1
|
Kochan NA, Heffernan M, Valenzuela M, Sachdev PS, Lam BCP, Fiatarone Singh M, Anstey KJ, Chau T, Brodaty H. Reliability, Validity, and User-Experience of Remote Unsupervised Computerized Neuropsychological Assessments in Community-Living 55- to 75-Year-Olds. J Alzheimers Dis 2022; 90:1629-1645. [PMID: 36314208 DOI: 10.3233/jad-220665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Self-administered computerized neuropsychological assessments (CNAs) provide lower cost, more accessible alternatives to traditional in-person assessments but lack critical information on psychometrics and subjective experience of older adults in remote testing environments. OBJECTIVE We used an online brief battery of computerized tasks selected from the Cogstate Brief Battery (CBB) and Cambridge Brain Sciences (CBS) to 1) determine test-retest reliability in an unsupervised setting; 2) examine convergent validity with a comprehensive 'gold standard' paper-and-pencil neuropsychological test battery administered in-person; and 3) explore user-experience of remote computerized testing and individual tests. METHODS Fifty-two participants (mean age 65.8±5.7 years) completed CBB and CBS tests on their own computer, unsupervised from home, on three occasions, and visited a research center for an in-person paper-and-pencil assessment. They also completed a user-experience questionnaire. RESULTS Test-retest reliabilities varied for individual measures (ICCs = 0.20 to 0.83). Global cognition composites showed excellent reliability (ICCs > 0.8 over 1-month follow-up). A strong relationship between a combination of CNA measures and paper-and-pencil battery was found (canonical correlation R = 0.87, p = 0.04). Most tests were rated as enjoyable with easy-to-understand instructions. Ratings of general experience with online testing were mostly favorable; few had difficulty concentrating (17%) or using the computer for tasks (10%), although over one-third experienced performance anxiety (38%). CONCLUSION A combined brief online battery selected from two CNAs demonstrated robust psychometric standards for reliability (global composite), and convergent validity with a gold standard battery, and mostly good usability and acceptability in the remote testing environment.
Collapse
Affiliation(s)
- Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
| | - Megan Heffernan
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
| | - Michael Valenzuela
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia.,Skin2Neuron Pty Ltd, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia.,Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia.,UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
| | - Maria Fiatarone Singh
- Sydney School of Health Sciences and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, Australia.,Neuroscience Research Australia, Sydney, Australia.,UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
| | - Tiffany Chau
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia.,UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
| |
Collapse
|
2
|
Mundell NL, Owen PJ, Dalla Via J, Macpherson H, Daly RM, Livingston PM, Rantalainen T, Foulkes S, Millar J, Murphy DG, Fraser SF. Effects of a multicomponent resistance-based exercise program with protein, vitamin D and calcium supplementation on cognition in men with prostate cancer treated with ADT: secondary analysis of a 12-month randomised controlled trial. BMJ Open 2022; 12:e060189. [PMID: 35750461 PMCID: PMC9234801 DOI: 10.1136/bmjopen-2021-060189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The aim of this preplanned secondary analysis of a 12-month randomised controlled trial was to investigate the effects of a multicomponent exercise programme combined with daily whey protein, calcium and vitamin D supplementation on cognition in men with prostate cancer treated with androgen deprivation therapy (ADT). DESIGN 12-month, two-arm, randomised controlled trial. SETTING University clinical exercise centre. PARTICIPANTS 70 ADT-treated men were randomised to exercise-training plus supplementation (Ex+ Suppl, n=34) or usual care (control, n=36). INTERVENTION Men allocated to Ex + Suppl undertook thrice weekly resistance training with weight-bearing exercise training plus daily whey protein (25 g), calcium (1200 mg) and vitamin D (2000 IU) supplementation. PRIMARY AND SECONDARY OUTCOME MEASURES Cognition was assessed at baseline, 6 and 12 months via a computerised battery (CogState), Trail-making test, Rey auditory-verbal learning test and Digit span. Data were analysed with linear mixed models and an intention-to-treat and prespecified per-protocol approach (exercise-training: ≥66%, nutritional supplement: ≥80%). RESULTS Sixty (86%) men completed the trial (Ex + Suppl, n=31; control, n=29). Five (7.1%) men were classified as having mild cognitive impairment at baseline. Median (IQR) adherence to the exercise and supplement was 56% (37%-82%) and 91% (66%-97%), respectively. Ex + Suppl had no effect on cognition at any time. CONCLUSIONS A 12-month multicomponent exercise training and supplementation intervention had no significant effect on cognition in men treated with ADT for prostate cancer compared with usual care. Exercise training adherence below recommended guidelines does not support cognitive health in men treated with ADT for prostate cancer. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trial Registry (ACTRN12614000317695, registered 25/03/2014) and acknowledged under the Therapeutic Goods Administration Clinical Trial Notification Scheme (CT-2015-CTN-03372-1 v1).
Collapse
Affiliation(s)
- Niamh Liana Mundell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Jack Dalla Via
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | | | - Timo Rantalainen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Faculty of Sport and Health Sciences, Department of Health Sciences, Jyvaskylan Yliopisto, Jyvaskyla, Finland
| | - Stephen Foulkes
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jerremy Millar
- Radiation Oncology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
3
|
Pase MP, Rowsthorn E, Cavuoto MG, Lavale A, Yassi N, Maruff P, Buckley RF, Lim YY. Association of Neighborhood-Level Socioeconomic Measures With Cognition and Dementia Risk in Australian Adults. JAMA Netw Open 2022; 5:e224071. [PMID: 35333361 PMCID: PMC8956972 DOI: 10.1001/jamanetworkopen.2022.4071] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Up to 40% of dementia cases are potentially preventable; therefore, it is important to identify high-risk groups to whom resources could be targeted for maximal impact in preventing late-life dementia. The association of neighborhood-level socioeconomic status (SES) with cognition and dementia risk is not well known, particularly in midlife when late-life dementia may still be preventable through established interventions, such as blood pressure management. OBJECTIVE To examine whether neighborhood-level SES is associated with differences in cognitive performance and dementia risk scores. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study analyzed data collected between November 17, 2016, and April 14, 2020, from 4656 participants in the longitudinal population-based Healthy Brain Project cohort. This large online cohort comprised community-dwelling individuals geographically dispersed across Australia. Participants were aged 40 to 70 years without dementia or other major neurological conditions. EXPOSURES Neighborhood-level SES was computed by matching participants' residential addresses to the Australian Bureau of Statistics Index of Relative Socio-economic Advantage and Disadvantage (IRSAD). Postcodes provided by each participant were used to derive an IRSAD score that ranked participants according to deciles of neighborhood-level SES (range, 1-10, with higher deciles indicating greater socioeconomic advantage); neighborhoods in deciles 1 to 7 were considered to have low or intermediate SES, and neighborhoods in deciles 8 to 10 were considered to have high SES. MAIN OUTCOMES AND MEASURES Dementia risk estimated using the dementia risk score from the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) tool (n = 4656) and cognitive composite scores for memory and attention measured by the Cogstate Brief Battery (n = 2181). RESULTS Of 4656 participants (mean [SD] age, 56.1 [7.2] years; 3445 women [74.0%]), 2688 individuals (57.7%) lived in areas with high neighborhood-level SES (IRSAD decile ≥8), and 1968 (42.3%) lived in areas with low or intermediate neighborhood-level SES (IRSAD decile <8), with 1263 individuals (27.1%) residing in rural or regional areas. A total of 6 participants (0.1%) identified as African, 121 (2.6%) as Asian, 57 (1.2%) as Indigenous Australian, 24 (0.5%) as Latin American, 9 (0.2%) as Pacific Islander, 3671 (78.8%) as White or European, and 768 (16.5%) indicated other race (not specified). Each decile unit increase in neighborhood-level SES was associated with a lower CAIDE dementia risk score after adjustment for race and rurality (β [SE] = -0.070 [0.019]; P = .004). Each decile unit increase was also associated with better memory (β [SE] = 0.022 [0.006]; P = .006) but not with better attention (β [SE] = 0.009 [0.007]; P = .34), as measured by Cogstate Brief Battery composite z scores after adjustment for age, sex, race, years of education, and rurality. When comparing memory performance between individuals with IRSAD scores higher and lower than decile 8, neighborhood-level SES interacted with age (F1-2171 = 6.33; P = .02) and CAIDE dementia risk scores (F1-2173 = 4.02; P = .08). Differences in memory between neighborhood-level SES categories were larger among participants who were older and had a higher risk of dementia. CONCLUSIONS AND RELEVANCE In this study, higher neighborhood-level SES was associated with better memory and lower dementia risk scores. These results suggest that efforts to lower dementia risk factors in disadvantaged areas are needed to curtail the increasing burden of dementia and that inclusion of individuals living in areas with lower SES in research on dementia is warranted to improve understanding and potential interventions.
