Overview

The Computer Assessment of Mild Cognitive Impairment (CAMCI®) is a computerized screening tool designed to provide a valid assessment of abnormal cognitive decline in older individuals at an early stage. The CAMCI battery of tasks, consisting of 8 sub-tasks testing multiple cognitive domains, and a series of self-report questions to gain information from the patient, is self-administered via tablet computer using touchscreen technology for response input. The sub-tasks include an innovative virtual environment task (watch demo) and a delayed verbal recall task.

CAMCI Tasks Preview

In a study of 524 community-dwelling, non-demented participants, CAMCI was highly sensitive (86%) and specific (94%) in the identification of Mild Cognitive Impairment*.

Patients participate at their own pace (average time is 25 minutes). The patient’s report is then immediately generated for on-screen inspection or to be printed for the interpreting physician. Scored responses are compared to age and education adjusted normative data to provide a comprehensive summary score, as well as domain and task level scores based on accuracy and reaction time data. Longitudinal summary score data is reported for comparison across successive test sessions.

CAMCI is intended as a computerized assessment tool to contribute to the pre-clinical evaluation of cognitive function, and changes over multiple test sessions, as compared to normative data**. The patient self-administers CAMCI, requiring no direct supervision by the physician or office staff. CAMCI is user-friendly, and requires no training, specific education or previous computer use. The interpretation of the report must be performed by a qualified health care professional.

Current reporting features use normative data collected from elderly subjects ages 60+.

Cognitive Domains Tested:

Attention
Executive Function
Memory (Verbal, Nonverbal, Functional and Incidental)
Processing Speed

CAMCI is billable under CPT code 96120 (Neuropsychological testing administered by a computer). The reimbursement covers the neuropsychological testing by a computer and the interpretation and reporting time for the physician or clinical psychologist.

Effective 01-01-06: Medicare Part B coverage of neuropsychological tests is authorized under section 1861(s)(2)(C) of the Social Security Act. Payment for neuropsychological tests is authorized under section 1842 (b)(2)(A) of the Social Security Act.

This product is currently in the research, development, and pre-market stage. It is currently only available to researchers with an IRB approved protocol.

*Saxton et al. Computer assessment of mild cognitive impairment. Postgraduate Medicine. 2009; 121(2):177-185.

**Intended Use
CAMCI is intended as a computerized assessment tool to contribute to the pre-clinical evaluation of cognitive function, and changes over multiple test sessions, as compared to normative data. CAMCI alone does not directly offer a medical diagnosis of any type. A diagnosis of MCI, dementia, or similar disease can only be made by a qualified physician or psychologist considering a wide range of potential contributing factors. The results of the CAMCI, when interpreted by a qualified healthcare professional, may assist in the identification of patients in need of a complete, neuropsychological exam.

Indications for use
CAMCI is indicated for the pre-clinical screening of abnormal cognitive decline.

Contraindications
CAMCI is not indicated for patients suffering from any psychiatric disorder, such as, schizophrenia and bipolar disorder, patients who are unable to read at a fifth grade reading level, who do not have adequate cognitive functioning to allow understanding of the task instructions, or visual and auditory acuity to permit adequate perception of instructions or stimuli, patients falling outside of the age range of the normative data, or patients with physical disability that would prohibit response.

Device description
CAMCI is a computerized screening tool designed to provide a valid assessment of abnormal cognitive decline in older individuals at an early stage, administered via tablet computer using touchscreen technology for response input. The CAMCI battery of tasks consists of 8 sub-tasks testing multiple cognitive domains (attention, verbal memory, nonverbal memory, functional memory, incidental memory, executive function, and processing speed), and a series of self-report questions to gain information from the patient (e.g., memory loss, alcohol use, depression, anxiety). Scored responses are compared to age and education adjusted normative data to produce a performance report providing a comprehensive summary score, as well as domain and task level scores based on accuracy and reaction time data. Longitudinal summary score data is reported for comparison across successive test sessions.

