Time required for psychological testing of dementia is useful for predicting asymptomatic brain lesions: validation using CADi2

Abstract

Abstract Cognitive test duration is related to brain lesions. However, few studies have addressed automated timing. CADi2 is a cognitive evaluation software. This study aimed to evaluate the use of automatically calculating the time required to answer questions in a 10-item in CADi2, in addition to the questionnaire score, to assess cognitive function and estimate asymptomatic brain lesions. Among 556 patients who underwent a brain scan at the Shimane Institute of Health Science between March 28, 2019 and March 24, 2021 and interacted with CADi2, we enrolled 429 patients aged ≥ 50 years with paraventricular and deep subcortical white matter hyperintensity scores of ≥ 2 as per the Fazekas classification, microbleeds, and asymptomatic brain lesions. CADi2 total time was more accurate at predicting the presence of a silent brain infarction (SBI) than the Mini-Mental State Examination Particularly, the time required to answer questions 2, 7, and 8 was related to the presence of SBI. The odds ratio of having SBI was 3.75 (2.00–7.05) when using the summed time to answer these three questions. The time required for cognitive testing using CADi2 is useful for predicting the presence of asymptomatic lesions and could be used as a non-invasive, prehospital stroke risk screening tool.