Collapse
Affiliation(s)
- Matthew P. Pase
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Ella Rowsthorn
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Marina G. Cavuoto
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Alexandra Lavale
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Paul Maruff
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- Cogstate Ltd, Melbourne, Victoria, Australia
| | - Rachel F. Buckley
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
4
|
Lynham AJ, Jones IR, Walters JTR. Web-Based Cognitive Testing in Psychiatric Research: Validation and Usability Study. J Med Internet Res 2022; 24:e28233. [PMID: 35142640 PMCID: PMC8874806 DOI: 10.2196/28233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/11/2021] [Accepted: 11/21/2021] [Indexed: 01/23/2023] Open
Abstract
Background Cognitive impairments are features of many psychiatric disorders and affect functioning. A barrier to cognitive research on psychiatric disorders is the lack of large cross-disorder data sets. However, the collection of cognitive data can be logistically challenging and expensive. Web-based collection may be an alternative; however, little is known about who does and does not complete web-based cognitive assessments for psychiatric research. Objective The aims of this study are to develop a web-based cognitive battery for use in psychiatric research, validate the battery against the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, and compare the characteristics of the participants who chose to take part with those of the individuals who did not participate. Methods Tasks were developed by The Many Brains Project and selected to measure the domains specified by the MATRICS initiative. We undertook a cross-validation study of 65 participants with schizophrenia, bipolar disorder, depression, or no history of psychiatric disorders to compare the web-based tasks with the MATRICS Consensus Cognitive Battery. Following validation, we invited participants from 2 large ongoing genetic studies, which recruited participants with psychiatric disorders to complete the battery and evaluated the demographic and clinical characteristics of those who took part. Results Correlations between web-based and MATRICS tasks ranged between 0.26 and 0.73. Of the 961 participants, 887 (92.3%) completed at least one web-based task, and 644 (67%) completed all tasks, indicating adequate completion rates. Predictors of web-based participation included being female (odds ratio [OR] 1.3, 95% CI 1.07-1.58), ethnicity other than White European (OR 0.66, 95% CI 0.46-0.96), higher levels of education (OR 1.19, 95% CI 1.11-1.29), diagnosis of an eating disorder (OR 2.17, 95% CI 1.17-4) or depression and anxiety (OR 5.12, 95% CI 3.38-7.83), and absence of a diagnosis of schizophrenia (OR 0.59, 95% CI 0.35-0.94). Lower performance on the battery was associated with poorer functioning (B=−1.76, SE 0.26; P<.001). Conclusions Our findings offer valuable insights into the advantages and disadvantages of testing cognitive function remotely for mental health research.
Collapse
Affiliation(s)
- Amy Joanne Lynham
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychiatry and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Ian R Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychiatry and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - James T R Walters
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychiatry and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| |
Collapse
|
5
|
Yassi N, Pase MP, Buckley RF, Rosenich E, Watson R, Maruff P, Lim YY. Cardiovascular Risk Associated with Poorer Memory in Middle-Aged Adults from the Healthy Brain Project. J Alzheimers Dis 2022; 86:1081-1091. [PMID: 35147538 DOI: 10.3233/jad-215375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Midlife cardiovascular risk factors (CVRF) are associated with reduced cognition and an increased risk of dementia. OBJECTIVE To further investigate this association using remote unsupervised online assessment of cognition and cardiovascular risk in middle-aged adults; and to explore the extent to which the association is altered by carriage of the APOE ɛ4 allele. METHODS The Healthy Brain Project is an online cohort of middle-aged cognitively unimpaired adults (40-70 years) who have undergone cognitive assessment and provided self-reports of demographic and health history. Cardiovascular risk was determined by ascertaining history of hypertension, hypercholesterolemia, diabetes mellitus, overweight (body mass index≥25), and current cigarette smoking. Participants (n = 2,480) were then grouped based on the number of reported CVRF into no CVRF, 1, 2, and≥3 CVRF. Associations between the number of CVRF as a continuous variable, CVRF group, and each individual CVRF with composite measures of attention, memory and subjective cognitive function were investigated. RESULTS Higher number of CVRF was associated with poorer attention (β= -0.042, p = 0.039) and memory (β= -0.080, p < 0.001), but not with subjective cognitive function. When considered individually, current smoking (β= -0.400, p = 0.015), diabetes (β= -0.251, p = 0.023), and hypercholesterolemia (β= -0.109, p = 0.044) were independently associated with poorer memory performance. APOE ɛ4 carriers with≥1 CVRF performed worse on memory than ɛ4 carriers with no CVRFs (β(SE) = 0.259(0.077), p = 0.004). This was not observed in ɛ4 non-carriers. CONCLUSION In cognitively normal middle-aged adults, CVRF were associated with poorer cognition, particularly in the memory domain. These results support feasibility of online assessment of cardiovascular risk for cognitive impairment.
