Conversational Assessment of Mild Cognitive Impairment with Virtual Agents

Over 55 million adults worldwide have dementia, a syndrome characterized by deterioration in cognitive functioning. Screening for mild cognitive impairment is important to identify dementia early to facilitate diagnosis and initiate treatment that may modify the disease trajectory. However, standard cognitive screening tools are time-consuming, require expert administration, and make people feel as if they are being tested and are thus potentially stigmatizing. Consequently, standard cognitive screening tools are underutilized, and dementia is often identified much later in the disease process leading to greater health-related and societal harms. We explored cognitive ability assessments using virtual agents, in which assessments are made during conversational dialogues. We evaluated four strategies for the assessment of cognitive ability in a sample of 41 individuals with varying cognitive ability, comparing each strategy to scores on the Mini Mental Status Exam (MMSE), the gold standard clinical screening tool for cognitive impairment. One of the four conversational strategies demonstrated significant agreement with the MMSE, with a sensitivity of 92.3% and a specificity of 48.3% for identification of impairment compared to the MMSE. Participants reported moderate levels of satisfaction with the agent-based conversational assessment. This approach could be used to identify individuals warranting more evaluation for possible cognitive impairment.