Identifying dementia & mild cognitive impairment

mild cognitive impairment

Dr Timothy Kwok, Professor at The Chinese University of Hong Kong, shares the development of the Electronic Cognitive Screen (EC-Screen) for population screening of dementia in older people

The prevalence rate of dementia is high, around 5% to 8% in age over 60 worldwide. Dementia is a syndrome in which there is a progressive deterioration of cognitive functions such as memory, visuospatial abilities, and executive functions. Mild cognitive impairment is the intermediate stage between normal ageing and dementia. Early diagnosis can promote timely, professional advice and support for older persons with dementia and their family members. A brief digital cognitive test can help early diagnosis.

Electronic Cognitive Screen

The Electronic Cognitive Screen (EC-Screen) is a validated and brief digital cognitive test, that uses a cloud-based platform, and runs on a tablet. The EC-Screen can be self-administrated, and the administration time is approximately five minutes. The EC-Screen includes three sub-tests, that is a clock setting test, a story test, and a five-word delayed recognition test which assesses memory, visuospatial abilities, executive functions, and mental flexibility. The diagnostic performance of the EC-Screen is good for the identification of mild cognitive impairment and dementia in older people in the community.

Traditionally, only the score on a cognitive test is used for the assessment of the cognitive ability of an older person. Our validation study reveals that time spent in the digital cognitive test can be a behavioural marker for the identification of mild cognitive impairment and dementia. Patients with dementia have a significantly longer time spent in the five-word delayed recognition test than patients with mild cognitive impairment, and patients with mild cognitive impairment have a significantly longer time spent than healthy older adults. The behaviour maker can be an objective measurement for cognitive decline. Therefore, both the time spent and score are used in the calculation of the patient’s performance on the EC-Screen.

mild cognitive impairment

Dementia & mild cognitive impairment

The EC-Screen can facilitate a timely cognitive screening for an older person with initial signs and symptoms of memory loss and cognitive impairment. The older people and their families can decide whether they need to seek medical and professional advice after the assessment. Therefore, the EC-Screen can be a useful tool for case finding in the community.

The EC-Screen is developed by the Department of Medicine and Therapeutics and the Division of Neurology of The Chinese University of Hong Kong. The development of EC-Screen is supported by The Hong Kong Jockey Club Charities Trust, and the design is assisted by the Jockey Club Centre for Positive Ageing.


Chan JYC, Wong A, Yiu B, Mok H, Lam P, Kwan P, Chan A, Mok VCT, Tsoi KKF, Kwok TCY. Electronic Cognitive Screen Technology for Screening Older Adults With Dementia and Mild Cognitive Impairment in a Community Setting: Development and Validation Study. J Med Internet Res 2020;22:12 e17332.


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