iCog (Early Dementia Screening)

An app to administer cognitive screening tests like the Mini-Cog to screen for Dementia in its early stages and improve accessibility. 

According to the World Health Organization, around 55 million people have a Dementia-related illness. This number is only rising and is expected to reach 139 million by 2050. 

There are an estimated 41 million cases of Dementia around the world that are undiagnosed, with over 90% of undiagnosed cases in low-middle-income countries. 

The lack of a proper diagnosis can be attributed to three main factors:
a.) A lack of access to medical facilities due to their prohibitive cost and limited access, especially in developing areas.
b.) The medical facilities that are available, are overwhelmed and experience lots of delays, leading many to give up before they receive the medical help they need.
c.) The main culprit - the stigma associated with visiting a doctor due to a lack of understanding and public awareness of the disease. Around 1 in 3 people believe that nothing can be done about Dementia. Many are unwilling to acknowledge that they have a problem.

This is a major problem as a diagnosis, especially an early one, is key to taking action, in the right step, before it is too late. Early detection allows for earlier intervention and treatment, which can be more effective at mitigating the progression of the disease. Some types of cognitive impairment, such as a head injury, can be treated or mitigated with proper help. It is important to take key action steps early before it is too late especially when planning for the future. 

My app, the iCog, provides a solution by making the neurological tests doctors use to screen for Dementia available in the form of the app. The goal of this app is to expand the accessibility of an accurate screening by making it free and available through the use of a smartphone and website, so anyone can access it anywhere at any time.

It has tests like the Mini-Cog that can screen and help detect Dementia in its early stages. It shows the user's score on a graph to show the rate of change over time. All the data is stored anonymously in a secure cloud database to personalize the experience the moment the user logins in. 

It can read out the instructions of the test similar to how a doctor would technologies such as text-to-speech. It also contains information about Dementia such as helplines that are only a click away. 

The app can also be translated into several languages to overcome language barriers. It also has the option to use a family member as a "middleman" to navigate through the app if the user is unable to navigate through the app properly. 

It has the ability to adjust text zoom and contrast filters and adjust volume settings to accommodate a multitude of disabilities the user may have. All these settings and more can be edited on the settings page. 

The iCog is primarily targeted at serving the elderly, especially those living in rural or developing areas. Many people in developing areas do not have access to proper medical facilities or are financially restricted from proper screenings, with over 90% of cases being undiagnosed in low-middle-income countries. 

The digital iCog can be taken in the form of a mobile app or website and can be accessed by anyone regardless of their internet connection, location, language, or financial situation. This app would work hand-in-hand with medical professionals to share the results and facilitate a proper diagnosis. The iCog also has a multitude of accessibility options to account for any impairments the user may have.

The app would overcome the stigma associated with visiting a doctor, as more people are likely to take an anonymous cognitive screening test, rather than visit a doctor. Improving accessibility and removing unnecessary barriers to proper screening is key to taking an early first step before it is too late.  

I have partnered with Dr. Soo Borson, the creator of the Mini-Cog, a widely-accepted and used cognitive screening test, to ensure this app is accurate and reliable. With this collaboration, I can ensure my app is always up-to-date with the newest research and practices with cognitive screening. Additionally, this app is more likely to gain credibility and recognition, especially with any distribution channels the Mini-Cog may have. This can increase the acceptance and adoption of this app by both healthcare professionals and users around the world. This leads to more accurate screenings and better outcomes for those affected by Dementia.

I have included an optional survey that collects key demographic information such as age, location, native language, and any impairments the user may have such as vision or hearing loss. This can help in 4 key ways: 

1. By collecting key demographic information I can make sure that the app's features are tailored to best meet the needs of the population, or if it needs to be updated to adopt changes for a changing population. 
2. I can identify the needs of each individual user by collecting any impairments they may have and making sure the app can accommodate those needs, or if more features need to be added. 
3. I can use this data to help collect any disparities in healthcare that may be otherwise unknown. I can use this data to inform other organizations that may be better equipped at serving these areas.
4. By collecting data over time I can track and predict population trends to update or change the app in any way which may be necessary. 

Additionally, I am working with the Mini-Cog, a widely-accepted and used cognitive screening test, to ensure this app is accurate and reliable.

There are no easily accessible tools that can accurately screen for Dementia at its early stages. My app, the iCog will be the only accurate digital version of screening for Dementia. The iCog uniquely removes language and location barriers and can be taken on both the web and on a mobile app. The app can also be taken completely offline and user data is then collected anonymously for further research and analysis. The app is also completely anonymous to directly address the social stigma associated with getting help for Dementia. The iCog is also backed by the Mini-Cog, which is one of the few cognitive screening tools proven to work and is well adopted. This allows for the iCog to be the only app that is given permission to digitalize the Mini-Cog to screen for Dementia. 

Our impact goal is to increase accessibility and remove unnecessary barriers to receiving an accurate Dementia screening. This is done by ensuring the iCog can be taken anonymously, both online and offline, at any time anywhere, to combat the stigma around visiting a doctor. 

I use Flutter, a framework for creating apps for multiple platforms in one language. I also use Artificial Intelligence and Neural Networks to grade user drawings of clocks which is part of the Mini-Cog screening process. Finally, I use Firebase or an online cloud to host data and make sure that the website can be accessed from anywhere.

I have not launched this solution just yet as it is still in the prototype phase. Once I launch it, I plan to serve tens of millions of people around the world next year. 

There are some problems with making sure that the cloud is able to scale with the user count. As of now, I am using the free tier of an online cloud database which may limit the number of users that can access the app due to financial restrictions. Additionally, I am currently using a free domain to host the website, which may not reach lots of users. 

There are other legal problems with clearly communicating with the user that this app only collects anonymous data. I also want to make sure that data is collected in a way that meets regulations and is secure from data breaches.

Additionally, another problem is making sure this app is marketed correctly so that millions know about this and it is easily accessible from Google or the App Store. 

I have partnered with Dr. Soo Borson, the creator of the Mini-Cog, a widely-accepted and used cognitive screening test, to ensure this app is accurate and reliable. With this collaboration, I can ensure my app is always up-to-date with the newest research and practices with cognitive screening. Additionally, this app is more likely to gain credibility and recognition, especially with any distribution channels the Mini-Cog may have. This can increase the acceptance and adoption of this app by both healthcare professionals and users around the world. This leads to more accurate screenings and better outcomes for those affected by Dementia.

We offer our services tailored specifically to those without access to medical facilities or to those who face stigma around visiting a doctor. According to our AlzInt 90% of cases in low-middle-income countries go undiagnosed which roughly adds up to around 41 million cases. We allow these users to access the app on a mobile device or a website both online and offline. Our utmost priority is to allow anyone to talk the Mini-Cog anywhere.

The iCog would use a non-profit business model. The utmost priority of the app is to make sure it is free and available to anyone anywhere. For now, most of our work can be done for free but if we wish to scale, we would contact other third-party organizations to get sponsors and rely on donations or grants. We would keep our costs as low as possible and rely on donations and grants primarily from other third-party organizations if necessary.