Features

Highly sensitive and specific screening tool
Self-administered
User-friendly
Several cognitive domains tested

Attention
Executive Function
Processing Speed
Memory

Verbal
Nonverbal
Functional
Incidental

Accuracy and response times tracked and reported
Report immediately available to view on-screen or to print
Report of performance at overall level, domain, and task level
Reimbursable under CPT code 96120
Pre-installed on a Tablet PC (Motion J3400)

Sealed design is easily cleaned and disinfected
Ergonomic
Portable
Lightweight
Integrated digital camera
Natural pen/speech input
Optimal viewing in all light conditions

Research

CAMCI is currently in use in research studies addressing cognitive assessment of primary care patients, intervention in dementia, traumatic brain injury, HIV-related cognitive decline, mobility assessment, and exercise interventions, as well as in studies examining the elderly and arthritis. Over 1,000 participants have used the CAMCI with overwhelmingly positive results.

Current research studies involving CAMCI:

Pilot study on Moderate to Severe Traumatic Brain Injury

Principal Investigator: L. Morrow, Ph.D., University of Pittsburgh School of Medicine
Brain Trauma Research Center collecting pilot data on moderate to severe TBI subjects (ages 20-60 to add to the current database of ages 60+).

Cognitive Assessment of Primary Care Patients (NIA)

Principal Investigator: J. Saxton, Ph.D., University of Pittsburgh
The major goal of this study is to investigate the utility of cognitive testing in the Primary Care setting using CAMCI. Both clinical outcomes and clinical practice are being investigated in this five-year study involving 1,000 subjects over age 65 and 24 community Primary Care Physicians.

Detection, Diagnosis and Intervention in Dementia in Rural and Urban Elderly (Pennsylvania State funded Center for Excellence-4100027294)

Principal Investigator: J. Saxton, Ph.D., University of Pittsburgh
Investigating the utility of computerized testing as a screening tool for identification of persons with MCI, the stability of performance on a computerized test over 2 years, the agreement between performance on a computerized test and comprehensive diagnostic assessment at the ADRC ("gold standard"), and whether level of diagnostic certainty, as measured by computerized testing, increases with additional information, specifically results of caregiver interview and/or PCP medical chart review. Preliminary data analysis indicates we can successfully recruit rural and African American elderly to participate in research but preferably if they do not have to travel to a university setting, about 25% of individuals will be lost to follow-up each year, and a brief cognitive assessment correctly identifies ~ 80% of individuals with normal cognition and ~ 80% of individuals with borderline functioning.

HIV-related Cognitive Assessment Study

Principal Investigator: N. Sacktor, Ph.D., Johns Hopkins University
An HIV cognitive assessment study, with 85 HIV positive patients and 45 HIV negative controls currently enrolled, to evaluate the utility of the CAMCI for functional performance. Analysis of the baseline data is underway to investigate the relationship between CAMCI test scores and the original American Academy of Neurology (AAN) criteria for HIV associated neurocognitive disorders (HAND).

Pilot Study of an Internet-based Cognitive Stimulation Program in AIDS (NIMH- NCT00619567)

Principal Investigator: J.T. Becker, Ph.D., University of Pittsburgh
The neurocognitive manifestations of HIV/AIDS have long been recognized as important for the management, survival, and quality of life of affected patients and their families. Following the advent of Highly active anti-retroviral therapy (HAART) the incidence of HIV-associated dementia (HAD) has fallen, but the prevalence of the milder forms of HIV-related cognitive disorders has risen. This is important because alterations in cognitive function can have significant impact on work and social activities, mood, and perceived quality of life. To date, pharmacological management of HIV-associated cognitive disorders - apart from HAART - have met with limited success (e.g., Peptide T, Ritalin). Therefore, it appears reasonable to ask whether the use of non-pharmacological tools might help alleviate or ameliorate the symptoms of the milder forms of cognitive impairment, and thus improve mood and activities of daily living. The purpose of this application is to request funds to allow us to complete a feasibility/pilot study of the merits of using an internet-based cognitive stimulation program (CSP) to improve the cognitive functions and quality of life of individuals with HIV/AIDS, and, secondarily, to detect such changes using a computerized assessment tool designed for use in a health care practitioner's office (Computer-Based Assessment of Mild Cognitive Impairment (CAMCI)).

