Validation of MyCog: A Self-Administered Rapid Detection Tool for Cognitive Impairment in Everyday Clinical Settings

ABSTRACT

Objective: To present initial validity evidence for MyCog. Background: Cognitive Impairment (CI) affects more than 16 million people, with dementia or severe cognitive decline projected to increase significantly by 2050. MyCog is a brief, standardized iPad-based, self-administered cognitive screening assessment designed for use in diverse clinical settings, among older adults or any patient with a recognized cognitive concern. It will address the need for sensitive measures of CI feasible for use in primary care settings. Design/Methods: Participants were recruited from an ongoing cognitive aging study conducted in academic internal medicine clinic and community health centers. CI was determined based on either a chart diagnosis of dementia or mild cognitive impairment (MCI), or by normative performance on a comprehensive cognitive battery within the prior 18 months. The MyCog assessments, Dimensional Change Card Sort (DCCS) and Picture Sequence Memory (PSM), measure executive function, cognitive flexibility, and episodic memory. We evaluated the efficacy of MyCog as a detection tool using sensitivity, specificity, and receiver operator characteristic (ROC) curves. Results: Of the 80 participants administered the MyCog assessment, 31 were classified as CI. In the sub-sample of participants who expressed concern about their cognition (n = 52), PSM and DCCS demonstrated exceptional ability in detecting CI (the area under the ROC curve, or AUC, = 0.92), with an average administration time of 12 minutes. When only including the first of two PSM trials along with DCCS, time was reduced on an average to <7 minutes, with little change in AUC (0.90). Conclusions: Preliminary validity evidence supports the use of MyCog as a self-administered cognitive screening battery. Given the COVID-19 pandemic, it is important to provide physicians and clinical staff access to well-designed cognitive assessments that can be selfadministered. We are currently validating MyCog in MCI clinical populations, and our next steps include a clinical trial with modified clinic workflows.