Development and validation of the Uniform Data Set (v3.0) executive function composite score (UDS3‐EF)

INTRODUCTION: Cognitive composite scores offer a means of precisely measuring executive functioning (EF). METHODS: We developed the Uniform Data Set v3.0 EF composite score (UDS3‐EF) in 3507 controls from the National Alzheimer's Coordinating Center dataset using item‐response theory and applied nonlinear and linear demographic adjustments. The UDS3‐EF was validated with other neuropsychological tests and brain magnetic resonance imaging from independent research cohorts using linear models. RESULTS: Final model fit was good‐to‐excellent: comparative fit index = 0.99; root mean squared error of approximation = 0.057. UDS3‐EF scores differed across validation cohorts (controls > mild cognitive impairment > Alzheimer's disease‐dementia ≈ behavioral variant frontotemporal dementia; P < 0.001). The UDS3‐EF correlated most strongly with other EF tests (βs = 0.50 to 0.85, Ps < 0.001) and more with frontal, parietal, and temporal lobe gray matter volumes (βs = 0.18 to 0.33, Ps ≤ 0.004) than occipital gray matter (β = 0.12, P = 0.04). The total sample needed to detect a 40% reduction in UDS3‐EF change (n = 286) was ≈40% of the next best measure (F‐words; n = 714). CONCLUSIONS: The UDS3‐EF is well suited to quantify EF in research and clinical trials and offers psychometric and practical advantages over its component tests.