Frequently Asked Questions about Cognition and Cognitive Testing with Mindmore
General - Introduction to Mindmore
Why should our clinic prioritize cognitive testing?
Can all staff at our clinic use Mindmore?
What is a good use for cognitive testing?
Are there integrated systems to avoid double record keeping?
Are these digital versions of self-scoring scales like KEDS, MADRS and PHQ-9?
Use / application
How are the results interpreted and who can do the interpretation?
How often can a person be tested with Mindmore?
Who should do cognitive tests - is it part of primary care's work?
What clinical value does continuous cognitive status provide?
Practical details
How long will it take for the patient to complete a test?
Do the patient perform the test on site or is it done remotely?
Technology and data security
How does Mindmore work with data security?
How do you store users and patients personal data?
Do Mindmore follow GDPR-regulations?
How do you keep our data separate from other customers data?
According to what is the product medically approved for, e.g. - MDD, MDR, SOSFS?
Are your tests compatible with Linux operating systems or only Windows?
Other
Questions related to tests & forms
What is cognition?
Cognition can simply be described as the thought processes that the brain uses to take in, process, store and retrieve information. Cognition is usually divided into a number of functions, or domains:
Memory, attention, language, visuospatial ability and executive function.
Our cognitive functions mean that we can:
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Interpret and understand information
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Maintain attention and concentration
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Remember and learn new things
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Plan, organize and prioritize
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Solve problems and make good decisions
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Understand language and communicate
Together, these functions are among the most important we have for a well-functioning brain health. The cognitive functions often work together - for example, attention is required to focus on information, so that it can be stored in the memory bank. Studying only a cognitive function in isolation therefore seldom gives an exhaustive picture of how an individual functions cognitively.
What are these tests?
Mindmore have created digital versions of evidence-based, well-established neuropsychological tests that clinicans have long used, but then in the format of pen and paper tests.
By digitizing these pen and paper tests, we have created a very fine-meshed instrument that can detect signs of dementia, or other cognitive impairment that have arose due to, for example, stress or depression. We have thus translated analog pen and paper tests and developed an easy-to-use tool, which the patients themselves can use before meeting with e.g. the doctor.
Why should our clinic prioritize cognitive testing?
As a clinician, it can be difficult to meet patients with complaints and thoughts about their cognition. The patient often finds it difficult to put into words what does not work as before. Today, a lot of time is spent understanding the large group of patients with stress and supporting patients who are worried about their memory and cognitive ability.
The cognitive profile generated through Mindmore testing is a support for the clinician. The main purpose of the testing is to determine whether there is a cognitive impact or not, which cognitive domain is affected and to what extent this is affected.
Mindmore is used in both primary care, occupational health care and specialist care - in assessments and mapping, in planning and follow-up of rehabilitation, to adapt work return as well as to provide sickness certificates.
Is this an intelligence test?
No. Cognitive tests are used to measure cognitive functions, that meaning, how the brain works, which cannot be equated with a person's perceived intelligence.
Our tests are mainly designed for medical assessment / investigation as well as research on neurodegenerative diseases, TBI (traumatic brain injury), fatigue and depression.
Can all staff at our clinic lead test sessions with Mindmore and interpret the results?
Mindmore educates relevant personnel to use the tool before it is used. Anyone who has received the education can administer a test with Mindmore - because no specific test leader competence is required, meaning it can be done by, for example, a nurse.
Interpretation of the test results should be done by staff who have the competence for this, for example a psychologist or doctor. These can of course also administer the test itself if desired. The fact that it does not have to be the same person who leads the test and interprets the results provides flexibility and the opportunity to further streamline the process.
What is a good use for cognitive testing?
Diagnosis
Cognitive tests can be used in assessment and diagnosis of all diseases, or suspicion of such, where cognition is often impacted and where you wish to see and follow up the cognitive status. It is important to remember that what is obtained is a snapshot - the results may improve or deteriorate over time. Common disease groups where cognitive status is valuable are cognitive diseases (dementia diseases), stress-related mental illness, brain damage, neuropsychiatric conditions and neurological diseases.
