Development of a New Tablet-Based Cognitive Screening Test for Community-Dwelling Older Adults

Background: Early detection of cognitive decline in community-dwelling older adults requires accessible, automated screening tools that minimize the burden on healthcare personnel. To address this, we developed a novel, tablet-based cognitive screening tool that might be administered within the Specific Health Checkups (SHC) framework and used by Minsei-iin (Commissioned Volunteer Community Welfare Officers). Methods: We developed "Cognitive Assessment for Community-Dwelling Older Adults" (CANDIDE), a tablet-based cognitive test designed to evaluate multiple cognitive domains within eight minutes. Over a period of six months, outpatients at our hospital's memory clinic (Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Ōbu, Japan) underwent both the CANDIDE and the Japanese version of the Mini-Mental State Examination (MMSE-J). To accommodate diverse sensory needs, instructions were presented via both auditory and visual modalities. The statistical correlation between the two assessments was evaluated to determine the provisional cutoff score of the new tool. Results: A total of 70 participants were enrolled (34 males, 36 females; mean age: 80.9 ± 6.5 years; mean education years: 11.6 ± 2.2 years). A strong positive correlation was observed between the total scores of the CANDIDE and the MMSE-J (r = 0.721, p < 0.001). Based on linear regression, the standard MMSE-J cutoff score of 24 corresponded to a CANDIDE score of 21.2. Conclusion: The CANDIDE might be a feasible tool for screening of cognitive decline in individuals aged 40-74. Further investigation is warranted to validate its clinical utility and cost-effectiveness within the annual SHC framework, as well as its efficacy as an objective assessment tool for Minsei-iin.