title: Screening for Mild Cognitive Impairment and Dementia with Automated, Anonymous Online and Telephone Cognitive Self-Tests.
abstract: Many older people worry about cognitive decline. Early cognitive screening in an anonymous and easily accessible manner may reassure older people who are unnecessarily worried about normal cognitive aging while it may also expedite help seeking in case of suspicious cognitive decline.
  
  
  
  To develop and validate online and telephone-based automated self-tests of cognitive function.
  
  
  
  We examined the feasibility and validity of the self-tests in a prospective study of 117 participants of whom 34 had subjective cognitive decline (SCD), 30 had mild cognitive impairment (MCI), and 53 had dementia. The ability of these self-tests to accurately distinguish MCI and dementia from SCD was examined with ROC curves. Convergent validity was examined by calculating rank correlations between the self-tests and neuropsychological tests.
  
  
  
  Both the online and telephone cognitive self-tests were feasible, because the majority of participants (86% and 80%, respectively) were able to complete them. The online self-test had adequate diagnostic accuracy in the screening for MCI and dementia versus SCD with an Area under the Curve (AUC) of 0.86 (95% CI: 0.78-0.93). The AUC of the MMSE was 0.82 (95% CI: 0.74-0.89). By contrast, the telephone self-test had lower diagnostic accuracy (AUC = 0.75, 95% CI: 0.64-0.86). Both self-tests had good convergent validity as demonstrated by moderate to strong rank correlations with neuropsychological tests.
  
  
  
  We demonstrated good diagnostic accuracy and convergent validity for the online self-test of cognitive function. It is therefore a promising tool in the screening for MCI and dementia.
authors.affiliation: Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Van Mierlo
authors.affiliation: Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.|Department of Pharmacy, Unit of Pharmacotherapy and Pharmaceutical Care, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Wouters
authors.affiliation: Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.|Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.|Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands.
authors.forename: Sietske A M
authors.initials: SA
authors.lastname: Sikkes
authors.affiliation: Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.|Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands.
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: Van der Flier
authors.affiliation: Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.|Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands.
authors.forename: Niels D
authors.initials: ND
authors.lastname: Prins
authors.affiliation: Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jonne A E
authors.initials: JA
authors.lastname: Bremer
authors.affiliation: Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Teddy
authors.initials: T
authors.lastname: Koene
authors.affiliation: Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Hein P J
authors.initials: HP
authors.lastname: Van Hout
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D009862:Online Systems; D012372:ROC Curve; D012647:Self-Assessment; D012680:Sensitivity and Specificity; D013689:Telephone
keywords: Alzheimer’s disease; cognitive screening; online and telephone cognitive self-test; sensitivity; specificity