Performance of a computer-based assessment of cognitive function measures in two cohorts of seniors

Int J Geriatr Psychiatry. 2013 Dec;28(12):1239-50. doi: 10.1002/gps.3949. Epub 2013 Apr 16.

Abstract

Background: Computer-administered assessment of cognitive function is being increasingly incorporated in clinical trials; however, its performance in these settings has not been systematically evaluated.

Design: The Seniors Health and Activity Research Program pilot trial (N = 73) developed a computer-based tool for assessing memory performance and executive functioning. The Lifestyle Interventions and Independence for Elders investigators incorporated this battery in a full-scale multicenter clinical trial (N = 1635). We describe relationships that test scores have with those from interviewer-administered cognitive function tests and risk factors for cognitive deficits and describe performance measures (completeness, intraclass correlations [ICC]).

Results: Computer-based assessments of cognitive function had consistent relationships across the pilot and full-scale trial cohorts with interviewer-administered assessments of cognitive function, age, and a measure of physical function. In the Lifestyle Interventions and Independence for Elders cohort, their external validity was further demonstrated by associations with other risk factors for cognitive dysfunction: education, hypertension, diabetes, and physical function. Acceptable levels of data completeness (>83%) were achieved on all computer-based measures; however, rates of missing data were higher among older participants (odds ratio = 1.06 for each additional year; p < 0.001) and those who reported no current computer use (odds ratio = 2.71; p < 0.001). ICCs among clinics were at least as low (ICC < 0.013) as for interviewer measures (ICC < 0.023), reflecting good standardization. All cognitive measures loaded onto the first principal component (global cognitive function), which accounted for 40% of the overall variance.

Conclusion: Our results support the use of computer-based tools for assessing cognitive function in multicenter clinical trials of older individuals.

Trial registration: ClinicalTrials.gov NCT00688155 NCT01072500.

Keywords: clinical trial; cognitive function; performance measures.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Cognition Disorders / prevention & control
  • Cognitive Behavioral Therapy
  • Cohort Studies
  • Diagnosis, Computer-Assisted*
  • Female
  • Humans
  • Life Style
  • Male
  • Pilot Projects
  • Risk Factors

Associated data

  • ClinicalTrials.gov/NCT00688155
  • ClinicalTrials.gov/NCT01072500