Explore the vast range of titles available.

ObjectivesAnnual cognitive screening in older adults is essential for early detection of cognitive impairment, yet primary care settings face time constraints that present barriers to routine screening. MyCog Mobile is a self-administered, smartphone-based cognitive screener that has the potential to help overcome these screening obstacles. We compared MyCog Mobile to ‘gold-standard’ measures to support its reliability and validity and examined performance differences between in-person versus remote assessment.DesignCross-sectional convenience sample study comparing MyCog Mobile measures to established cognitive assessments.SettingFive in-person research facility locations in Georgia, Texas, New Jersey, Florida and Arizona.Participants200 adults aged 65–87 years (M=72.56, SD=5.11) who spoke English.Primary outcome measuresConvergent and divergent validity were examined via Spearman’s rho correlations between MyCog Mobile measures (MyPictures, MyFaces, MySorting and MySequences) and established measures (verbal paired associates, digit span, letter-number sequencing, Color-Word Interference Test and Trail Making Test), as well as a confirmatory factor analysis using these same measures. Internal consistency was assessed via Spearman-Brown split-half correlations. Score distributions were compared between in-person and remote administration.ResultsInternal consistency for all MyCog Mobile measures was above acceptable thresholds, ranging from ρ=0.71 to 0.89. Strong correlations were found between MyCog Mobile subtests and their tablet counterparts (MyPictures-Picture Sequence Memory: ρ=0.52; MySorting-dimensional change card sorting: ρ=0.55). MyPictures and MyFaces demonstrated large correlations with convergent memory measures (verbal paired associates immediate ρ=0.51 and 0.56, respectively) and small correlations with discriminant measures. Confirmatory factor analysis supported a two-factor model with subtests loading onto episodic memory and executive functioning factors as expected (χ²(25)=39.136; Comparative Fit Index (CFI) = 0.965; Tucker–Lewis Index (TLI) = 0.950; Root Mean Square Error of Approximation (RMSEA) = 0.053; Standardized Root Mean Square Residual (SRMR) = 0.040). Remote participants scored significantly higher on the MyPictures task overall (t(249)=2.98, p=0.004), while in-person participants scored higher on the MyFaces First Letter subtest and MySequences.ConclusionsMyCog Mobile offers a reliable and valid assessment of executive functioning and episodic memory in older adults. Performance may differ by setting, but further research is needed. These findings support future clinical validation studies to determine the diagnostic accuracy of MyCog Mobile to detect cognitive impairment.

IntroductionAnnual cognitive screening in older adults is essential for early detection of cognitive impairment, yet primary care settings face time constraints that present barriers to routine screening. A remote cognitive screener completed on a patient’s personal smartphone before a visit has the potential to save primary care clinics time, encourage broader screening practices and increase early detection of cognitive decline. MyCog Mobile is a promising new remote smartphone-based cognitive screening app for primary care settings. We propose a combined construct and clinical validation study of MyCog Mobile.Methods and analysisWe will recruit a total sample of 300 adult participants aged 65 years and older. A subsample of 200 healthy adult participants and a subsample of 100 adults with a cognitive impairment diagnosis (ie, dementia, mild cognitive impairment, cognitive deficits or other memory loss) will be recruited from the general population and specialty memory care centres, respectively. To evaluate the construct validity of MyCog Mobile, the healthy control sample will self-administer MyCog Mobile on study-provided smartphones and be administered a battery of gold-standard neuropsychological assessments. We will compare correlations between performance on MyCog Mobile and measures of similar and dissimilar constructs to evaluate convergent and discriminant validity. To assess clinical validity, participants in the clinical sample will self-administer MyCog Mobile on a smartphone and be administered a Mini-Cog screener and these data will be combined with the healthy control sample. We will then apply several supervised model types to determine the best predictors of cognitive impairment within the sample. Area under the receiver operating characteristic curve, accuracy, sensitivity and specificity will be the primary performance metrics for clinical validity.Ethics and disseminationThe Institutional Review Board at Northwestern University (STU00214921) approved this study protocol. Results will be published in peer-reviewed journals and summaries provided to the study’s funders.

