Abstract
Introduction: Cognitive decline causes disability and dependence in older people, affecting the individuals, families, and society. This study aimed to use a gamified smart test, the CogMate™ assessment, to measure the cognitive function of community-dwelling older people and compare the test with the Mini-Mental State Examination (MMSE). Methods: We recruited 150 older people for testing with two cognitive assessment tools, the MMSE and CogMate™. After completing data collection, we conducted descriptive and inferential statistical analyses. Results: The MMSE results showed that only 38% (n = 57) of participants had normal cognitive function and their mean brain age was 79.31 ± 9.00 years, 4.41 years more than the actual mean age. Common factors affecting both MMSE and CogMate™ tests included age, education level, marital status, and health status. The weighted kappa of the MMSE and CogMate™ scores for two categories (participants with normal and impaired cognitive function) showed moderate consistency (correlation coefficient, 0.522) and the Pearson product-moment correlation coefficient showed moderately significant positive correlation (r = 0.480). The CogMate™ brain age and difference in brain age test results showed moderately significant negative correlation with the MMSE results. Receiver operator character curve analysis using the MMSE for validation yielded an area under the curve value of 0.736, showing that the CogMate™ tool had good cognitive function prediction results. Conclusion: CogMate™ is an interesting and simple gamified tool that demonstrates moderate consistency with the MMSE. It can replace the MMSE as a community cognitive screening tool, help community care centers, and identify older people with potential cognitive decline early for referral to interventional medical centers.
Plain Language Summary
As populations age globally, the number of older adults is increasing. In Taiwan, 18.01% of people aged 65 and over have mild cognitive impairment, and 7.64% have dementia. This means that about one in four (25.65%) older adults in Taiwan experience some level of cognitive impairment. This highlights the importance of tools that can help assess or screen for cognitive function. This study suggests that the CogMate™ test, along with brain age and brain age difference assessments, show promise as reliable and effective screening tools similar to the Mini-Mental State Examination. These tools could be useful for early assessment in communities to detect cognitive decline in older adults.
