The Puppy Escape Narrative: Validation of an Openly Available Recall Task for MCI Detection
Kleiman, M. J.; O'Shea, D.; Rader, K.; Baig, M.; Camacho, S.; Salcedo, A.; Galvin, J. E.
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Introduction: Narrative recall is widely used to detect cognitive impairment, but dominant instruments carry proprietary restrictions. The Craft Story 21 (CS), the non-proprietary NACC UDS4 standard, is not available standalone. Here, we validate the freely available Puppy Escape (PE). Methods: 346 participants (153 cognitively normal, 106 subjective cognitive impairment, 87 mild cognitive impairment) completed PE and CS. Analyses evaluated convergent and criterion validity, MCI-vs-control discrimination, and incremental validity. Results: PE and CS converged (r=.43-.47) and were equivalent on 10/12 neuropsychological measures. PE Delayed discriminated MCI from controls (d=1.03; ROC-AUC equal to CS, DeLong p=.510) and added variance beyond CS (R2=+.054, p<.001). Automated subscores revealed MCI deficits in location, action, and name content. PE-18 short form retained discrimination (d=1.02) with 18 items. Discussion: PE matched CS across all validation domains and captured complementary diagnostic information. PE and PE-18 are available via online registration explicitly permitting industry-sponsored research and fee-for-service clinical use.
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