Validity of the MemTrax Memory Test Compared to the Montreal Cognitive Assessment in the Detection of Mild Cognitive Impairment and Dementia due to Alzheimer’s Disease in a Chinese Cohort

Article type: Research Article

Authors: Liu, Xiaolei^{a; b; 1; *} | Chen, Xinjie^{a; b; 1} | Zhou, Xianbo^{c; d; 1} | Shang, Yajun^{b; e} | Xu, Fan^f | Zhang, Junyan^g | He, Jingfang^g | Zhao, Feng^h | Du, Boⁱ | Wang, Xuanⁱ | Zhang, Qi^c | Zhang, Weishan^c | Bergeron, Michael F.^j | Ding, Taoⁱ | Ashford, J. Wesson^{k; l} | Zhong, Lianmei^{a; b; *}

Affiliations: [a] Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China | [b] Yunnan Provincial Clinical Research Center for Neurological Diseases, Yunnan, China | [c] SJN Biomed Ltd., Kunming, Yunnan, China | [d] Center for Alzheimer’s Research, Washington Institute of Clinical Research, Vienna, VA, USA | [e] Neurosurgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China | [f] Department of Public Health, Chengdu Medical College, Sichuan, China | [g] Bothwin Clinical Study Consultant, Shanghai, China | [h] Department of Neurology, Dehong People’s Hospital, Dehong, Yunnan, China | [i] Department of Rehabilitation Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China | [j] SIVOTEC Analytics, Boca Raton, FL, USA | [k] War Related Illness and Injury Study Center, VA Palo Alto HCS, Palo Alto, CA, USA | [l] Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA

Correspondence: [*] Correspondence to: Dr. Xiaolei Liu and Dr. Lianmei Zhong, Department of Neurology, the First Affiliated Hospital of Kunm-ing Medical University, Kunming, Yunnan Province 650032, China. Tel.: +86 13888812292/+86 13888967787; E-mail: [email protected]. (Xiaolei Liu) and E-mail: [email protected]. (Lianmei Zhong)

Note: [1] These authors contributed equally to this study.

Abstract: Background:A valid, reliable, accessible, engaging, and affordable digital cognitive screen instrument for clinical use is in urgent demand. Objective:To assess the clinical utility of the MemTrax memory test for early detection of cognitive impairment in a Chinese cohort. Methods:The 2.5-minute MemTrax and the Montreal Cognitive Assessment (MoCA) were performed by 50 clinically diagnosed cognitively normal (CON), 50 mild cognitive impairment due to AD (MCI-AD), and 50 Alzheimer’s disease (AD) volunteer participants. The percentage of correct responses (MTx-% C), the mean response time (MTx-RT), and the composite scores (MTx-Cp) of MemTrax and the MoCA scores were comparatively analyzed and receiver operating characteristic (ROC) curves generated. Results:Multivariate linear regression analyses indicated MTx-% C, MTx-Cp, and the MoCA score were significantly lower in MCI-AD versus CON and in AD versus MCI-AD groups (all with p≤0.001). For the differentiation of MCI-AD from CON, an optimized MTx-% C cutoff of 81% had 72% sensitivity and 84% specificity with an area under the curve (AUC) of 0.839, whereas the MoCA score of 23 had 54% sensitivity and 86% specificity with an AUC of 0.740. For the differentiation of AD from MCI-AD, MTx-Cp of 43.0 had 70% sensitivity and 82% specificity with an AUC of 0.799, whereas the MoCA score of 20 had 84% sensitivity and 62% specificity with an AUC of 0.767. Conclusion:MemTrax can effectively detect both clinically diagnosed MCI and AD with better accuracy as compared to the MoCA based on AUCs in a Chinese cohort.

Keywords: Alzheimer’s disease, cognitive assessment instrument, continuous recognition task paradigm, mild cognitive impairment

DOI: 10.3233/JAD-200936

Journal: Journal of Alzheimer's Disease, vol. 80, no. 3, pp. 1257-1267, 2021