Aims: The prevalence of dementia is increasing with the aging population. However, cognitive screening rates remain low in Thailand due to workforce shortages and limited specialized services. We developed a voice-based, Self-Administered test for Memory, Orientation, and fluNcy for the Geriatric population (SAMONG), consisting of registration, orientation (1 point), fruit fluency (1 point), and 3-word recall (3 points). Its web-based format enhances accessibility, improving screening rates. This study evaluates the diagnostic accuracy of SAMONG in identifying dementia among Thai older adults.
Methods: This cross-sectional study enrolled patients aged ≥60 years, with and without dementia, classified by geriatricians using DSM-5 and the Clinical Dementia Rating (CDR). All participants completed SAMONG under standardized conditions. Test results were automatically interpreted by an algorithm, independent of DSM-5 diagnosis. Diagnostic performance was assessed using ROC and AUC. Agreement between automatic and human interpretation of recorded audio was analyzed using Bland-Altman analysis.
Results: SAMONG demonstrated an AUC of 0.899 (0.863–0.934). A cutoff of ≥2/5 achieved 97% sensitivity and 72% specificity. Fruit fluency alone showed an AUC of 0.884 (0.836–0.932), with a cutoff of ≥10 yielding 79% sensitivity and 85% specificity. Automatic interpretation showed high agreement with human interpretation for both total and individual items.
Conclusions: SAMONG demonstrates excellent diagnostic accuracy in dementia screening among Thai older adults. With its strong performance and potential for optimization, it can enhance cognitive screening accessibility across diverse populations. Its implementation could improve efficiency and reduce the burden on healthcare systems.