For the test person and / or relatives
The results can be used to validate / confirm difficulties that a person states that they experience in everyday life, but which are not captured with other examinations. It can create a better understanding of one's own condition and how it affects everyday life. It can also provide an explanation to relatives who may distrust or do not understand the difficulties the person is experiencing.
Documentation for municipality / authority
In communication with authorities or the municipality for assessed assistance measures, it is not uncommon for specific documentation regarding cognitive difficulties to be requested. Although the assistance assessors always make their own evaluations, the documentation from cognitive testing can be of great help. Even traffic medical centers or the Swedish Social Insurance Agency (Försäkringskassan) can benefit from having a better and more objective basis at their disposal.
Evaluation of treatment
Another good area of use is in the follow-up / evaluation of treatment interventions, where there is a question of whether cognition changes in some direction. Through repeated measurements, it is possible to follow a development and see whether a patients cognition improves, deteriorates or is not affected at all. In this way, the treatment can be adapted according to what the patient responds best to.
A challenge for us clinicians is double record keeping.
Are there integrated systems?
Mindmore has a so-called light integration - a cut and paste function of the results - in this way relevant information can be easily copied to the journal.
The point is not to integrate the results from a screening completely, as all information from the testing is not relevant to be found directly in the journal, but should first be interpreted.
KEDS, MADRS and PHQ-9 are examples of rating scales, i.e. subjective measures of how the patient themselves experiences their situation today. Cognitive testing is not about asking patients how they are feeling, but about giving them data that measures brain function. This is valuable because self-assessments of cognitive function have been shown to be inconsistent with actual function.
Subjective symptoms in general, such as depression, pain and fatigue, tend to correlate with each other and the measures of quality of life. However, cognitive test results tend to correlate poorly with such symptoms, but are strongly related to abilities to cope with daily activities (ADLs) and work. Therefore, it is within these functional domains that we must seek anchorage when interpreting the test results.
What evidence is there for your tests?
We have used existing evidence-based, well-established neuropsychological tests that clinicians have long used in the pen and paper versions. We lean confidently against the evidence that already exists.
We also conduct ongoing studies together with external researchers and universities, to further ensure the clinical quality of our tool.
Read more about the research behind Mindmore here .
How are the results interpreted and who can do the interpretation?
The results do not need to be calculated manually, but in Mindmore's Results Portal, reliable and objective measurement values are automatically presented that the caregiver can rely on in their clinical assessment of the patient. The result is thus a basis for the caregiver to interpret, in the same way as the result from a pen and paper test would be.
Certified staff (nurses, occupational therapists, doctors and psychologists), who have received training from us, are the ones who become users of our Results Portal and thus interpret the test results.
How often can a person be tested with Mindmore?
Learning effects can never be completely ruled out. The usual recommended interval for cognitive tests is at least 6 months - then a possible learning effect is expected to have decreased so much that it does not affect the result. For some tests, Mindmore has taken measures that reduce learning effects and also enable retesting over shorter time intervals.
Who should do cognitive tests - is it part of primary care's work?
Cognitive tests can be used continuously to measure cognition both for preventive purposes, when cognitive problems have arisen and during follow-up. In short, everyone can benefit from having a cognitive measurement value.
The flexibility in the application of the tool is made possible by the fact that Mindmore is not an independent diagnostic tool, but is connected to e.g. anamnesis and the clinical picture in general. Testing enables cognitive influence to be considered in the clinical assessment.
The stage of the care process in which the tool is used must be based on the problem that it is intended to solve. The test results are an objective piece of the puzzle about the patient's cognitive status that can be a key to solving clinical problems.
What clinical value does continuous cognitive status provide?
