An easy-to-use computerized test that measures the speed and accuracy of a person’s ability to pick out animals in photographs may be a more effective tool for detecting early signs of dementia than standard pen-and-paper tests, according to a new study.
The study, published in the journal Nature on Thursday, shows the visual processing test, called the Integrated Cognitive Assessment, can be used as a valid and reliable tool to assess one’s cognitive performance. This test was developed by Britain-based Cognetivity Inc., which has its North American headquarters in Vancouver.
The authors of the Nature study, including Cognetivity’s chief executive Sina Habibi, point out that current tests routinely used for screening neurodegenerative disorders, such as Alzheimer’s disease and other types of dementia, depend on the users’ language skills and education. That means patients who do not speak English as a first language, for example, may not perform as well if they are tested in English rather than their native language. Moreover, standard pen-and-paper tests typically “suffer from a learning bias,” the authors wrote. That is, patients’ scores can improve with practice, and thus, they may not reflect changes in their brain function.
These current paper-based tests include the Mini Mental State Examination, the Addenbrooke’s Cognitive Examination and the Montreal Cognitive Assessment. The last test, developed by neurologist Ziad Nasreddine in Montreal, garnered considerable media attention last year when U.S. President Donald Trump reportedly passed it with a perfect score. It involves a series of tasks, such as drawing a clock and naming animals.
To address the shortcomings of these conventional tests, a number of digital cognitive-screening tests have emerged as potential replacements – among them, Cognetivity’s Integrated Cognitive Assessment.
“What we really hope we’ve developed here, and we believe we’ve developed here, is a very usable tool which can make a significant difference,” Cognetivity chief operating officer Thomas Sawyer said. “It’s easy to administer, it’s free from a lot of the other troubles [associated with standard screening tests], so we think it’s quite a significant tool that can be used to really help to get [an] early diagnosis.”
The test involves having participants view a series of black-and-white photographs that flash for 100 milliseconds on an iPad. The participants are asked to tap the left or right side of the screen, depending on whether they see the image of an animal in the photograph.
In the Nature study, researchers asked 448 participants to take the test. They then compared the participants’ test results with a series of standard pen-and-paper tests.
Dr. Habibi and Dr. Sawyer explained their test is based on research showing that problems in visual processing can be an earlier sign of dementia than memory problems, which not only arise later but also tend to be subjective. Since the difficulty level of recognizing animals in the photographs varies, ranging from a bear in the centre of the photo to a bird in a bush, the test can be used to detect those who have very early cognitive impairment.
Dr. Habibi said his company’s tool is intended to be used as part of a regular doctor’s checkup. If patients’ computer-generated scores land in the red or yellow zone, their doctor may ask them to retake the test or send them to a memory clinic or specialist to perform further tests, including magnetic resonance imaging (MRIs), to reach a diagnosis.
“The dementia, Alzheimer’s diagnosis at the moment is very, very difficult and it’s very expensive,” Dr. Habibi said. By providing an easy way of screening patients, he said, he hopes individuals with dementia can be diagnosed much earlier.
He added the tool may also be used for research to test how well participants respond to various treatments. The company will seek Health Canada approval after a clinical validation study, expected to be completed by early 2020.