Cognitive impairment screening using m-health: an android implementation of the mini-mental state examination (MMSE) using speech recognition

Key Summary PointsAimThis paper describes and evaluates an m-health application that allows cognitive functions to be tested.FindingsUsing speech-processing techniques an Android application of a slightly modified Mini Mental state Examination (MMSE) test was developed. A small-scale pilot study was conducted in a nursing home showing comparable scores between the MMSE app and the (paper) MMSE test.MessageA mobile digital version of the slightly modified MMSE test has the potential to be used as an attractive alternative for the conventional paper version of the test. AbstractPurposeThis paper describes an implementation of an Android application that allows cognitive functions to be tested.MethodsThe application consists of a slightly modified Mini Mental state Examination (MMSE) test that provides examiner assistance in diagnosing cognitive impairments. The application deploys speech recognition techniques to allow easy and automated scoring of the test. The test results and test-related information are stored in a database providing easy access to data for follow-up and analysis, resulting in overall benefits to the examiner workflow. A small-scale pilot study of 5 months duration was conducted in a nursing home where 15 residents were tested with the MMSE app test and with the (paper) MMSE test with the aim of determining the agreement between the two test methods.ResultsThe final MMSE test scores, with a maximum score of 30, agree; the differences have a mean of 0.1, a standard deviation of 2.1 and fall in a [- 4, + 4] range as is illustrated in a Bland-Altman analysis. From examiner reflections, the motoric skills of the participant are indicated to contribute strongly to the time benefit of the assessment itself.ConclusionsThe findings of this study suggest that the mobile digital version of the slightly modified MMSE test has the potential to be used as an attractive alternative for the conventional paper version of the test.