Cognitive test results provide different reference values than the clinical ones; what the patient says is quite seldom consistent with what is seen in the testing. Using tests for complementary, objective measurement values can therefore nuance and give extra weight to an assessment / diagnosis. Repeated test sessions provide a personal, to the individual unique, cognitive profile that becomes a valuable and reliable base measure for future investigations.
It depends on which test battery the patient performs. For the test administrator it takes less than a minute to administer and start a test.
Examples of time required for our most common batteries *:
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Cognitive screening: ~ 40 minutes
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Short cognitive screening: ~ 30 minutes
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Burnout/depression: ~ 40 minutes
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Short Burnout/Depression: ~ 20 minutes
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TBI: ~ 30 minutes
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Dementia: ~ 30 minutes
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Distance: ~ 50 minutes
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Short Distance: ~ 40 minutes
* Individual factors affect time
Do the patient perform the test on site or is it done remotely?
Mindmore has two different solutions for testing:
On site at the clinic. The patient takes the tests on a Mindmore-tablet specifically for the purpose or on a computer (laptop or desktop).
Remotely. The patient is invited to take the test at home on their own computer. In this case the caregiver creates a test invitation in our system, which the patient receives by email.
We always educate you about the solution that you are going to use. Regardless if the testing is done on site or remotely, the results are automatically calculated and available in Mindmore's Results Portal after the testing.
We only store personal data that is necessary. All data that belongs to a patient is pseudonymized and all traffic in the service is encrypted. Mindmore also offers two-step authentication.
We use a centralized authorization structure that makes it easy to decide which user is allowed to do what in the system. We continuously spend time improving our processes and stay up to date on what is happening in software development and management of cloud services in terms of security and juridical. All employees at Mindmore have signed confidentiality agreements and employment agreements that require compliance with the GDPR when handling data. The same type of agreement is concluded with consultants who work within Mindmore.
How do you store users and patients personal data?
Mindmore only stores pseudonymous data about test takers. No identifying information (name, email, IP address, social security number, telephone number, postal address, age, gender) is stored in Mindmore's system or is accessible by Mindmore or its subcontractors. Instead of name or social security number, a registration code is used in the system.
When we handle the users '(clinics') personal data we use servers and cloud-based services that exist within the EU / EEA. As the person responsible for personal data for the processing of personal data, we are obliged to stop processing the personal data when we no longer have a need or purpose for the processing.
Mindmore is constantly working to improve processes and increase security when handling personal data. We always sign personal data assistant agreements with our customers for handling the test takers' data. For handling personal data where Mindmore is responsible for personal data, see Privacy Policy here . If you as a user or test taker are looking for complete information about your rights, please see the Data Protection Regulation Chapter 3.
Mindmore offers a multitenant solution. This means that each organization's data is separated via access control in the application and is only accessible to authenticated users with the correct organization affiliation and authorization.
You write that the product is an approved medical device.
What is it approved from - MDD, MDR, SOSFS?
Mindmore provides a CE-marked medical device product classified as Class I according to the MDD and is actively working to certify the product as Class IIa according to the MDR. According to the decision by the European Commission, Class I products are required to meet MDR requirements since May 2024, but for Class IIa products, the deadline has been extended to December 2028. We comply with the MDR through technical documentation, risk management, clinical evaluation, and post-market surveillance (PMS). The regulations have been applied since the fall of 2023, and we expect certification in 2025. SOSFS is not applicable to Mindmore as this is the responsibility of the healthcare provider.
Are there also self-scoring scales in the tool?
Yes, self-scoring scales are currently available via Mindmore and new self-assessment scales are being added as the copyright holders approve Mindmore to post them in our digital tool.
Do you need to have good computer skills to do your tests?
No, we have not seen such impact. In our standard data, people up to the age of 93 have performed our tests with good results. It is up to the responsible clinician to decide whether the patient can handle testing that takes place digitally.
Are our results included in your research studies?
No, the results are yours and we do not have access to them!
Corresponding cognitive tests for children are available, but not in digital form as Mindmore has not established norms for them yet. Read more about our norms here .
Are your tests compatible with Linux operating systems or only Windows?