IntroductionDeficits in decision-making (DM) can lead to adverse outcomes across multiple domains such as financial management and medical care. By hindering such DM abilities, cognitive impairment (CI) often affects quality of life. Routine screening for CI, however, does not include systematic and comprehensive assessment of DM ability. While there are many DM measures, there is considerable heterogeneity in what constructs are measured and the populations in which they have been validated. This scoping review protocol details the proposed comprehensive examination of published literature on DM measures used in adults aged 45 years and older.Methods and analysisArksey and O’Malley’s (2005) scoping review methodology framework will guide the current scoping review. We will systematically search Embase (Elsevier), MEDLINE (Ovid), PsycINFO (Ebsco), Cochrane Library (Wiley), Web of Science (Clarivate) and Scopus (Elsevier) to identify the studies meeting our eligibility criteria. We will review literature published between January 2018 and November 2023. Following best practice recommendations, a two-stage study selection process will be applied. First, titles and abstracts will be independently reviewed by two reviewers based on our eligibility criteria. Second, full texts will be screened and data will be extracted only from the articles included after the full review. The results of the current scoping review will be reported in adherence to PRISMA-Scr guidelines.Ethics and disseminationThis study does not require ethics approval as the scoping review methodology involves reviewing results from publicly available published materials. Results of the scoping review will be submitted for publication in a peer-reviewed journal.Trial registration numberNIA grant number 1U24AG082022-01.

Objectives Self‐administered, user‐friendly apps that can detect initial symptoms of cognitive impairment have enormous potential to improve early detection of cognitive decline. We examine the psychometric properties of the redesigned version of MyCog, MyCog 2.0, an app‐based tool for older adults that assesses executive function and episodic memory. MyCog 2.0 aims to improve usability while maintaining the psychometric validity demonstrated in the original version. Methods Feedback from clinicians and patients on MyCog was gathered to inform the human‐centered design improvements of MyCog 2.0. To assess the psychometric properties of the improved tool, data from a community sample (n = 200; mean age = 73 years) who had completed MyCog 2.0 were compared to an age‐matched sample who had completed the original MyCog. Internal consistency and construct validity were evaluated via confirmatory factor analysis. Bayesian differential item functioning was employed to evaluate the evidence for equivalence of MyCog and MyCog 2.0. Results Internal consistency was high for executive function and episodic memory tests (ωt = 0.84). A two‐factor model showed excellent fit, demonstrating that tests measured two related yet distinct constructs, episodic memory and executive functioning, as expected. Differential item functioning between the two test versions was not observed for episodic memory performance or executive functioning accuracy; however, response time on five executive function items was found to differ across versions. Conclusions Findings support MyCog 2.0 as the first reliable self‐administered cognitive screener designed specifically for ease of use among older adults. Findings support the internal consistency and construct validity of MyCog 2.0 and provide a foundation for the forthcoming clinical validation studies.

Routine cognitive screening is essential in the early detection of dementia, but time constraints in primary care settings often limit clinicians' ability to conduct screenings. MyCog Mobile is a newly developed cognitive screening system that patients can self-administer on their smartphones before a primary care visit, which can help save clinics' time, encourage broader screening practices, and increase early detection of cognitive decline. The goal of this pilot study was to examine the feasibility, acceptability, and initial psychometric properties of MyCog Mobile. Research questions included (1) Can older adults complete MyCog Mobile remotely without staff support? (2) Are the internal consistency and test-retest reliability of the measures acceptable? and (3) How do participants rate the user experience of MyCog Mobile? A sample of adults aged 65 years and older (N=51) self-administered the MyCog Mobile measures remotely on their smartphones twice within a 2- to 3-week interval. The pilot version of MyCog Mobile includes 4 activities: MyFaces measures facial memory, MySorting measures executive functioning, MySequences measures working memory, and MyPictures measures episodic memory. After their first administration, participants also completed a modified version of the Simplified System Usability Scale (S-SUS) and 2 custom survey items. All participants in the sample passed the practice items and completed each measure. Findings indicate that the Mobile Toolbox assessments measure the constructs well (internal consistency 0.73 to 0.91) and are stable over an approximately 2-week delay (test-retest reliability 0.61 to 0.71). Participants' rating of the user experience (mean S-SUS score 73.17, SD 19.27) indicated that older adults found the usability of MyCog Mobile to be above average. On free-response feedback items, most participants provided positive feedback or no feedback at all, but some indicated a need for clarity in certain task instructions, concerns about participants' abilities, desire to be able to contact a support person or use in-app technical support, and desire for additional practice items. Pilot evidence suggests that the MyCog Mobile cognitive screener can be reliably self-administered by older adults on their smartphones. Participants in our study generally provided positive feedback about the MyCog Mobile experience and rated the usability of the app highly. Based on participant feedback, we will conduct further usability research to improve support functionality, optimize task instructions and practice opportunities, and ensure that patients feel comfortable using MyCog Mobile. The next steps include a clinical validation study that compares MyCog Mobile to gold-standard assessments and tests the sensitivity and specificity of the measures for identifying dementia.