Collapse
Affiliation(s)
- Nawaf Yassi
- Departments of Medicine and Neurology, Melbourne Brain Centre @ The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.,Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Matthew P Pase
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rachel F Buckley
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia.,Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Emily Rosenich
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia
| | - Rosie Watson
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.,Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Paul Maruff
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia.,Cogstate Ltd., Melbourne, VIC, Australia
| | - Yen Ying Lim
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia
| |
Collapse
|
6
|
Elucidating the association between depression, anxiety, and cognition in middle-aged adults: Application of dimensional and categorical approaches. J Affect Disord 2022; 296:559-566. [PMID: 34648818 DOI: 10.1016/j.jad.2021.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND In older adults, depressive and anxiety symptoms are associated with dementia risk, and represent a manifestation of the dementia prodrome. Understanding how these symptoms are related to cognition in midlife may inform risk models of dementia. METHODS This study examined the relationship between depressive and anxiety symptoms, and cognition, in a sample (n= 2,657) of participants enrolled in the Healthy Brain Project. Depressive and Anxiety symptoms were assessed using the Depression Anxiety and Stress Scale, Hospital Anxiety and Depression Scale, and centre for Epidemiological Studies Depression Scale. Objective cognition was assessed using the Cogstate Brief Battery and subjective cognition assessed using the Alzheimer's disease Cooperative Study Cognitive Function Instrument. RESULTS Somatic- and panic-related anxiety symptoms were associated significantly with poorer attention; while tension- and panic-related anxiety were associated significantly with poorer memory. Having clinically meaningful anxiety or depressive symptoms was associated with increased subjective cognitive concerns (d=-0.37). This was further increased for those with clinically meaningful anxiety and depressive symptoms (d = -1.07). LIMITATIONS This study reports cross-sectional data, and uses a sample enriched with individuals with a family history of dementia who are therefore at a higher risk of developing dementia compared to the general population. Additionally, biological markers such as cortisol, Aβ, and tau were unavailable. CONCLUSION The results support the hypothesis that depressive and anxiety symptoms may increase risk of cognitive decline. Further, they suggest that using depression and anxiety as clinical markers may be helpful in identifying the earliest signs of cognitive decline.
Collapse
|
7
|
Edgar CJ, Siemers E, Maruff P, Petersen RC, Aisen PS, Weiner MW, Albala B. Pilot Evaluation of the Unsupervised, At-Home Cogstate Brief Battery in ADNI-2. J Alzheimers Dis 2021; 83:915-925. [PMID: 34366337 PMCID: PMC8543269 DOI: 10.3233/jad-210201] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: There is a need for feasible, scalable assessments to detect cognitive impairment and decline. The Cogstate Brief Battery (CBB) is validated for Alzheimer’s disease (AD) and in unsupervised and bring your own device contexts. The CBB has shown usability for self-completion in the home but has not been employed in this way in a multisite clinical trial in AD. Objective: The objective of the pilot was to evaluate feasibility of at-home, self-completion of the CBB in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) over 24 months. Methods: The CBB was included as a pilot for cognitively normal (CN) and mild cognitive impairment (MCI) participants in ADNI-2, invited to take the assessment in-clinic, then at at-home over a period of 24 months follow-up. Data were analyzed to explore acceptability/usability, concordance of in-clinic and at-home assessment, and validity. Results: Data were collected for 104 participants (46 CN, 51 MCI, and 7 AD) who consented to provide CBB data. Subsequent analyses were performed for the CN and MCI groups only. Test completion rates were 100%for both the first in-clinic supervised and first at-home unsupervised assessments, with few repeat performances required. However, available follow-up data declined sharply over time. Good concordance was seen between in-clinic and at-home assessments, with non-significant and small effect size differences (Cohen’s d between -0.04 and 0.28) and generally moderate correlations (r = 0.42 to 0.73). Known groups validity was also supported (11/16 comparisons with Cohen’s d≥0.3). Conclusion: These data demonstrate the feasibility of use for the CBB for unsupervised at-home, testing, including MCI groups. Optimal approaches to the application of assessments to support compliance over time remain to be determined.
Collapse
Affiliation(s)
| | | | | | | | - Paul S Aisen
- University of Southern California, San Diego, CA, USA
| | - Michael W Weiner
- Department of Radiology, Medicine, and Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | | | | |
Collapse
|
8
|
Lim YY, Pase MP, Buckley RF, Yassi N, Bransby L, Fowler C, Laws SM, Masters CL, Maruff P. Visual Memory Deficits in Middle-Aged APOE ɛ4 Homozygotes Detected Using Unsupervised Cognitive Assessments. J Alzheimers Dis 2021; 79:1563-1573. [DOI: 10.3233/jad-201281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The apolipoprotein E (APOE) ɛ4 allele is associated with dose-response effects on cognitive dysfunction and dementia risk in older adults. However, its effects on cognition in middle-aged adults remains unclear. Objective: We examined effects of ɛ4 heterozygosity and homozygosity on objective and subjective cognition in middle-aged adults enrolled in the Healthy Brain Project (HBP) and in older adults from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study. Methods: HBP participants (1,000 non-carriers; 450 ɛ4 heterozygotes; 50 ɛ4 homozygotes) completed unsupervised assessments of the Cogstate Brief Battery (CBB), ratings of subjective cognitive function and provided a saliva sample. AIBL cognitively normal participants (650 non-carriers; 204 ɛ4 heterozygotes; 31 ɛ4 homozygotes) completed in-person assessments of the CBB, ratings of subjective cognitive function and provided a blood sample. Results: Greater memory impairment was observed in middle-aged ɛ4 homozygotes compared with ɛ4 heterozygotes and non-carriers. When data from middle-aged (HBP) and older (AIBL) adults were pooled, the effect of ɛ4 homozygosity and memory impairment increased with age. In both middle-aged and older adults, ɛ4 heterozygotes did not differ from non-carriers on any measure of objective or subjective cognition. Conclusion: Memory impairment in ɛ4 homozygotes is evident in adults aged 50-60 years, and this can be detected through unsupervised cognitive assessments. The effect of ɛ4 homozygosity increases with older age. APOE ɛ4 homozygosity has a negative impact on memory as early as midlife, but due to the subtle magnitude of effect, our findings support the necessity of online platforms in large cohorts to assess these complex relationships.
Collapse
Affiliation(s)
- Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Matthew P. Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rachel F. Buckley
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Lisa Bransby
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Christopher Fowler
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Simon M. Laws
- Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Colin L. Masters
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
- Cogstate Ltd., Melbourne, Victoria, Australia
| |
Collapse
|
9
|
Cyr AA, Romero K, Galin-Corini L. Web-Based Cognitive Testing of Older Adults in Person Versus at Home: Within-Subjects Comparison Study. JMIR Aging 2021; 4:e23384. [PMID: 33522972 PMCID: PMC8081157 DOI: 10.2196/23384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 01/30/2023] Open
Abstract
Background Web-based research allows cognitive psychologists to collect high-quality data from a diverse pool of participants with fewer resources. However, web-based testing presents unique challenges for researchers and clinicians working with aging populations. Older adults may be less familiar with computer usage than their younger peers, leading to differences in performance when completing web-based tasks in their home versus in the laboratory under the supervision of an experimenter. Objective This study aimed to use a within-subjects design to compare the performance of healthy older adults on computerized cognitive tasks completed at home and in the laboratory. Familiarity and attitudes surrounding computer use were also examined. Methods In total, 32 community-dwelling healthy adults aged above 65 years completed computerized versions of the word-color Stroop task, paired associates learning, and verbal and matrix reasoning in 2 testing environments: at home (unsupervised) and in the laboratory (supervised). The paper-and-pencil neuropsychological versions of these tasks were also administered, along with questionnaires examining computer attitudes and familiarity. The order of testing environments was counterbalanced across participants. Results Analyses of variance conducted on scores from the computerized cognitive tasks revealed no significant effect of the testing environment and no correlation with computer familiarity or attitudes. These null effects were confirmed with follow-up Bayesian analyses. Moreover, performance on the computerized tasks correlated positively with performance on their paper-and-pencil equivalents. Conclusions Our findings show comparable performance on computerized cognitive tasks in at-home and laboratory testing environments. These findings have implications for researchers and clinicians wishing to harness web-based testing to collect meaningful data from older adult populations.
