The development of an iPad based App to support clinical and research assessment of cognition in dementia: ACEmobile. (Preprint)

BACKGROUND Cognitive screening is common practice in efforts to identify Alzheimer’s dementia in the early stages. The need for reliable and accurate assessment is critical, at this stage, to avoid distress or missed opportunities to support people with developing health needs. Administrator errors are observed to be both significant and common when clinicians deliver cognitive screening tools in clinical contexts, often as a result of complicated rules and the need for mental arithmetic. The Addenbrooke’s Cognitive Examination-III is one of the most used cognitive screening tools in the UK, observed to be prone to such user errors. OBJECTIVE We aimed to develop and release a computerized cognitive screening support tool for clinicians who use the Addenbrooke’s Cognitive Examination-III to screen for dementia. METHODS We undertook an innovation pathways approach, including problem identification, feasibility assessment, design and implementation. This project required numerous stages of consideration to meet data protection and NHS standards for implementation, this process is detailed. RESULTS Clinicians were provided an iPad based app (ACEmobile) via iTunes, which draws on usability research to standardize user behavior – thus standardizing the assessment of cognitive impairment alongside automated scoring. Results include continued use after three years in the market, registration from over 1,100 clinical users and the consented collection of over 4,300 dementia assessments to support further research into the development of ACE-III and ACEmobile. CONCLUSIONS ACEmobile has demonstrated itself as a clinical tool which continues to support a large number of clinicians and large scale research projects. The focus on usability has added value to its predecessor (ACE-III) in that the clinician’s assessment is now supported to be standardized. Feedback relating to ACEmobile has been unanimously positive and reflects these strengths.