Increasing Minority Participation in Mobility Assessment and Exercise Interventions (Claude Pepper Center)

Principal Investigator: S. Albert, Ph.D., GSPH, University of Pittsburgh
In the Boosting Minority Involvement study, 96 African-American men and women aged 60 and older completed performance tests of physical and cognitive function. The mean age was 73, 78% were female, and 67% lived alone. Physical function was assessed with the Short Physical Performance Battery (SPPB), a test of gait, balance, and leg strength. Cognition was assessed with standard paper and pencil tests as well as the CAMCI. Z-score composite measures were developed from the CAMCI to assess the domains of attention, verbal memory, and executive function. In adjusted analyses, global memory and executive function explained 45% of the variability in SPPB. Gait and balance may in part depend on multifaceted higher cognitive demands, such as higher-order executive function. Nieto ML, Albert SM, Morrow LA, Saxton J. Cognitive status and physical function in older african americans. J Am Geriatr Soc. 2008;56(11):2014–2019.

Computer Assessment of Mild Cognitive Impairment (NIH/NIA 5R44AG022792-03)

Principal Investigator: A. Eschman, MS, Psychology Software Tools, Inc.
The Computer Assessment of Mild Cognitive Impairment (CAMCI) is a self-administered, user-friendly computer test that scores automatically and can be completed independently in a quiet space, such as a doctor's examination room. The goal of this study was to compare the sensitivity and specificity of the CAMCI and the Mini Mental State Examination (MMSE) to identify mild cognitive impairment (MCI) in 524 nondemented individuals > 60 years old who completed a comprehensive neuropsychological and clinical assessment together with the CAMCI and MMSE. We hypothesized that the CAMCI would exhibit good sensitivity and specificity and would be superior compared with the MMSE in these measures. The results indicated that the MMSE was relatively insensitive to MCI. In contrast, the CAMCI was highly sensitive (86%) and specific (94%) for the identification of MCI in a population of community-dwelling nondemented elderly individuals. Saxton J, Morrow L, Eschman A, Archer G, Luther J, Zuccolotto A. Computer Assessment of Mild Cognitive Impairment. Postgrad Med. 2009 Mar; 121(2):177-85.

FAQs

Q: What research has been conducted showing the ability of CAMCI to detect MCI?
A: CAMCI yielded sensitivity of 86% and specificity of 94% in a study of 524 community-dwelling, non-demented participants*. This analysis compared the CAMCI results to the adjudication of each participant (performed by trained neuropsychologists) using a full neuropsychological battery.

*Saxton et al. Computer assessment of mild cognitive impairment. Postgraduate Medicine. 2009; 121(2):177-185.

Q: Is CAMCI being used in any other research studies?
A: CAMCI is currently in use in research studies addressing cognitive assessment of primary care patients, intervention in dementia, traumatic brain injury, HIV-related cognitive decline, mobility assessment, and exercise interventions, as well as in studies examining the elderly and arthritis.

Q: Can elderly patients use a computer?
A: Over 1,000 elderly participants have used the CAMCI with overwhelmingly positive results. Not one participant has been unable to complete the CAMCI battery of tasks due to an inability to use a computer.

Q: What tests are involved?
A: CAMCI includes tests of simple attention, visual and verbal memory, executive abilities, and working memory. A virtual reality driving task provides an innovative approach to testing domains, such as prospective memory, not often assessed by paper-pencil tasks.

Q: When are the results available?
A: Results are available immediately! The patient’s report is immediately generated for on-screen inspection or to be printed for the interpreting physician.

Q: What does the report consist of?
A: The report contains the patient’s overall performance and an interpretation of results, as well as a thorough account of domain and task level performance.

Q: Does Medicare cover CAMCI testing?
A: CAMCI is billable under CPT code 96120 (Neuropsychological testing administered by a computer). The reimbursement covers the neuropsychological testing by a computer and the interpretation and reporting time for the physician or clinical psychologist.

Effective 01-01-06: Medicare Part B coverage of neuropsychological tests is authorized under section 1861(s)(2)(C) of the Social Security Act. Payment for neuropsychological tests is authorized under section 1842 (b)(2)(A) of the Social Security Act.

Pricing

CAMCI is currently in the research, development, and pre-market stage. It is currently only available to researchers with an IRB approved protocol.

Please contact us for more information.

Overview

Features

Research

FAQs

Pricing

CAMCI Interface

CAMCI Tasks