Collapse
Affiliation(s)
- Andrée-Ann Cyr
- Department of Psychology, Glendon Campus, York University, Toronto, ON, Canada
| | - Kristoffer Romero
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Laura Galin-Corini
- Department of Psychology, Glendon Campus, York University, Toronto, ON, Canada
| |
Collapse
|
10
|
Thompson F, Cysique LA, Harriss LR, Taylor S, Savage G, Maruff P, Mcdermott R. Acceptability and Usability of Computerized Cognitive Assessment Among Australian Indigenous Residents of the Torres Strait Islands. Arch Clin Neuropsychol 2020; 35:1288-1302. [PMID: 32647858 DOI: 10.1093/arclin/acaa037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/23/2020] [Accepted: 05/29/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This cross-sectional study aimed to investigate the acceptability and usability of the Cogstate Brief Battery (CBB) in a community-based sample of Australian Indigenous people from the Torres Strait region, based on a user experience framework of human-computer interaction. METHODS Two-hundred community participants completed the four subtests of the CBB on an iPad platform, during a free adult health check on two islands in the region, between October and December 2016. Acceptability was defined as completing the learning trial of a task and usability as continuing a task through to completion, determined by examiner acumen and internal Cogstate completion and integrity criteria. These were combined into a single dichotomous completion measure for logistic regression analyses. Performance-measured as reaction times and accuracy of responses-was analyzed using linear regression analyses. RESULTS CBB completion ranged from 82.0% to 91.5% across the four tasks and the odds of completing decreased with age. After adjusting for age, iPad/tablet familiarity increased the odds of completion for all tasks while level of education and employment increased the odds for some tasks only. These variables accounted for 18.0%-23.8% of the variance in reaction times on speeded tasks. Age and education had the most effect, although semipartial correlations were modest. CONCLUSIONS When administered in a health-screening context, the acceptability and usability of the CBB were greatest in young- to middle-aged participants with some education and iPad/tablet experience. Older and more vulnerable participants may have benefited from additional time and practice on the CBB prior to administration.
Collapse
Affiliation(s)
- Fintan Thompson
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Lucette A Cysique
- Neurosciences Research Australia, Psychology Department, University of New South Wales, Sydney, New South Wales, Australia
| | - Linton R Harriss
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Sean Taylor
- Top End Health Service, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Greg Savage
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | | | - Robyn Mcdermott
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| |
Collapse
|
11
|
Perin S, Buckley RF, Pase MP, Yassi N, Lavale A, Wilson PH, Schembri A, Maruff P, Lim YY. Unsupervised assessment of cognition in the Healthy Brain Project: Implications for web-based registries of individuals at risk for Alzheimer's disease. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12043. [PMID: 32607409 PMCID: PMC7317647 DOI: 10.1002/trc2.12043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/26/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Web-based platforms are used increasingly to assess cognitive function in unsupervised settings. The utility of cognitive data arising from unsupervised assessments remains unclear. We examined the acceptability, usability, and validity of unsupervised cognitive testing in middle-aged adults enrolled in the Healthy Brain Project. METHODS A total of 1594 participants completed unsupervised assessments of the Cogstate Brief Battery. Acceptability was defined by the amount of missing data, and usability by examining error of test performance and the time taken to read task instructions and complete tests (learnability). RESULTS Overall, we observed high acceptability (98% complete data) and high usability (95% met criteria for low error rates and high learnability). Test validity was confirmed by observation of expected inverse relationships between performance and increasing test difficulty and age. CONCLUSION Consideration of test design paired with acceptability and usability criteria can provide valid indices of cognition in the unsupervised settings used to develop registries of individuals at risk for Alzheimer's disease.
Collapse
Affiliation(s)
- Stephanie Perin
- Melbourne Dementia Research CentreFlorey Institute of Neuroscience and Mental Health and the University of MelbourneParkvilleVictoriaAustralia
- School of Psychological Sciences, Turner Institute for Brain and Mental HealthMonash UniversityClaytonVictoriaAustralia
- School of PsychologyFaculty of Health SciencesAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Rachel F. Buckley
- Melbourne Dementia Research CentreFlorey Institute of Neuroscience and Mental Health and the University of MelbourneParkvilleVictoriaAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Department of NeurologyMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Matthew P. Pase
- Melbourne Dementia Research CentreFlorey Institute of Neuroscience and Mental Health and the University of MelbourneParkvilleVictoriaAustralia
- School of Psychological Sciences, Turner Institute for Brain and Mental HealthMonash UniversityClaytonVictoriaAustralia
- Harvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Nawaf Yassi
- Melbourne Dementia Research CentreFlorey Institute of Neuroscience and Mental Health and the University of MelbourneParkvilleVictoriaAustralia
- Department of Medicine and NeurologyMelbourne Brain Centre at The Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
- Population Health and Immunity DivisionThe Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
| | - Alexandra Lavale
- Melbourne Dementia Research CentreFlorey Institute of Neuroscience and Mental Health and the University of MelbourneParkvilleVictoriaAustralia
- School of Psychological Sciences, Turner Institute for Brain and Mental HealthMonash UniversityClaytonVictoriaAustralia
| | - Peter H. Wilson
- School of PsychologyFaculty of Health SciencesAustralian Catholic UniversityMelbourneVictoriaAustralia
| | | | - Paul Maruff
- Melbourne Dementia Research CentreFlorey Institute of Neuroscience and Mental Health and the University of MelbourneParkvilleVictoriaAustralia
- Cogstate LtdMelbourneVictoriaAustralia
| | - Yen Ying Lim
- Melbourne Dementia Research CentreFlorey Institute of Neuroscience and Mental Health and the University of MelbourneParkvilleVictoriaAustralia
- School of Psychological Sciences, Turner Institute for Brain and Mental HealthMonash UniversityClaytonVictoriaAustralia
| |
Collapse
|
12
|
Cerhan JH, Caine C, Anderson SK, Johnson DR, Lachance DH, Yan E, Brown PD. Preliminary exploration of a computerized cognitive battery and comparison with traditional testing in patients with high-grade glioma. Neurooncol Pract 2019; 6:71-77. [PMID: 31386012 DOI: 10.1093/nop/npy013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Cognitive function is an important outcome measure in many brain tumor clinical trials, and investigators are interested in employing the most efficient methods of cognitive assessment for this purpose. Computerized testing can be appealing because of the perceived ease of use and electronic data generated. Traditional tests may have the advantage of accumulated validity evidence and comparability across historic trials. Methods We evaluated feasibility of a Cogstate battery in 39 patients with high-grade glioma, and compared it with a commonly used paper-and-pencil battery. Results Both batteries were well tolerated and rated equally likeable. Correlations between the batteries were low to low-moderate. More patients showed impairment at baseline and decline across trials on traditional tests. Conclusions Both batteries were well tolerated, but the most complicated tasks (from both batteries) could not be completed by all subjects. Preliminary validity evidence for the Cogstate tasks was mixed, but a larger sample is needed.
