, specific notes are briefly addressed and updated for a summative prospective from this symposium and the recent literature.
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Affiliation(s)
- Yen Chun G. Liu
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Corresponding author. Dept. of Oral Hygiene & COBR, College of Dental Medicine, Kaohsiung Medical University; No. 100, Shih-Chun 1st Rd, Kaohsiung 807, Taiwan. Fax: +886 07 3223141.
| | - Shou-Jen Lan
- Dept. of Healthcare Administration, Asia University, Tai-Chung, Taiwan
| | - Hirohiko Hirano
- Research Team for Promoting Independence & Mental Health, and Dentistry & Oral Surgery, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Li-min Lin
- Div. of Oral Pathology & Oral Maxillo-facial Radiology, School of Dentistry, Kaohsiung Medical University & KMU-Hospital, Kaohsiung, Taiwan
| | - Kazuhiro Hori
- Div. of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Chia-shu Lin
- Dept. of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Samuel Zwetchkenbaum
- Rhode Island Dept. of Health, Rhode Island, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - Shunsuke Minakuchi
- Gerodontology & Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Andy Yen-Tung Teng
- Center for Osteoimmunology & Biotechnology Research (COBR) and Dept. of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan
- Center for Osteoimmunology & Biotechnology Research (COBR) and School of Dentistry, College of Dental Medicine, Kaohsiung Medical University and KMU-Hospital, Kaohsiung, Taiwan
- Corresponding author. Center for Osteoimmunology and Biotechnology Research (COBR), College of Dental Medicine, Kaohsiung Medical University (KMU) & KMU-Hospital, Kaohsiung, Taiwan.
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Takahashi J, Kawai H, Suzuki H, Fujiwara Y, Watanabe Y, Hirano H, Kim H, Ihara K, Miki A, Obuchi S. Development and validity of the Computer-Based Cognitive Assessment Tool for intervention in community-dwelling older individuals. Geriatr Gerontol Int 2020; 20:171-175. [PMID: 31916344 PMCID: PMC7065126 DOI: 10.1111/ggi.13836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/17/2019] [Accepted: 11/11/2019] [Indexed: 01/09/2023]
Abstract
Aim The Mini‐Mental State Examination is a widely used cognitive assessment tool. However, it has several limitations, including the learning effect and interrater reliability. Therefore, we developed a Computer‐Based Cognitive Assessment Tool (CompBased‐CAT), which runs on a tablet or personal computer. In this study, we examined the validity and discrimination ability of the CompBased‐CAT. Methods Participants were recruited from the Otasha‐Kenshin study carried out in 2016. We included 773 community‐dwelling older individuals in Japan (332 men, 441 women, aged 65–97 years). CompBased‐CAT scores were converted to z‐scores, and the correlation with Mini‐Mental State Examination scores was examined using Pearson's correlation coefficient. Furthermore, the ability to discern cognitive impairment was examined using the receiver operating characteristic curve. Results The Pearson's correlation coefficient for the Mini‐Mental State Examination scores and each task component of the CompBased‐CAT ranged from 0.24 to 0.41 (P < 0.001), and the correlation coefficient of the total z‐scores was 0.51 (P < 0.001). The sensitivity, specificity and area under the receiver operating characteristic curve of the discriminating ability of the CompBased‐CATool for cognitive impairment were 0.81, 0.77 and 0.85, respectively. Conclusions The CompBased‐CAT certainly possesses validity, discriminating ability and utility as a new cognitive assessment tool in community‐dwelling older individuals. Geriatr Gerontol Int 2020; ••: ••–••.
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Affiliation(s)
- Junta Takahashi
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Hiroyuki Suzuki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.,Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Hunkyung Kim
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Akiko Miki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
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