Machine learning-based detection of cognitive decline using SSWTRT: classification performance and decision analysis

These findings demonstrate that machine learning applied to SSWTRT responses can moderately classify individuals with potential cognitive decline using a non-invasive, resource-efficient approach. The model's interpretability analysis highlighted key image features and response tendencies associated with cognitive status, providing guidance for test refinement. Although the current cohort consisted solely of iNPH patients, limiting generalizability, the proposed framework offers a promising foundation for scalable, language-specific cognitive screening tools.