A Self-Administered Digital Test Battery for Early Detection of Cognitive Impairment in Alzheimer’s Disease
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Introduction
Early detection of cognitive decline is crucial for timely intervention in Alzheimer’s disease (AD). Traditional paper-pencil assessments often face limitations in accessibility, lengthy administration, and interrater reliability, restricting their broader application across diverse populations. Digital tools may overcome these restrictions by offering user-friendly, non-verbal, and scalable assessments. This study investigated the diagnostic accuracy of BraincheX, a newly developed digital test battery designed with a focus on accessibility and usability, by comparing its subtest performance to equivalents of the Consortium to Establish a Registry for AD (CERAD)-Plus battery.
Methods
Fifty-six participants with early AD and healthy controls were recruited from the LMU hospital memory clinic. Diagnostic groups were defined by amyloid positivity and clinical expert consensus. Participants completed both the BraincheX digital battery and the CERAD-Plus assessment. A total BraincheX score was calculated by summing standardized subtest scores. Data were analyzed using receiver operating curve (ROC) analysis and the Youden Index to determine diagnostic accuracy. Correlations between BraincheX and CERAD-Plus subtests were examined, and group differences were analyzed via ANOVA.
Results
ROC analysis revealed strong diagnostic accuracy for the BraincheX total score in differentiating between early AD and controls (AUC = .86; optimal cut-off = -1.51), with a sensitivity of 89.7% and a specificity of 32%. BraincheX total scores correlated strongly with CERAD total scores (r = .73, p < .001). BraincheX demonstrated high internal consistency (Cronbach’s α = .84). ANOVA confirmed significant group differences across all BraincheX subtests (p < .01). Additionally, individual BraincheX subtests showed strong correlations with their CERAD-Plus equivalents, such as the Clock Drawing Test (r = .73) and TMT-B (r = .48).
Discussion
These findings support BraincheX as a promising, accessible digital screening tool for cognitive decline, offering advantages such as automated scoring, immediate feedback, and reduced examiner bias. Its design promotes greater equity and inclusivity in cognitive assessment. Future research is underway to validate BraincheX in larger and more diverse populations.
