Specific brain regions - specific memory tests
Mild cognitive impairment (MCI: ICD code F06.7) refers to an impairment of cognitive performance that goes beyond what is normal according to the age and education of the person affected, but does not cause any significant restrictions in everyday life.
The neotivCare tests - consisting of three types of cognitive tasks - enable an efficient assessment of whether patients aged 60 and over with suspected early Alzheimer's disease have mild cognitive impairment of the amnestic type or whether their memory performance is normal for their age.
Performance in the three tests is not only associated with activity in specific areas of the brain, but also to different domain-specific processing pathways that may be compromised by the presence of Alzheimer‘s pathology.1,2,3,4
More than ten years of extensive research
neotivCare is based on the latest findings in neuroscience and dementia research.
Scientifically validated
The cognitive tests are validated against diagnostic neuropsychological procedures
(PACC55 score*) and biomarkers (CSF6, amyloid PET7,8).
Reliable composite score
The composite score, which is calculated based on the performance in each of the three neotivCare tests, serves as a basis for further differential diagnostic examinations by specialists.
Intended patient population
The app is suitable for adults, especially for 60-80 years old.
Opportunities with neotivCare
Diagnostic certainty
Meaningful assessment of suspected MCI with neotivCare
Significant time savings
Reduction in the complexity of the diagnostic process for cognitive impairments
Robust results
Attenuation of performance fluctuations via repeated measurements
Continuity
Report of the results provided to support further diagnostic and therapeutic decisions. Progress monitoring
Targeted care
Early information for a better risk management and the initiation of lifestyle (secondary prevention) or the start of drug therapy
Choice of test time
Independent start of memory tasks at their own convenience
Meaningful assessment
Recording cognitive performance over the course of twelve weeks means the final result is more than a snapshot by taking into account that memory capabilities can vary over days and weeks
Avoiding fears and concerns
Carrying out the memory tasks in the comfort of their own home, repeated measurements reduce potential concerns about the performance in individual tests
Monitoring
Repeating the test once a year allows the objective observation of cognitive changes over time
neotivCare test procedure
Using neotivCare is easy. The test schedule for your patients aged 60 and over with suspected MCI is as follows:
- Completion of one task each week
- Test types are repeated regularly over a total period of twelve weeks
- Carried out in the comfort of their own home and without supervision
This procedure puts fluctuations in performance into perspective, so that robust results that reflect everyday life can be obtained. In this way, indications of pathological cognitive impairments can be obtained in contrast to the normal aging process. The neotivCare tests offer higher diagnostic sensitivity and specificity compared to paper-pencil tests.9,10
Would you like more information about neotivCare? We would be happy to provide you with a demo version.
neotivCare - three types of cognitive tasks*
Indoors & outdoors - photographic memory (recognition memory)
Cognitive mechanisms: recognition, recollection, familiarity
- Memorization phase: Presentation of photographic images of indoor or outdoor scenes – patients are asked to indicate whether the images show an indoor or outdoor scene.
- Recall phase: After a certain delay period (65 minutes), their photographic recognition memory is tested by asking them to distinguish the previously seen images from novel images.
Memorize objects - memory for spatial relationship of objects and scenes
Cognitive mechanisms: pattern completion, associative memory, recollection
- Memorization phase: Presentation of different room images, each containing two objects. The objects and their respective position in the room must be memorized
- Recall phase: After a certain delay period (30 minutes), the long-term memory for the objects and their position in the room is tested
Detect differences - precision memory for objects and rooms
Cognitive mechanisms: pattern separation, object processing, perceptual discrimination
Repeated presentation of individual images of objects and scenes: for each image, the patient has to decide whether the image is the same (as seen before) or whether there is a difference (e.g., in its shape or geometry)
Two levels of difficulty:
- Level 1: Learning one object/room
- Level 2: Learning two objects/rooms
* The illustrations shown here are exemplary and simplified representations of the test sequences.
Scientifically validated
neotivCare is the product of more than 10 years of research in the field of neuroscience, neurology and dementia research. The neotivCare digital application makes complex science directly usable for patients. The performance of the app has been proven by studies conducted by leading specialist institutes**.
The report - the efficient way to early MCI diagnosis
The report of the results, which can be downloaded in the app at any time, provides you with a meaningful overview of your patients‘ memory performance. The more tests are completed, the more accurate the report will be. In addition to the presentation of all individual test results, information on the patient‘s self-assessment of performance and concentration as well as on special events enables better interpretation of the results. This self-assessment is completed by the patients within the app after each test. Thus, you receive a quick overview of whether the overall result of the measurements corresponds to a standard representative value or whether the test result should be taken with caution.
