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Feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment

It is critical to intervene early in the mild cognitive impairment (MCI) stage of the Alzheimer's disease trajectory, but traditional cognitive testing methods are costly, burdensome, and difficult to access. We examined adherence and validity data to a 30-day self-administered ecological momen...

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Autores principales: Moore, Raeanne C., Ackerman, Robert A., Russell, Madisen T., Campbell, Laura M., Depp, Colin A., Harvey, Philip D., Pinkham, Amy E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9390883/
https://www.ncbi.nlm.nih.gov/pubmed/35990012
http://dx.doi.org/10.3389/fdgth.2022.946685
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author Moore, Raeanne C.
Ackerman, Robert A.
Russell, Madisen T.
Campbell, Laura M.
Depp, Colin A.
Harvey, Philip D.
Pinkham, Amy E.
author_facet Moore, Raeanne C.
Ackerman, Robert A.
Russell, Madisen T.
Campbell, Laura M.
Depp, Colin A.
Harvey, Philip D.
Pinkham, Amy E.
author_sort Moore, Raeanne C.
collection PubMed
description It is critical to intervene early in the mild cognitive impairment (MCI) stage of the Alzheimer's disease trajectory, but traditional cognitive testing methods are costly, burdensome, and difficult to access. We examined adherence and validity data to a 30-day self-administered ecological momentary cognitive testing protocol among a sample of older adults with MCI and cognitively normal controls to evaluate feasibility, tolerability, and initial validity in comparison to standard neuropsychological tests. Participants included 48 participants with MCI (Mean age = 72 years, SD = 7 years) and 46 demographically-matched cognitively normal (NC) control participants (Mean age = 70 years, SD = 7 years). Participants completed traditional neuropsychological testing to determine MCI status, followed by 30 days of remote ecological momentary cognitive testing. Ecological momentary assessment (EMA) surveys were administered 3 times per day for 30 days (possible total = 90), and mobile cognitive tests were administered every other day (for a total of 15 administrations). Mobile cognitive tests included the Variable Difficulty List Memory Test (VLMT; measure of learning and memory), Memory Matrix (measure of visual working memory), and the Color Trick Test (measure of executive function). EMA and mobile cognitive test adherence, fatigue effects, mobile cognitive test performance and group differences, and psychometrics (reliability, convergent validity, ceiling effects, and practice effects) were examined. Overall mean-level adherence to the mobile cognitive tests was 85% and did not differ by MCI status. The reliability of stable between-person individual differences for the VLMT and Memory Matrix were very high. Moreover, although the reliability of within-person change for Memory Matrix was adequate, the corresponding reliability for VLMT was somewhat low. Averaged performance on the mobile cognitive tests was correlated with lab-based tests measuring the same construct. Participants with MCI performed worse than NCs on the VLMT and Color Trick Test, and there was no evidence of fatigue effects for these two tests. These findings support the feasibility and potential for ecological momentary cognitive testing to support clinical trials and for measuring cognitive changes over time in persons with increased risk for Alzheimer's disease such as those with MCI.
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spelling pubmed-93908832022-08-20 Feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment Moore, Raeanne C. Ackerman, Robert A. Russell, Madisen T. Campbell, Laura M. Depp, Colin A. Harvey, Philip D. Pinkham, Amy E. Front Digit Health Digital Health It is critical to intervene early in the mild cognitive impairment (MCI) stage of the Alzheimer's disease trajectory, but traditional cognitive testing methods are costly, burdensome, and difficult to access. We examined adherence and validity data to a 30-day self-administered ecological momentary cognitive testing protocol among a sample of older adults with MCI and cognitively normal controls to evaluate feasibility, tolerability, and initial validity in comparison to standard neuropsychological tests. Participants included 48 participants with MCI (Mean age = 72 years, SD = 7 years) and 46 demographically-matched cognitively normal (NC) control participants (Mean age = 70 years, SD = 7 years). Participants completed traditional neuropsychological testing to determine MCI status, followed by 30 days of remote ecological momentary cognitive testing. Ecological momentary assessment (EMA) surveys were administered 3 times per day for 30 days (possible total = 90), and mobile cognitive tests were administered every other day (for a total of 15 administrations). Mobile cognitive tests included the Variable Difficulty List Memory Test (VLMT; measure of learning and memory), Memory Matrix (measure of visual working memory), and the Color Trick Test (measure of executive function). EMA and mobile cognitive test adherence, fatigue effects, mobile cognitive test performance and group differences, and psychometrics (reliability, convergent validity, ceiling effects, and practice effects) were examined. Overall mean-level adherence to the mobile cognitive tests was 85% and did not differ by MCI status. The reliability of stable between-person individual differences for the VLMT and Memory Matrix were very high. Moreover, although the reliability of within-person change for Memory Matrix was adequate, the corresponding reliability for VLMT was somewhat low. Averaged performance on the mobile cognitive tests was correlated with lab-based tests measuring the same construct. Participants with MCI performed worse than NCs on the VLMT and Color Trick Test, and there was no evidence of fatigue effects for these two tests. These findings support the feasibility and potential for ecological momentary cognitive testing to support clinical trials and for measuring cognitive changes over time in persons with increased risk for Alzheimer's disease such as those with MCI. Frontiers Media S.A. 2022-08-05 /pmc/articles/PMC9390883/ /pubmed/35990012 http://dx.doi.org/10.3389/fdgth.2022.946685 Text en © 2022 Moore, Ackerman, Russell, Campbell, Depp, Harvey and Pinkham. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Digital Health
Moore, Raeanne C.
Ackerman, Robert A.
Russell, Madisen T.
Campbell, Laura M.
Depp, Colin A.
Harvey, Philip D.
Pinkham, Amy E.
Feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment
title Feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment
title_full Feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment
title_fullStr Feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment
title_full_unstemmed Feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment
title_short Feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment
title_sort feasibility and validity of ecological momentary cognitive testing among older adults with mild cognitive impairment
topic Digital Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9390883/
https://www.ncbi.nlm.nih.gov/pubmed/35990012
http://dx.doi.org/10.3389/fdgth.2022.946685
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