Early detection of mild cognitive impairment (MCI) is essential for initiating timely intervention and delaying progression to dementia. However, current diagnostic approaches often lack scalability and efficiency, limiting their utility in primary care and community settings.
Objective
This study developed and validated the Integrated Cognitive Screening Platform (ICSP), a self-administered, tablet-based tool designed for rapid, multidomain screening of MCI.
Methods
ICSP comprises five cognitive tasks involving immediate and delayed memory, attention, sensory perception, and executive function. Both accuracy scores and reaction times (RTs) were recorded and processed within five minutes. A total of 126 participants (76 with MCI, 50 cognitively normal controls) completed standard neuropsychological assessments and the ICSP battery. A multivariate logistic regression model was developed using 60% of the data as a training set and evaluated on the remaining 40% as a validation set.
Results
RTs and accuracy scores in sensory perception and executive function tasks, along with educational attainment, were identified as significant predictors of MCI. The model achieved high classification performance (AUC: 0.915; p < 0.001), with robust validation performance (AUC: 0.821; p < 0.001).
Conclusions
ICSP is an accurate and scalable digital screening tool capable of identifying MCI with high specificity. Its multimodal design and automated analysis make it well-suited for clinical and community-level early detection of cognitive impairments.
Trial registration
This study was registered with the Chinese Clinical Trial Registry (Registration No. ChiCTR2400082429) on March 28, 2024.
SchneiderJAArvanitakisZLeurgansSE, et al.The neuropathology of probable Alzheimer disease and mild cognitive impairment. Ann Neurol2009; 66: 200–208.
2.
BaiWChenPCaiH, et al.Worldwide prevalence of mild cognitive impairment among community dwellers aged 50 years and older: a meta-analysis and systematic review of epidemiology studies. Age Ageing2022; 51: afac173.
3.
LivingstonGHuntleyJSommerladA, et al.Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet2020; 396: 413–446.
4.
WangJHuangSLanG, et al.Diagnostic accuracy of plasma p-tau217/Aβ42 for Alzheimer's disease in clinical and community cohorts. Alzheimers Dement2025; 21: e70038.
5.
BernierPJGourdeauCCarmichaelPH, et al.It's all about cognitive trajectory: accuracy of the cognitive charts-MoCA in normal aging, MCI, and dementia. J Am Geriatr Soc2023; 71: 214–220.
6.
JeongSYSuhCHKimSJ, et al.Amyloid-related imaging abnormalities in the era of anti-amyloid beta monoclonal antibodies for Alzheimer's disease: recent updates on clinical and imaging features and MRI monitoring. Korean J Radiol2024; 25: 726–741.
7.
AntoniadesMSrinivasanDWenJ, et al.Relationship between MRI brain-age heterogeneity, cognition, genetics and Alzheimer's disease neuropathology. EBioMedicine2024; 109: 105399.
8.
O'BryantSEZhangFPetersenM, et al.A blood screening tool for detecting mild cognitive impairment and Alzheimer's disease among community-dwelling Mexican Americans and non-Hispanic Whites: a method for increasing representation of diverse populations in clinical research. Alzheimers Dement2022; 18: 77–87.
9.
KarikariTKPascoalTAAshtonNJ, et al.Blood phosphorylated tau 181 as a biomarker for Alzheimer's disease: a diagnostic performance and prediction modelling study using data from four prospective cohorts. Lancet Neurol2020; 19: 422–433.
10.
LiHJiaJYangZ. Mini-Mental State Examination in elderly Chinese: a population-based normative study. J Alzheimers Dis2016; 53: 487–496.
11.
NasreddineZSPhillipsNABédirianV, et al.The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc2005; 53: 695–699.
12.
De WitLGoldsteinFCSaurmanJL, et al.Discrepancies between self- and informant-ratings of functional abilities and objective cognition: predictors of bias in mild cognitive impairment. J Int Neuropsychol Soc2024; 30: 448–453.
13.
ChanJYCBatBKKWongA, et al.Evaluation of digital drawing tests and paper-and-pencil drawing tests for the screening of mild cognitive impairment and dementia: a systematic review and meta-analysis of diagnostic studies. Neuropsychol Rev2022; 32: 566–576.
14.
LesoilCBonomisSGuinebretiereO, et al.Validation study of “Santé-Cerveau”, a digital tool for early cognitive changes identification. Alzheimers Res Ther2023; 15: 70.
15.
SabbaghMNBoadaMBorsonS, et al.Early detection of mild cognitive impairment (MCI) in an at-home setting. J Prev Alzheimers Dis2020; 7: 171–178.
16.
World Health Organization. World health statistics 2023: monitoring health for the SDGs, Sustainable Development Goals. Geneva: World Health Organization, 2023.
17.
TornatoreJBHillELaboffJA, et al.Self-administered screening for mild cognitive impairment: initial validation of a computerized test battery. J Neuropsychiatry Clin Neurosci2005; 17: 98–105.
18.
MaruffPThomasECysiqueL, et al.Validity of the CogState brief battery: relationship to standardized tests and sensitivity to cognitive impairment in mild traumatic brain injury, schizophrenia, and AIDS dementia complex. Arch Clin Neuropsychol2009; 24: 165–178.
19.
ChanJWongAYiuB, et al.Electronic cognitive screen technology for screening older adults with dementia and mild cognitive impairment in a community setting: development and validation study. J Med Internet Res2021; 23: e26724.
20.
AlegretMMuñozNRobertoN, et al.A computerized version of the Short Form of the Face-Name Associative Memory Exam (FACEmemory®) for the early detection of Alzheimer's disease. Alzheimers Res Ther2020; 12: 25.
21.
