Tablet-Based Assessment of Picture Naming in Prodromal Alzheimer's Disease: An Accessible and Effective Tool for Distinguishing Mild Cognitive Impairment from Normal Aging.

INTRODUCTION

Effective mild cognitive impairment (MCI) screening requires accessible testing. This study compared two tests for distinguishing MCI patients from controls: rapid automatized naming (RAN) for naming speed and low-contrast letter acuity (LCLA) for sensitivity to low-contrast letters.

METHODS

Two RAN tasks were used: the Mobile Universal Lexicon Evaluation System (MULES, picture naming) and the Staggered Uneven Number test (SUN, number naming). Both RAN tasks were administered on a tablet and in a paper/pencil format. The tablet format was administered using the Mobile Integrated Cognitive Kit application. LCLA was tested at 2.5% and 1.25% contrast.

RESULTS

Sixty-four participants (31 MCI, 34 controls; mean age 73.2 ± 6.8 years) were included. MCI patients were slower than controls for paper/pencil (75.0 vs. 53.6 s, p < 0.001), and tablet MULES (69.0 s vs. 50.2 s, p = 0.01). The paper/pencil SUN showed no significant difference (MCI: 59.5 s vs. controls: 59.9 s, p = 0.07) nor did the tablet SUN (MCI: 59.3 s vs. controls: 55.7 s, p = 0.36). MCI patients had worse performance on LCLA testing at 2.5% contrast (33 letters vs. 36, p = 0.04*) and 1.25% (0 letters vs. 14 letters, p < 0.001). Receiver operating characteristic (ROC) analysis showed similar performance of paper/pencil and tablet MULES in distinguishing MCI from controls (area under the ROC curve [AUC] = 0.77), outperforming both SUN (AUC = 0.63 paper, 0.59 tablet) and LCLA (2.5% contrast: AUC = 0.65, 1.25% contrast: AUC = 0.72).

CONCLUSION

The MULES, in both formats, may be a valuable screening tool for MCI.