Objective:

To explore the ability of MyCog, a tablet-based cognitive screener, to identify individuals who would be flagged for impairment in primary care settings by a commonly used cognitive screener, the Mini-Cog. 

Background:

Rapid and reliable cognitive screeners are imperative to early detection of cognitive impairment in primary care settings. To this end, the NIH funded MyCog, a tablet-based screener that is self-administered during the rooming process of a primary care visit and can integrate with an EHR. In order to meet the needs of both patients and providers, the MyCog app was recently upgraded to reduce test time, improve usability, and increase patient satisfaction, yet the ability of the new version of MyCog to identify patients suspected of impairment has yet to be tested.

Design/Methods:

A convenience sample of 200 older adults 65+ (mean age 72.56), were administered the Mini-Cog and self-administered MyCog, which includes two subtests measuring executive functioning and episodic memory. A logistic regression was conducted to predict suspected impairment (Mini-Cog score ≤ 2) based on the two MyCog measures.  

Results:

Twenty (20) participants had a Mini-Cog score ≤ 2. The logistic regression model with the two MyCog subtests demonstrated an AUC of .75 (95% bootstrap CI [.61, .87]), sensitivity of .73 (95% bootstrap CI [.56, .94]), and specificity of .75 (95% bootstrap CI [.49, .96]).  

Conclusions:

The upgraded version of MyCog demonstrated adequate sensitivity and specificity to identify participants who failed the Mini-Cog and would be referred for further evaluation in a primary care setting. MyCog shows promise as a primary care cognitive screener, especially in low-resource environments with limited staff for test administration. Further research to establish the clinical validity of MyCog in a larger sample using documented clinical diagnoses is warranted and forthcoming.