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Comparative Performance of Conventional, Informant-Based, and Digital Cognitive Screening Tools in Community-Dwelling Older Adults: A Cross-Sectional Study
Chuang H, Hsieh M, Huang C, Cheng Y, Huang S.. Research Square, 2026-09-21
Topic: Brain imaging, connectivity and assessment
Background Early identification of cognitive impairment is increasingly important in aging societies. Multiple cognitive screening tools are available, but their diagnostic strengths and clinical roles may differ according to healthcare setting and screening purpose. This study aimed to provide quantitative evidence for selecting and combining conventional, informant-based, and digital cognitive assessment tools in different clinical scenarios. Methods This cross-sectional community-based cognitive screening study included 250 community-dwelling older adults aged 65 years or older who were recruited between March 2025 and June 2025. Participants underwent cognitive assessment using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), reverse-scored AD8, Clinical Dementia Rating (CDR), and CogMate™ digital cognitive tests. Participants were classified into cognitively normal and cognitively impaired groups according to CDR status. Group differences, Spearman rank correlations, and receiver operating characteristic curve analyses were performed. Results Among 250 participants, 195 were classified as CDR = 0 and 55 as CDR ≥ 0.5. Cognitive impairment was significantly associated with older age and lower educational level. Participants with CDR ≥ 0.5 had significantly lower scores on MMSE, MoCA, reverse-scored AD8, CogMate™ memory, and CogMate™ attention. MoCA and MMSE showed the highest AUC values, both 0.778. MoCA had the highest sensitivity, whereas MMSE had the highest Youden index. CogMate™ memory and attention showed moderate diagnostic performance. Conclusions This study provides quantitative evidence supporting the complementary use of multiple cognitive assessment tools. MoCA may be useful for broad initial screening, MMSE may provide a balanced profile for outpatient assessment, CogMate™ may serve as a convenient supplementary digital tool that works together with established cognitive assessments to support early clinical identification of possible cognitive concerns, and AD8 may add informant-based functional information. These findings support a flexible, scenario-based strategy for earlier recognition, timely referral, and clinical management of cognitive impairment. Trial registration: Not applicable.
Key findings
- Results Among 250 participants, 195 were classified as CDR = 0 and 55 as CDR ≥ 0.5.
- Cognitive impairment was significantly associated with older age and lower educational level.
- Participants with CDR ≥ 0.5 had significantly lower scores on MMSE, MoCA, reverse-scored AD8, CogMate™ memory, and CogMate™ attention.
- These findings support a flexible, scenario-based strategy for earlier recognition, timely referral, and clinical management of cognitive impairment.
Study details
- Study designcross-sectional
- Participants250
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 35 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 22 of the 62 points we could judge it on, which is 35 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Research Square) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 250 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 22 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 22 of the 62 points we could judge it on is 35 out of 100. |
| Total | 35 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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APA 7th
Chuang, H., Hsieh, M., Huang, C., Cheng, Y., & Huang, S. (2026). Comparative Performance of Conventional, Informant-Based, and Digital Cognitive Screening Tools in Community-Dwelling Older Adults: A Cross-Sectional Study. Research Square. https://doi.org/10.21203/rs.3.rs-10608928/v1
Vancouver
Chuang H, Hsieh M, Huang C, Cheng Y, Huang S. Comparative Performance of Conventional, Informant-Based, and Digital Cognitive Screening Tools in Community-Dwelling Older Adults: A Cross-Sectional Study. Research Square. 2026. doi:10.21203/rs.3.rs-10608928/v1.
BibTeX
@article{chuang2026-fb532b10,
author = {Chuang, H. and Hsieh, M. and Huang, C. and Cheng, Y. and Huang, S.},
title = {{Comparative Performance of Conventional, Informant-Based, and Digital Cognitive Screening Tools in Community-Dwelling Older Adults: A Cross-Sectional Study}},
journal = {Research Square},
year = {2026},
doi = {10.21203/rs.3.rs-10608928/v1},
url = {https://doi.org/10.21203/rs.3.rs-10608928/v1}
}