Validity of the Web-Based, Self-Directed, NeuroCognitive Performance Test in Mild Cognitive Impairment

Article type: Research Article

Authors: Doraiswamy, P. Murali^{a; b; *} | Goldberg, Terry E.^c | Qian, Min^d | Linares, Alexandra R.^a | Nwosu, Adaora^a | Nino, Izael^c | D’Antonio, Jessica^c | Phillips, Julia^c | Ndouli, Charlie^c | Hellegers, Caroline^a | Michael, Andrew M.^b | Petrella, Jeffrey R.^e | Andrews, Howard^d | Sneed, Joel^{f; g} | Devanand, Davangere P.^c

Affiliations: [a] Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA | [b] Duke Institute for Brain Sciences, Durham, NC, USA | [c] Department of Psychiatry, Columbia University Medical Center, and the New York State Psychiatry Institute, New York, NY, USA | [d] Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA | [e] Department of Radiology, Duke University Medical Center, Durham, NC, USA | [f] Department of Psychology, Queens College, City University of New York, Flushing, NY, USA | [g] Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA

Correspondence: [*] Correspondence to: P. Murali Doraiswamy, Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA. E-mail: murali.doraiswamy@duke.edu.

Abstract: Background:Digital cognitive tests offer several potential advantages over established paper-pencil tests but have not yet been fully evaluated for the clinical evaluation of mild cognitive impairment. Objective:The NeuroCognitive Performance Test (NCPT) is a web-based, self-directed, modular battery intended for repeated assessments of multiple cognitive domains. Our objective was to examine its relationship with the Alzheimer’s Disease Assessment Scale-Cognition Subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) as well as with established paper-pencil tests of cognition and daily functioning in mild cognitive impairment (MCI). Methods:We used Spearman correlations, regressions and principal components analysis followed by a factor analysis (varimax rotated) to examine our objectives. Results:In MCI subjects, the NCPT composite is significantly correlated with both a composite measure of established tests (r = 0.78, p < 0.0001) as well as with the ADAS-Cog (r = –0.55, p < 0.0001). Both NCPT and paper-pencil test batteries had a similar factor structure that included a large “g” component with a high eigenvalue. The correlation for the analogous tests (e.g., Trails A and B, learning memory tests) were significant (p < 0.0001). Further, both the NCPT and established tests significantly (p < 0.0001) predicted the University of California San Diego Performance-Based Skills Assessment and Functional Activities Questionnaire, measures of daily functioning. Conclusion:The NCPT, a web-based, self-directed, computerized test, shows high concurrent validity with established tests and hence offers promise for use as a research or clinical tool in MCI. Despite limitations such as a relatively small sample, absence of control group and cross-sectional nature, these findings are consistent with the growing literature on the promise of self-directed, web-based cognitive assessments for MCI.

Keywords: Alzheimer’s disease, clinical trials, computerized cognitive tests, neurocognitive performance test

DOI: 10.3233/JAD-220015

Journal: Journal of Alzheimer's Disease, vol. 86, no. 3, pp. 1131-1136, 2022