Collapse
Affiliation(s)
- Jane H Cerhan
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Chip Caine
- Intermountain Medical Center, Neurosciences Institute, Intermountain Medical Center, Murray, Utah.,University of Phoenix, Utah Campus
| | - S Keith Anderson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | - Elizabeth Yan
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - Paul D Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| |
Collapse
|
13
|
Uncertainty Analysis of Mobile Phone Use and Its Effect on Cognitive Function: The Application of Monte Carlo Simulation in a Cohort of Australian Primary School Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132428. [PMID: 31288491 PMCID: PMC6651811 DOI: 10.3390/ijerph16132428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 11/19/2022]
Abstract
Previous epidemiological studies on health effects of radiation exposure from mobile phones have produced inconsistent results. This may be due to experimental difficulties and various sources of uncertainty, such as statistical variability, measurement errors, and model uncertainty. An analytical technique known as the Monte Carlo simulation provides an additional approach to analysis by addressing uncertainty in model inputs using error probability distributions, rather than point-source data. The aim of this investigation was to demonstrate using Monte Carlo simulation of data from the ExPOSURE (Examination of Psychological Outcomes in Students using Radiofrequency dEvices) study to quantify uncertainty in the output of the model. Data were collected twice, approximately one year apart (between 2011 and 2013) for 412 primary school participants in Australia. Monte Carlo simulation was used to estimate output uncertainty in the model due to uncertainties in the call exposure data. Multiple linear regression models evaluated associations between mobile phone calls with cognitive function and found weak evidence of an association. Similar to previous longitudinal analysis, associations were found for the Go/No Go and Groton maze learning tasks, and a Stroop time ratio. However, with the introduction of uncertainty analysis, the results were closer to the null hypothesis.
Collapse
|
14
|
Takaeda K, Kamimura T, Inoue T, Nishiura Y. Reliability and acceptability of using a social robot to carry out cognitive tests for community-dwelling older adults. Geriatr Gerontol Int 2019; 19:552-556. [PMID: 30884153 DOI: 10.1111/ggi.13655] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 02/07/2019] [Accepted: 02/18/2019] [Indexed: 11/30/2022]
Abstract
AIM To improve access to cognitive testing for older adults, the reliability and acceptability of a speech-based cognitive test administered by a social robot were investigated. METHODS The Japanese version of the Telephone Interview for Cognitive Status was administered by a social robot to participants recruited from retirement homes and adult daycare facilities. The robot's dialogue and gestures were preprogrammed, while the researcher controlled the timing of proceeding to the next question and scored participants' responses. We examined the internal consistency, alternate form reliability (experiment 1) and test-retest reliability (experiment 2) of the cognitive test. The acceptability of the cognitive test was also examined using a questionnaire in experiment 2. RESULTS A total of 66 individuals (mean age 81.2 ± 5.8 years) participated in experiment 1; the internal consistency (Cronbach's α) of the test was 0.691 and its alternate form reliability (measured by interclass correlation coefficient) was 0.728. A total of 40 of these individuals (mean age 82.0 ± 5.4 years) also participated in experiment 2, and the test-retest reliability was 0.818. According to the questionnaire responses, over half of the participants wanted (or very much wanted) to use the robot version of the test to measure the deterioration of their cognitive function. CONCLUSIONS A robot-administered cognitive test might have satisfactory reliability and acceptability to community-dwelling older adults if those aspects of the test implemented by the researcher can also be successfully automated. Geriatr Gerontol Int 2019; 19: 552-556.
Collapse
Affiliation(s)
- Kana Takaeda
- Department of Medical Sciences, Graduate School of Medicine, Shinshu University, Matsumoto, Japan
| | - Tomoko Kamimura
- Department of Medical Sciences, Graduate School of Medicine, Shinshu University, Matsumoto, Japan
| | - Takenobu Inoue
- Department of Assistive Technology, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Yuko Nishiura
- Department of Assistive Technology, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| |
Collapse
|
15
|
De Meijer L, Merlo D, Skibina O, Grobbee EJ, Gale J, Haartsen J, Maruff P, Darby D, Butzkueven H, Van der Walt A. Monitoring cognitive change in multiple sclerosis using a computerized cognitive battery. Mult Scler J Exp Transl Clin 2018; 4:2055217318815513. [PMID: 30559973 PMCID: PMC6293367 DOI: 10.1177/2055217318815513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/11/2018] [Accepted: 11/01/2018] [Indexed: 11/15/2022] Open
Abstract
Background Cognitive monitoring that can detect short-term change in multiple sclerosis is challenging. Computerized cognitive batteries such as the CogState Brief Battery can rapidly assess commonly affected cognitive domains. Objectives The purpose of this study was to establish the acceptability and sensitivity of the CogState Brief Battery in multiple sclerosis patients compared to controls. We compared the sensitivity of the CogState Brief Battery to that of the Paced Auditory Serial Addition Test over 12 months. Methods Demographics, Expanded Disability Status Scale scores, depression and anxiety scores were compared with CogState Brief Battery and Paced Auditory Serial Addition Test performances of 51 patients with relapsing-remitting multiple sclerosis, 19 with secondary progressive multiple sclerosis and 40 healthy controls. Longitudinal data in 37 relapsing-remitting multiple sclerosis patients were evaluated using linear mixed models. Results Both the CogState Brief Battery and the Paced Auditory Serial Addition Test discriminated between multiple sclerosis and healthy controls at baseline (p<0.001). CogState Brief Battery tasks were more acceptable and caused less anxiety than the Paced Auditory Serial Addition Test (p<0.001). In relapsing-remitting multiple sclerosis patients, reaction time slowed over 12 months (p<0.001) for the CogState Brief Battery Detection (mean change -34.23 ms) and Identification (-25.31 ms) tasks. Paced Auditory Serial Addition Test scores did not change over this time. Conclusions The CogState Brief Battery is highly acceptable and better able to detect cognitive change than the Paced Auditory Serial Addition Test. The CogState Brief Battery could potentially be used as a practical cognitive monitoring tool in the multiple sclerosis clinic setting.