You will also gain an impression of whether your patients regularly over- or underestimate their cognitive performance and will be provided with information about the time each test was carried out.
The design of the neotivCare tests also allows them to be used repeatedly as part of regular follow-up checks. For proactive memory protection for your patients.
One score, one clear decision
Validated against an established neuropsychological test battery, the PACC5*, the composite test result from neotivCare (composite score) is a comparative value, indicating the relationship to the normative value of the results of cognitively unimpaired people in the corresponding age group.
- Results that deviate from the norm may indicate the presence of Alzheimer's biomarkers and the existence of mild cognitive impairment (MCI). Further diagnostics are required.
- Normal or inconspicuous results initially give the all-clear, if a cognitive disorder was suspected.
This finding may indicate mild cognitive impairment (amnestic).
Results that that deviate from the norm (are below the cut-off)
- are indicative of mild cognitive impairment (MCI)
- may require further clarification of the etiology
Measures that positively influence the course of MCI or have a preventive effect against the development of Alzheimer‘s disease are recommended.
This finding is better than would be expected for a mild cognitive impairment (amnestic).
Normal or inconspicuous results (are above the cut-off)
- initially give the all-clear, if a cognitive disorder was suspected
- the initiation of specific measures is not required at this stage
A healthy lifestyle is nonetheless recommended for memory complaints without MCI. It can improve or stabilize memory performance. Regular exercise, social activities and getting as much sleep as possible are also recommended11.
Would you like to find out more about the medical background behind neotivCare? You can find all relevant studies and publications here.
Suspected diagnosis of MCI - what next?
It is estimated that around 40% of dementia cases can be attributed to twelve modifiable risk factors12.
With neotivCare, you can help to maintain your patients‘ independence and quality of life by ...
- referring them for further differential diagnosis by a specialist,
- promptly initiating secondary prevention measures, e.g. dietary adjustments, sufficient physical exercise, cognitive training, physiotherapy and occupational therapy12,
- encouraging avoidance of risk factors that can impair memory performance, e.g., elective general anesthesia, prolonged sedation, being bedridden and cognitively unfavorable medications such as benzodiazepines.
Fig. modified after Livingston et al, 2017; 390(1011))
One thing is certain: Those affected can benefit from the introduction of supportive measures. Known and modifiable risk factors for dementia include cardiovascular diseases such as hypertension, metabolic diseases such as diabetes mellitus and lifestyle factors, e.g. lack of exercise, certain dietary patterns („Western Diet“), nicotine and excessive alcohol consumption and a lack of social activity. Depression is also an important risk factor. Hormonal disorders, electrolyte imbalances and vitamin deficiencies can also be relevant12.
* PACC5: Preclinical Alzheimer's Cognitive Composite-5, a composite score of 5 neuropsychological tests (assessing episodic memory, executive function and global cognitive performance). An established test battery with high sensitivity for early risk assessment of memory disorders typical of Alzheimer's disease.
** German Center for Neurodegenerative Diseases (DZNE); Institute for Cognitive Neurology and Dementia Research (IKND) at Otto von Guericke University Magdeburg
1. Düzel et al., Hippocampus 21.8 (2011): 803-814. doi.org/10.1002/hipo.20834
2. Maass et al., Nature communications 5.1 (2014): 5547. doi.org/10.1038/ncomms6547
3. Berron et al., Journal of Neuroscience 36.29 (2016): 7569-7579. https://doi.org/10.1523/JNEUROSCI.0518-16.2016
4. Berron et al., Neurobiology of aging 65 (2018): 86-97. doi.org/10.1016/j.neurobiolaging.2017.12.030
5. Berron et al, medRxiv 2021.11.12.21266226; doi.org/10.1101/2021.11.12.21266226
6. Berron et al., Journal of Neuroscience, 2019, 39(44), 8788-8797. doi.org/10.1523/JNEUROSCI.1279-19.2019
7. Maass et al., .Brain 2019; 142(8): 2492–2509. doi.org/10.1093/brain/awz154
8. Düzel et al., Brain 145.4 (2022): 1473-1485. doi.org/10.1093/brain/awab405
9. Spencer et al., Exp Aging Res. 2013; 39(4): 382–97. https://doi.org/10.1080/0361073X.2013.808109
10. Bransby et al., J Clin Exp Neuropsychol. 2019; 41(6): 59100. https://doi.org/10.1080/13803395.2019.1593949
11. Ngandu et al., The Lancet 385.9984 (2015): 2255-2263. doi.org/10.1016/S0140-6736(15)60461-5
12. Livingston et al., The Lancet 390.10113 (2017): 2673-2734. doi.org/10.1016/S0140-6736(17)31363-6