Cog-First: Standardization of a Tablet-Based Self-Administered Cognitive Screening

Background

Acquired brain injuries can lead to subtle cognitive impairments that are often difficult to detect, yet significantly influence long-term functional outcomes. Cog-First was developed as a self-administered, tablet-based cognitive screening tool designed to evaluate executive function, memory, and attention in approximately 20 minutes, starting from the acute phase after brain injury.

Aim

To establish reliable normative data for Cog-First, allowing patient scores to be compared against a standardized reference population.

Methods

A cross-sectional study was conducted on 406 healthy French-speaking volunteers recruited from the Paris Brain Institute database. Each participant completed the seven Cog-First subtests under standardized conditions. A subsample of 95 participants repeated an alternative version of the test one month later to assess the test-retest effect. The influence of sex, age, education, and test version was analyzed using generalized linear models (GLMs). Correction formulas were derived to adjust scores and generate standardized percentiles.

Results

Sex, age, education, and test version significantly influenced several subscores. Test-retest analyses revealed a learning effect in four out of seven subtests. Corrected scores enabled the establishment of an automated standardization process integrated into the Cog-First software.

Conclusion

This standardization provides reliable norms for the clinical interpretation of Cog-First results, supporting early detection of cognitive impairments and guiding patient care.

Clinical impact

Cog-First is an innovative neuropsychological tool that enhances the detection and management of cognitive deficits following brain injury.