Collapse
Affiliation(s)
- L De Meijer
- Rijksuniversiteit, The Netherlands.,Erasmus MC Medical Center, The Netherlands
| | - D Merlo
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neuroscience, Monash University, Australia
| | - O Skibina
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neurology, Eastern Health, Australia.,Department of Neurology, Alfred Health, Australia
| | | | | | - J Haartsen
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neurology, Eastern Health, Australia
| | - P Maruff
- Department of Neuroscience, Monash University, Australia
| | - D Darby
- Department of Neurology, Eastern Health, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia
| | - H Butzkueven
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neuroscience, Monash University, Australia.,Department of Neurology, Eastern Health, Australia.,Department of Neurology, Alfred Health, Australia
| | - A Van der Walt
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neuroscience, Monash University, Australia.,Department of Neurology, Eastern Health, Australia.,Department of Neurology, Alfred Health, Australia.,These authors contributed equally
| |
Collapse
|
16
|
White N, Flannery L, McClintock A, Machado L. Repeated computerized cognitive testing: Performance shifts and test–retest reliability in healthy older adults. J Clin Exp Neuropsychol 2018; 41:179-191. [DOI: 10.1080/13803395.2018.1526888] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Naomi White
- Department of Psychology and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand, Dunedin, New Zealand
| | - Larnee Flannery
- Department of Psychology and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - Alice McClintock
- Department of Psychology and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - Liana Machado
- Department of Psychology and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand, Dunedin, New Zealand
| |
Collapse
|
17
|
Radiofrequency Electromagnetic Radiation and Memory Performance: Sources of Uncertainty in Epidemiological Cohort Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040592. [PMID: 29587425 PMCID: PMC5923634 DOI: 10.3390/ijerph15040592] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/21/2018] [Accepted: 03/23/2018] [Indexed: 12/23/2022]
Abstract
Uncertainty in experimental studies of exposure to radiation from mobile phones has in the past only been framed within the context of statistical variability. It is now becoming more apparent to researchers that epistemic or reducible uncertainties can also affect the total error in results. These uncertainties are derived from a wide range of sources including human error, such as data transcription, model structure, measurement and linguistic errors in communication. The issue of epistemic uncertainty is reviewed and interpreted in the context of the MoRPhEUS, ExPOSURE and HERMES cohort studies which investigate the effect of radiofrequency electromagnetic radiation from mobile phones on memory performance. Research into this field has found inconsistent results due to limitations from a range of epistemic sources. Potential analytic approaches are suggested based on quantification of epistemic error using Monte Carlo simulation. It is recommended that future studies investigating the relationship between radiofrequency electromagnetic radiation and memory performance pay more attention to treatment of epistemic uncertainties as well as further research into improving exposure assessment. Use of directed acyclic graphs is also encouraged to display the assumed covariate relationship.
Collapse
|
18
|
Barth J, Nickel F, Kolominsky-Rabas PL. Diagnosis of cognitive decline and dementia in rural areas - A scoping review. Int J Geriatr Psychiatry 2018; 33:459-474. [PMID: 29314221 DOI: 10.1002/gps.4841] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/21/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Due to the demographic change, the global prevalence of dementia will continually rise. Barriers to diagnosis and care are still high. But timely diagnosis is associated with valuable benefits and can promote timely and optimal management. Receiving an early diagnosis is especially in rural areas a problem due to the limited access to assessments. Therefore, the aim of our scoping review is to investigate different interventions targeted at rural living elderly to screen and diagnose cognitive decline and dementia. METHODS A scoping review was conducted in line with the framework of Arksey and O'Malley. The following databases were systematically searched: PubMed, PsycINFO, Cochrane Library, and ScienceDirect. The interventions were categorized in four main categories (interventions for general practitioners/institutions; online/mobile offers; telehealth applications; telephone-based screenings). RESULTS Thirty studies were included. The four categories show different scopes of application. Telehealth applications show that it is feasible and valid to diagnose dementia via videoconference. Assessments described in three other categories show that remotely used tools are appropriate to screen for mild cognitive impairment or cognitive decline, but are not valid to establish a dementia diagnosis. CONCLUSIONS Telehealth applications can appropriately be used to diagnose dementia. However, most of the studies included only small sample sizes and did not test the applications explicitly in rural or remote populations. Therefore, studies taking these limitations into account are needed. On top, only two RCTs are included in this review indicating that more high quality studies in this field are needed.
Collapse
Affiliation(s)
- Janina Barth
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-University of Erlangen-Nürnberg, Germany.,National Graduate College "Optimization strategies in Dementia (OptiDem)", Karl and Veronica Carstens-Foundation, Essen, Germany
| | - Franziska Nickel
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-University of Erlangen-Nürnberg, Germany.,National Graduate College "Optimization strategies in Dementia (OptiDem)", Karl and Veronica Carstens-Foundation, Essen, Germany
| | - Peter L Kolominsky-Rabas
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander-University of Erlangen-Nürnberg, Germany.,National Graduate College "Optimization strategies in Dementia (OptiDem)", Karl and Veronica Carstens-Foundation, Essen, Germany
| |
Collapse
|
19
|
Feenstra HEM, Murre JMJ, Vermeulen IE, Kieffer JM, Schagen SB. Reliability and validity of a self-administered tool for online neuropsychological testing: The Amsterdam Cognition Scan. J Clin Exp Neuropsychol 2017; 40:253-273. [PMID: 28671504 DOI: 10.1080/13803395.2017.1339017] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION To facilitate large-scale assessment of a variety of cognitive abilities in clinical studies, we developed a self-administered online neuropsychological test battery: the Amsterdam Cognition Scan (ACS). The current studies evaluate in a group of adult cancer patients: test-retest reliability of the ACS and the influence of test setting (home or hospital), and the relationship between our online and a traditional test battery (concurrent validity). METHOD Test-retest reliability was studied in 96 cancer patients (57 female; Mage = 51.8 years) who completed the ACS twice. Intraclass correlation coefficients (ICCs) were used to assess consistency over time. The test setting was counterbalanced between home and hospital; influence on test performance was assessed by repeated measures analyses of variance. Concurrent validity was studied in 201 cancer patients (112 female; Mage = 53.5 years) who completed both the online and an equivalent traditional neuropsychological test battery. Spearman or Pearson correlations were used to assess consistency between online and traditional tests. RESULTS ICCs of the online tests ranged from .29 to .76, with an ICC of .78 for the ACS total score. These correlations are generally comparable with the test-retest correlations of the traditional tests as reported in the literature. Correlating online and traditional test scores, we observed medium to large concurrent validity (r/ρ = .42 to .70; total score r = .78), except for a visuospatial memory test (ρ = .36). Correlations were affected-as expected-by design differences between online tests and their offline counterparts. CONCLUSIONS Although development and optimization of the ACS is an ongoing process, and reliability can be optimized for several tests, our results indicate that it is a highly usable tool to obtain (online) measures of various cognitive abilities. The ACS is expected to facilitate efficient gathering of data on cognitive functioning in the near future.
Collapse
Affiliation(s)
- Heleen E M Feenstra
- a Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jaap M J Murre
- b Department of Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Ivar E Vermeulen
- c Department of Communication Science , VU University Amsterdam , Amsterdam , The Netherlands
| | - Jacobien M Kieffer
- a Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Sanne B Schagen
- a Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute , Amsterdam , The Netherlands.,b Department of Psychology , University of Amsterdam , Amsterdam , The Netherlands
| |
Collapse
|
20
|
Patel SK, Meier AM, Fernandez N, Lo TTY, Moore C, Delgado N. Convergent and criterion validity of the CogState computerized brief battery cognitive assessment in women with and without breast cancer. Clin Neuropsychol 2017; 31:1375-1386. [PMID: 28080264 DOI: 10.1080/13854046.2016.1275819] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Computerized tests have increasingly garnered interest for assessing cognitive functioning due to their potential logistical and financial advantages over traditional 'pencil and-paper' neuropsychological tests. However, psychometric information is necessary to guide decisions about their clinical and research utility with varied populations. We explored the convergent construct validity and criterion validity of the CogState computerized tests in breast cancer survivors, a group known to present with mostly mild, subtle cognitive dysfunction. METHOD Fifty-three post-menopausal women (26 breast cancer survivors, 27 healthy controls) completed the CogState Brief Battery tests with passed performance checks, conceptually matched traditional neuropsychological tests, and a self-report measure of daily functioning, the Functional Activities Questionnaire. RESULTS Significant positive correlations were found between the CogState Brief Battery tests and traditional neuropsychological tests, although the traditional tests specifically hypothesized to correlate with CogState tests did not reach statistical significance. Analysis of Covariance results showed preliminary support for criterion validity, as the patient and control groups differed on the traditional test of working memory (Digits Backwards, p = .01), with a trend towards significance for the CogState test of working memory (One Back, p = .02), controlled for age, race, and mood. CONCLUSIONS The results provide preliminary support for further research to determine if the CogState tests are viable as screening tools to detect subtle cognitive differences between breast cancer survivors and healthy women. Our study was limited by the low base rate of cognitive impairment and small sample size. We recommend further research employing sufficiently powered sample sizes and a longitudinal, repeated measures study design.
