  Early detection of mild cognitive impairment and dementia is vital as many
therapeutic interventions are particularly effective at an early stage. A
self-administered touch-based cognitive screening instrument, called DemSelf,
was developed by adapting an examiner-administered paper-based instrument, the
Quick Mild Cognitive Impairment (Qmci) screen. We conducted five
semi-structured expert interviews including a think-aloud phase to evaluate
usability problems. The extent to which the characteristics of the original
subtests change by the adaption, as well as the conditions and appropriate
context for practical application, were also in question. The participants had
expertise in the domain of usability and human-machine interaction and/or in
the domain of dementia and neuropsychological assessment. Participants
identified usability issues in all components of the DemSelf prototype. For
example, confirmation of answers was not consistent across subtests. Answers
were sometimes logged directly when a button is tapped and cannot be corrected.
This can lead to frustration and bias in test results, especially for people
with vision or motor impairments. The direct adoption of time limits from the
original paper-based instrument or the simultaneous verbal and textual item
presentation also caused usability problems. DemSelf is a different test than
Qmci and needs to be re-validated. Visual recognition instead of a free verbal
recall is one of the main differences. Reading skill level seems to be an
important confounding variable. Participants would generally prefer if the test
is conducted in a medical office rather than at a patient's home so that
someone is present for support and the result can be discussed directly.