The tests work on Windows, ChromeOS, Linux and MacOS as long as you use the Chrome, Edge or Firefox browser.
Do you have a recommended test package for use in primary care?
In the current guidelines for cognitive disease, the recommendation is to use MMSE, the clock-drawing test, RUDAS, or MoCA.
What is your equivalent to this, and do you have a cutoff score for your tests? For example, in MMSE, a score below 24 indicates the need for further examination.
1. We recommend different test batteries depending on the initial clinical assessment of the patient. This allows us to be more person-centered even in cognitive testing.
a) Patients concerned about cognitive illness who experience occasional subjective memory lapses or confusion but are not affected in daily life: We use a test battery called Screening.
b) Patients with clear subjective cognitive difficulties, supported by information from relatives indicating cognitive decline: We use our test battery called Dementia.
c) Patients who do not have Swedish as their native language but can read Latin letters (A-Z): These individuals are generally more challenging to test. If RUDAS is not used, we recommend a test battery consisting solely of visual tests, called Language-Independent. We do not have strict cutoffs for our tests but evaluate z-scores in each domain. A score of -1.5z in any domain indicates the need for further evaluation. Our tests provide specific results for memory, language, executive function, visuospatial function, and attention/processing speed. While initially, reviewing five different results instead of one may seem more complex, this approach allows for earlier detection of cognitive impairment.
Are your tests already being used in primary care? If so, are there any results or studies available that we can access?
Mindmore's tests are used in several primary care units and rehabilitation centers. Currently, we have two studies related specifically to primary care. One study was conducted at Gustavsberg Health Center, focusing on stress-related disorders, and another at a primary care unit in Region Östergötland, focusing on dementia assessments.
You can read more about both studies here.
How does it work in practice when a patient takes the test? Is the data compatible with journalsystems such as TakeCare or does it need to be recorded by the clinician?
The result from Mindmore is converted to text that can be cut and pasted directly into TakeCare, so with just two clicks you can record the result. Since the result is completely de-identified, it is fine to download it as a PDF and upload it to your journal system that way as well.
The link I received is not working?
There are a few different reasons why this may not be working. The most common reason is that you have accessed the link once and are now trying to open it again at a later time.
With this type of link, it is important that when you first access it, you must use the same device and the same web browser the next time you try to open it in order to gain access.
If none of the above solutions work, follow these steps:
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Start by copying the link address and pasting it into your web browser. If this does not work, proceed to step 2.
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Ask your healthcare provider for a new link and forward the invitation email (where your link did not work) to support@mindmore.com so we can investigate the issue further.
Can I forward a link to others who need to fill in the information?
Each form related to a specific individual is linked to the email address provided when sent by the healthcare provider. Therefore, it cannot be forwarded to another recipient.
If multiple people need to fill in information related to a child, adolescent, or test participant, you should ask the healthcare provider to send a unique link to each person’s individual email address. Their responses will be collected in separate forms but under the same pseudonym ID within Mindmore’s digital tool.
It is the same form, but different individuals linked to the pseudonym ID fill in the information —
for example, a relative, mother, brother, counselor, or teacher.
My speaker and microphone are not working.
Make sure everything is updated in your web browser, then try restarting the test.
If that doesn’t work, try connecting a different microphone or speaker to your device, which should resolve the issue.
If the problem persists, take a screenshot or screen recording of the issue and email us at support@mindmore.com.
My invitation email looks strange.
Does the invitation email you received from your healthcare provider appear incorrect?
Forward it to support@mindmore.com, and we will review the issue. We will follow up via email with the next steps.
I have filled in information that is now gone?
This is usually due to the fact that you have only filled in certain information in a form and not all the information. Once you are inside a form, it is important that you fill in all the information in the form. It is only then that the information is saved.
You cannot fill in information, exit the form and then enter again. Then the information you filled in on the first occasion is gone.
It is important that when you fill in a form that you fill in all the information so that it is saved and available.