Collapse
Affiliation(s)
- Sunita K Patel
- a Department of Population Sciences , City of Hope , Duarte , CA , USA.,b Department of Supportive Care Medicine , City of Hope , Duarte , CA , USA
| | - Adrienne M Meier
- a Department of Population Sciences , City of Hope , Duarte , CA , USA.,b Department of Supportive Care Medicine , City of Hope , Duarte , CA , USA
| | | | - Tracy T Y Lo
- a Department of Population Sciences , City of Hope , Duarte , CA , USA.,b Department of Supportive Care Medicine , City of Hope , Duarte , CA , USA
| | - Colleen Moore
- a Department of Population Sciences , City of Hope , Duarte , CA , USA
| | - Nicole Delgado
- a Department of Population Sciences , City of Hope , Duarte , CA , USA
| |
Collapse
|
21
|
Hansen T, Lehn H, Evensmoen H, Håberg A. Initial assessment of reliability of a self-administered web-based neuropsychological test battery. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
22
|
Feenstra HEM, Vermeulen IE, Murre JMJ, Schagen SB. Online cognition: factors facilitating reliable online neuropsychological test results. Clin Neuropsychol 2016; 31:59-84. [DOI: 10.1080/13854046.2016.1190405] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Heleen E. M. Feenstra
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ivar E. Vermeulen
- Department of Communication Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jaap M. J. Murre
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanne B. Schagen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Redmayne M, Smith CL, Benke G, Croft RJ, Dalecki A, Dimitriadis C, Kaufman J, Macleod S, Sim MR, Wolfe R, Abramson MJ. Use of mobile and cordless phones and cognition in Australian primary school children: a prospective cohort study. Environ Health 2016; 15:26. [PMID: 26892106 PMCID: PMC4759913 DOI: 10.1186/s12940-016-0116-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 02/05/2016] [Indexed: 05/20/2023]
Abstract
BACKGROUND Use of mobile (MP) and cordless phones (CP) is common among young children, but whether the resulting radiofrequency exposure affects development of cognitive skills is not known. Small changes have been found in older children. This study focused on children's exposures to MP and CP and cognitive development. The hypothesis was that children who used these phones would display differences in cognitive function compared to those who did not. METHODS We recruited 619 fourth-grade students (8-11 years) from 37 schools around Melbourne and Wollongong, Australia. Participants completed a short questionnaire, a computerised cognitive test battery, and the Stroop colour-word test. Parents completed exposure questionnaires on their child's behalf. Analysis used multiple linear regression. The principal exposure-metrics were the total number of reported MP and CP calls weekly categorised into no use ('None'); use less than or equal to the median amount ('Some'); and use more than the median ('More'). The median number of calls/week was 2.5 for MP and 2.0 for CP. RESULTS MP and CP use for calls was low; and only 5 of 78 comparisons of phone use with cognitive measures were statistically significant. The reaction time to the response-inhibition task was slower in those who used an MP 'More' compared to the 'Some' use group and non-users. For CP use, the response time to the Stroop interference task was slower in the 'More' group versus the 'Some' group, and accuracy was worse in visual recognition and episodic memory tasks and the identification task. In an additional exploratory analysis, there was some evidence of a gender effect on mean reaction times. The highest users for both phone types were girls. CONCLUSIONS Overall, there was little evidence cognitive function was associated with CP and MP use in this age group. Although there was some evidence that effects of MP and CP use on cognition may differ by gender, this needs further exploration. CP results may be more reliable as parents estimated children's phone use and the CPs were at home; results for CP use were broadly consistent with our earlier study of older children.
Collapse
Affiliation(s)
- Mary Redmayne
- Population Health Research on Electromagnetic Energy (PRESEE), School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia.
| | - Catherine L Smith
- Population Health Research on Electromagnetic Energy (PRESEE), School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia.
| | - Geza Benke
- Population Health Research on Electromagnetic Energy (PRESEE), School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia.
| | - Rodney J Croft
- Population Health Research on Electromagnetic Energy (PRESEE), School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia.
- School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Anna Dalecki
- School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Christina Dimitriadis
- Population Health Research on Electromagnetic Energy (PRESEE), School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia.
| | - Jordy Kaufman
- Swinburne University of Technology, John Street, Hawthorn, VIC, 3122, Australia.
| | - Skye Macleod
- School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Malcolm R Sim
- Population Health Research on Electromagnetic Energy (PRESEE), School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia.
| | - Rory Wolfe
- Population Health Research on Electromagnetic Energy (PRESEE), School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia.
| | - Michael J Abramson
- Population Health Research on Electromagnetic Energy (PRESEE), School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia.
| |
Collapse
|
24
|
Lim YY, Maruff P, Schindler R, Ott BR, Salloway S, Yoo DC, Noto RB, Santos CY, Snyder PJ. Disruption of cholinergic neurotransmission exacerbates Aβ-related cognitive impairment in preclinical Alzheimer's disease. Neurobiol Aging 2015; 36:2709-15. [PMID: 26233262 DOI: 10.1016/j.neurobiolaging.2015.07.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 07/03/2015] [Accepted: 07/03/2015] [Indexed: 12/18/2022]
Abstract
Disruption in cholinergic neurotransmission is one of the earliest neuropathological changes in preclinical Alzheimer's disease (AD) and may be associated with abnormal beta-amyloid (Aβ) accumulation. Therefore, disruption of cholinergic neurotransmission with scopolamine may unmask otherwise undetectable cognitive deficits in preclinical AD. To compare the effects of low-dose (0.20 mg s.c.) scopolamine on cognition between Aβ+ and Aβ- cognitively normal (CN) older adults using the Groton Maze Learning Test (GMLT). CN older adults completed the GMLT predose and then received scopolamine (0.20 mg) subcutaneously. Participants were reassessed 1-, 3-, 5-, 7-, and 8-hours post dose. All participants underwent positron emission tomography neuroimaging for Aβ using (18)F-florbetapir within 6 weeks of their baseline visit. Rhode Island Hospital Clinical Research Center, Providence, USA. CN older adults (n = 63), with a family history of AD and subjective memory complaints were enrolled (15 were classified as Aβ+ and 48 were classified as Aβ-). Cognition was assessed using the computerized GMLT at all predose and post-dose time points. At 5-hours post dose, the Aβ+ group performed significantly worse than the Aβ- group on all measures of learning efficiency and working memory and/or executive function (Cohen's d = 1.13-1.56). When participants were classified as having an abnormal response to scopolamine (based on change score at 5-hours post dose >0), 100% were correctly classified as Aβ+ and 67% as Aβ-. The results of this study suggest that diminished cholinergic tone likely occurs in preclinical AD, and as such, the use of a cholinergic stress test to perturb an already compromised neurotransmitter system may be an effective way of identifying CN older adults who are in this preclinical stage of AD.