HuangLLiYWuJ, et al.Shanghai cognitive screening: a mobile cognitive assessment tool using voice recognition to detect mild cognitive impairment and dementia in the community. J Alzheimers Dis2023; 95: 227–236.
22.
WangCWangZXieB, et al.Binaural processing deficit and cognitive impairment in Alzheimer's disease. Alzheimers Dement2022; 18: 1085–1099.
23.
BezdicekOStepankovaHMartinec NovakovaL, et al.Toward the processing speed theory of activities of daily living in healthy aging: normative data of the Functional Activities Questionnaire. Aging Clin Exp Res2016; 28: 239–247.
24.
TichaZGeorgiHSchmandB, et al.Processing speed predicts SuperAging years later. BMC Psychol2023; 11: 34.
25.
Abd-AlrazaqAAhmedAAlaliH, et al.The effectiveness of serious games on cognitive processing speed among older adults with cognitive impairment: systematic review and meta-analysis. JMIR Serious Games2022; 10: e36754.
26.
SalthouseTA. Aging and measures of processing speed. Biol Psychol2000; 54: 35–54.
27.
SalthouseTAFerrer-CajaE. What needs to be explained to account for age-related effects on multiple cognitive variables?Psychol Aging2003; 18: 91–110.
28.
BondiMWEdmondsECJakAJ, et al.Neuropsychological criteria for mild cognitive impairment improves diagnostic precision, biomarker associations, and progression rates. J Alzheimers Dis2014; 42: 275–289.
29.
LiXWangXSuL, et al.Sino Longitudinal Study on Cognitive Decline (SILCODE): protocol for a Chinese longitudinal observational study to develop risk prediction models of conversion to mild cognitive impairment in individuals with subjective cognitive decline. BMJ Open2019; 9: e028188.
30.
BrownPJDevanandDPLiuX, et al.Functional impairment in elderly patients with mild cognitive impairment and mild Alzheimer disease. Arch Gen Psychiatry2011; 68: 617–626.
31.
KerchnerGARacineCAHaleS, et al.Cognitive processing speed in older adults: relationship with white matter integrity. PLoS One2012; 7: e50425.
32.
KochunovPCoyleTLancasterJ, et al.Processing speed is correlated with cerebral health markers in the frontal lobes as quantified by neuroimaging. Neuroimage2010; 49: 1190–1199.
33.
BrownPJLiuXSneedJR, et al.Speed of processing and depression affect function in older adults with mild cognitive impairment. Am J Geriatr Psychiatry2013; 21: 675–684.
34.
PhillipsMRogersPHaworthJ, et al.Intra-individual reaction time variability in mild cognitive impairment and Alzheimer's disease: gender, processing load and speed factors. PLoS One2013; 8: e65712.
35.
ParikhMHynanLSWeinerMF, et al.Single neuropsychological test scores associated with rate of cognitive decline in early Alzheimer disease. Clin Neuropsychol2014; 28: 926–940.
36.
HaworthJPhillipsMNewsonM, et al.Measuring information processing speed in mild cognitive impairment: clinical versus research dichotomy. J Alzheimers Dis2016; 51: 263–275.
37.
KimYBaeJSKimYJ, et al.Distorted time perception in patients with neurocognitive impairment. Heliyon2024; 10: e36002.
38.
TsaoAYousefzadehSAMeckWH, et al.The neural bases for timing of durations. Nat Rev Neurosci2022; 23: 646–665.
39.
KamathamPTShuklaRKhatriDK, et al.Pathogenesis, diagnostics, and therapeutics for Alzheimer's disease: breaking the memory barrier. Ageing Res Rev2024; 101: 102481.
40.
BastinCDelhayeEMoulinC, et al.Novelty processing and memory impairment in Alzheimer's disease: a review. Neurosci Biobehav Rev2019; 100: 237–249.
41.
ChinoBCuestaPPaciosJ, et al.Episodic memory dysfunction and hypersynchrony in brain functional networks in cognitively intact subjects and MCI: a study of 379 individuals. Geroscience2023; 45: 477–489.
42.
MitchellAJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res2009; 43: 411–431.
43.
MarshallGARentzDMFreyMT, et al.Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease. Alzheimers Dement2011; 7: 300–308.
44.
HeadleyADe Leon-BenedettiADongC, et al.Neurogranin as a predictor of memory and executive function decline in MCI patients. Neurology2018; 90: e887–e895.
45.
SaundersNLSummersMJ. Longitudinal deficits to attention, executive, and working memory in subtypes of mild cognitive impairment. Neuropsychology2011; 25: 237–248.
46.
GolovanevskyMEickhoffCSinghR. Multimodal attention-based deep learning for Alzheimer's disease diagnosis. J Am Med Inform Assoc2022; 29: 2014–2022.
47.
TuMCLoCPHuangCF, et al.Visual attention performances and related cerebral microstructural integrity among subjects with subjective cognitive decline and mild cognitive impairment. Front Aging Neurosci2018; 10: 268.
48.
KemppainenNMAaltoSKarraschM, et al.Cognitive reserve hypothesis: Pittsburgh Compound B and fluorodeoxyglucose positron emission tomography in relation to education in mild Alzheimer's disease. Ann Neurol2008; 63: 112–118.
49.
HoenigMCBischofGNHammesJ, et al.Tau pathology and cognitive reserve in Alzheimer's disease. Neurobiol Aging2017; 57: 1–7.
50.
HönigMAltomareDCaprioglioC, et al.Association between years of education and amyloid burden in patients with subjective cognitive decline, MCI, and Alzheimer disease. Neurology2024; 102: e208053.
51.
WuJTuJLiuZ, et al.An effective test (EOmciSS) for screening older adults with mild cognitive impairment in a community setting: development and validation study. J Med Internet Res2023; 25: e40858.
