title: The computerized self test (CST): an interactive, internet accessible cognitive screening test for dementia.
abstract: The computer self test (CST) is an interactive, internet-based instrument designed to assess functional cognitive domains impaired by Alzheimer's disease (AD) and mild cognitive impairment (MCI). This study consisted of 215 total subjects with a mean age of 75.24. The 84 cognitively impaired patients (excluding patients diagnosed as MCI) met all criteria set forth by NINCDS/ADRDA for the diagnosis of AD. Control participants consisted of 104 age-matched individuals who were cognitively unimpaired. All patients completed the CST prior to other routine neurocognitive procedures. The CST accurately classified 96% of the cognitively impaired individuals as compared to controls, while the Mini-Mental Status Examination (MMSE) accurately classified 71% and the Mini-Cog 69% in the same respect. In addition, the CST accurately classified 91% of the six experimental groups (control, MCI, early AD, mild to moderate, moderate to severe, and severe) as compared to 54% for the MMSE and 48% for the Mini-Cog. In conclusions, the CST demonstrates a high degree of sensitivity and specificity and is capable of accurately identifying cognitive impairment in patients with variable degrees of cognitive abnormality. This interactive internet-based cognitive screening tool may aid in early detection of cognitive impairment in the primary care setting. The ease of use and interpretation may also provide the means to obtain an accurate baseline from which to monitor cognitive changes over time.
authors.affiliation: Cole Neuroscience Center, Memory Disorder Clinic, University of Tennessee Medical Center, Knoxville, TN 37920, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Dougherty
authors.forename: Rex L
authors.initials: RL
authors.lastname: Cannon
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Nicholas
authors.forename: Lorin
authors.initials: L
authors.lastname: Hall
authors.forename: Felicia
authors.initials: F
authors.lastname: Hare
authors.forename: Erika
authors.initials: E
authors.lastname: Carr
authors.forename: Andrew
authors.initials: A
authors.lastname: Dougherty
authors.forename: Jennifer
authors.initials: J
authors.lastname: Janowitz
authors.forename: Justin
authors.initials: J
authors.lastname: Arunthamakun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008609:Mental Status Schedule; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D009716:Numerical Analysis, Computer-Assisted; D009949:Orientation / Q000502:physiology; D012372:ROC Curve; D015203:Reproducibility of Results; D013028:Space Perception / Q000502:physiology