Collapse
Affiliation(s)
- Yen Ying Lim
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Paul Maruff
- Cogstate Ltd, Melbourne, Victoria, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Brian R Ott
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Stephen Salloway
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Don C Yoo
- Department of Radiology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Richard B Noto
- Department of Radiology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Cláudia Y Santos
- Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, RI, USA
| | - Peter J Snyder
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA; Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, RI, USA; Lifespan Clinical Research Center, Rhode Island Hospital, Providence, RI, USA.
| |
Collapse
|
25
|
Scanlon L, O'Shea E, O'Caoimh R, Timmons S. Usability and Validity of a Battery of Computerised Cognitive Screening Tests for Detecting Cognitive Impairment. Gerontology 2015; 62:247-52. [PMID: 26113397 DOI: 10.1159/000433432] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/19/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Computerised cognitive screening (CCS) has the potential to detect cognitive impairment in the community, which is important for the early diagnosis of dementia. OBJECTIVE The aim of this study was to investigate the ability of older adults with dementia to engage with smart phone and tablet technologies and to determine the accuracy of a battery of CCS tasks to detect cognitive impairment in comparison with the Montreal Cognitive Assessment (MoCA). METHODS Patients with mild-moderate dementia (n = 40) attending a university-linked day hospital and normal controls (n = 20) completed (i) a questionnaire detailing the frequency and breadth of their technology use, (ii) three commercially available CCS tasks, and (iii) the MoCA. RESULTS The three CCS tasks were completed by 85% (n = 34) of the patients with dementia and all controls; only 4 reported the task as 'hard'. Those with dementia scored significantly lower on the CCS than controls (p < 0.001). CCS scores correlated with total MoCA scores (r = 0.78, p < 0.01). Further, the CCS scores significantly predicted MoCA scores, controlling for the effects of age, gender, educational attainment, and frequency of technology use (β = 0.71, p < 0.001), explaining 65.2% of the variance. Total CCS and MoCA scores (cut-off score <24) had similar sensitivity (94 and 95%, respectively) and accuracy (area under the curve 0.94 and 0.99, respectively, p = 0.5) in discriminating dementia from controls, though the CSS had lower specificity (60 vs. 100% for the MoCA). CONCLUSION The participants had little difficulty self-administering the CCS, which is an oft-cited barrier to computerised testing in this population. Our results support the criterion and construct validity of a CCS versus the commonly used MoCA. Although further research is required, CCS for cognitive impairment may be useful in the community and, by prompting referral to specialist services, could lead to an earlier diagnosis of dementia.
Collapse
|
26
|
Hansen TI, Haferstrom ECD, Brunner JF, Lehn H, Håberg AK. Initial validation of a web-based self-administered neuropsychological test battery for older adults and seniors. J Clin Exp Neuropsychol 2015; 37:581-94. [PMID: 26009791 PMCID: PMC4732451 DOI: 10.1080/13803395.2015.1038220] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction: Computerized neuropsychological tests are effective in assessing different cognitive domains, but are often limited by the need of proprietary hardware and technical staff. Web-based tests can be more accessible and flexible. We aimed to investigate validity, effects of computer familiarity, education, and age, and the feasibility of a new web-based self-administered neuropsychological test battery (Memoro) in older adults and seniors. Method: A total of 62 (37 female) participants (mean age 60.7 years) completed the Memoro web-based neuropsychological test battery and a traditional battery composed of similar tests intended to measure the same cognitive constructs. Participants were assessed on computer familiarity and how they experienced the two batteries. To properly test the factor structure of Memoro, an additional factor analysis in 218 individuals from the HUNT population was performed. Results: Comparing Memoro to traditional tests, we observed good concurrent validity (r = .49–.63). The performance on the traditional and Memoro test battery was consistent, but differences in raw scores were observed with higher scores on verbal memory and lower in spatial memory in Memoro. Factor analysis indicated two factors: verbal and spatial memory. There were no correlations between test performance and computer familiarity after adjustment for age or age and education. Subjects reported that they preferred web-based testing as it allowed them to set their own pace, and they did not feel scrutinized by an administrator. Conclusions: Memoro showed good concurrent validity compared to neuropsychological tests measuring similar cognitive constructs. Based on the current results, Memoro appears to be a tool that can be used to assess cognitive function in older and senior adults. Further work is necessary to ascertain its validity and reliability.
Collapse
Affiliation(s)
- Tor Ivar Hansen
- a Department of Neuroscience , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | | | | | | | | |
Collapse
|
27
|
Performance of the CogState computerized battery in the Mayo Clinic Study on Aging. Alzheimers Dement 2015; 11:1367-76. [PMID: 25858683 DOI: 10.1016/j.jalz.2015.01.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/13/2014] [Accepted: 01/19/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The feasibility and validity of brief computerized cognitive batteries at the population-level are unknown. METHODS Nondemented participants (n = 1660, age 50-97 years) in the Mayo Clinic Study on Aging completed the computerized CogState battery and standard neuropsychological battery. The correlation between tests was examined and comparisons between CogState performance on the personal computer (PC) and iPad (n = 331), and in the clinic vs. at home (n = 194), were assessed. RESULTS We obtained valid data on greater than 97% of participants on each test. Correlations between the CogState and neuropsychological tests ranged from -0.462 to 0.531. Although absolute differences between the PC and iPad were small and participants preferred the iPad, performance on the PC was faster. Participants performed faster on Detection, One Card Learning, and One Back at home compared with the clinic. DISCUSSION The computerized CogState battery, especially the iPad, was feasible, acceptable, and valid in the population.
Collapse
|
28
|
Computerized and on-line neuropsychological testing for late-life cognition and neurocognitive disorders: are we there yet? Curr Opin Psychiatry 2015; 28:165-72. [PMID: 25602241 DOI: 10.1097/yco.0000000000000141] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Cost-effective, valid, efficient and accessible tests for the detection of late-life neurocognitive disorders are crucial, as early identification facilitates appropriate early intervention. Proponents of computerized neuropsychological assessment devices (CNADs) assert that technology-based assessments improve upon traditional neuropsychological tests. However, there remain fundamental questions of validity, reliability, normative data and administration, raising the question of whether CNADs are appropriate alternatives. RECENT FINDINGS Since publication of the 2012 American Academy of Clinical Neuropsychology and National Academy of Neuropsychology joint position paper outlining appropriate standards for CNAD development, the field has not significantly advanced, with the majority of recommendations inadequately addressed. SUMMARY Whilst there is a pressing need for innovative and readily applicable cognitive tests, these requirements do not outweigh the necessity for valid measures. Overall, the psychometric quality, standardization, normative data and administration advice of CNADs for neurocognitive disorders are lacking. Therefore, the risk of diagnostic errors is potentially high and poor clinical decisions could potentially arise, having significant impact upon individuals in terms of their well being and access to treatment. We recommend clinicians and researchers make informed decisions about CNAD suitability for their clients and their individual requirements based upon published psychometric and other test information.
Collapse
|