From Play to Detection: Mini-SPACE as a Serious Game for Unsupervised Cognitive Impairment Screening

Abstract: Early detection of Cognitive Impairment (CI) is critical for timely intervention, preservation of independence, and reducing the burden of dementia. Yet, most screening tools remain lengthy, clinic-based, and poorly suited for large-scale unsupervised deployment. This paper evaluates the test-retest reliability, validity, and usability of mini-SPACE, a short iPad-based serious game for detecting early signs of CI. Participants played mini-SPACE at home without supervision once a week for three weeks, with a longer version of the game in the final week. Mini-SPACE showed good test-retest reliability in unsupervised settings. While younger age was the primary predictor of performance, usability, and cognitive load, participants of all ages were able to complete the tasks and reported good usability and low cognitive load. Importantly, the prediction of scores in the Montreal Cognitive Assessment (MoCA) improved with repeated measures. These findings highlight mini-SPACE as a promising digital marker for scalable, age-sensitive screening and potential longitudinal tracking of CI.