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

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 article 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 3 weeks, with a more challenging version of the game in the final week. Mini-SPACE showed good test-retest reliability in unsupervised settings. Younger age was the primary predictor of performance, usability, and cognitive load. Importantly, the prediction of scores in the Montreal Cognitive Assessment (MoCA) improved with repeated measures. These findings support the screening potential of mini-SPACE with respect to MoCA-defined impairment in unsupervised settings, while clinical diagnostic accuracy remain to be established.