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Diagnostic Validity of the Smart Aging Serious Game: An Innovative Tool for Digital Phenotyping of Mild Neurocognitive Disorder
Journal of Alzheimer’s Disease ( IF 4 ) Pub Date : 2021-08-27 , DOI: 10.3233/jad-210347
Sara Isernia 1 , Monia Cabinio 1 , Sonia Di Tella 1, 2 , Stefania Pazzi 3 , Federica Vannetti 1 , Filippo Gerli 1 , Irene Eleonora Mosca 1 , Gemma Lombardi 1 , Claudio Macchi 1 , Sandro Sorbi 1, 4 , Francesca Baglio 1
Affiliation  

Background:The Smart Aging Serious Game (SASG) is an ecologically-based digital platform used in mild neurocognitive disorders. Considering the higher risk of developing dementia for mild cognitive impairment (MCI) and vascular cognitive impairment (VCI), their digital phenotyping is crucial. A newunderstanding of MCI and VCI aided by digital phenotyping with SASG will challenge current differential diagnosis and open the perspective of tailoring more personalized interventions. Objective:To confirm the validity of SASG in detecting MCI from healthy controls (HC) and to evaluate its diagnostic validity in differentiating between VCI and HC. Methods:161 subjects (74 HC: 37 males, 75.47±2.66 mean age; 60 MCI: 26 males, 74.20±5.02; 27 VCI: 13 males, 74.22±3.43) underwent a SASG session and a neuropsychological assessment (Montreal Cognitive Assessment (MoCA), Free and Cued Selective Reminding Test, Trail Making Test). A multi-modal statistical approach was used: receiver operating characteristic (ROC) curves comparison, random forest (RF), and logistic regression (LR) analysis. Results:SASG well captures the specific cognitive profiles of MCI and VCI, in line with the standard neuropsychological measures. ROC analyses revealed high diagnostic sensitivity and specificity of SASG and MoCA (AUCs > 0.800) in detecting VCI versus HC and MCI versus HC conditions. A classification accuracy acceptable-to-excellent was found for MCI and VCI (HC versus VCI; RF: 90%, LR: 91%. HC versus MCI; RF: 75%; LR: 87%). Conclusion:SASG allows the early assessment of cognitive impairment through ecological tasks and potentially in a self-administered way. These features make this platform suitable for being considered a useful digital phenotyping tool, allowing a non-invasive and valid neuropsychological evaluation, with evident implications for future digital-health trails and rehabilitation.

中文翻译:

Smart Aging Serious Game 的诊断有效性:一种用于轻度神经认知障碍数字表型分析的创新工具

背景:Smart Aging Serious Game (SASG) 是一种基于生态的数字平台,用于轻度神经认知障碍。考虑到轻度认知障碍 (MCI) 和血管性认知障碍 (VCI) 患痴呆症的风险较高,他们的数字表型至关重要。借助 SASG 数字表型分析对 MCI 和 VCI 的新理解将挑战当前的鉴别诊断,并开启定制更个性化干预措施的视角。目的:确认SASG在检测健康对照(HC)的MCI中的有效性,并评估其区分VCI和HC的诊断有效性。方法:161 名受试者(74 名 HC:37 名男性,75.47±2.66 平均年龄;60 名 MCI:26 名男性,74.20±5.02;27 名 VCI:13 名男性,74.22±3。43) 接受了 SASG 会议和神经心理学评估(蒙特利尔认知评估 (MoCA)、自由和提示选择性提醒测试、跟踪测试)。使用了多模式统计方法:接收器操作特征 (ROC) 曲线比较、随机森林 (RF) 和逻辑回归 (LR) 分析。结果:SASG 很好地捕捉了 MCI 和 VCI 的特定认知特征,符合标准的神经心理学测量。ROC 分析揭示了 SASG 和 MoCA(AUC > 0.800)在检测 VCI 与 HC 和 MCI 与 HC 条件方面的高诊断灵敏度和特异性。发现 MCI 和 VCI 的分类准确度可以接受到优秀(HC 对 VCI;RF:90%,LR:91%。HC 对 MCI;RF:75%;LR:87%)。结论:SASG 允许通过生态任务并可能以自我管理的方式对认知障碍进行早期评估。这些功能使该平台适合被视为有用的数字表型分析工具,允许进行非侵入性和有效的神经心理学评估,对未来的数字健康追踪和康复具有明显的意义。
更新日期:2021-08-29
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