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Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline

Cognitive impairment is a common and pervasive feature of etiologically diverse disorders of the central nervous system, and a target indication for a growing number of symptomatic and disease modifying drugs. Remotely acquired digital endpoints have been recognized for their potential in providing...

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Autores principales: Atkins, Alexandra S., Kraus, Michael S., Welch, Matthew, Yuan, Zhenhua, Stevens, Heather, Welsh-Bohmer, Kathleen A., Keefe, Richard S. 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/PMC9448897/
https://www.ncbi.nlm.nih.gov/pubmed/36090378
http://dx.doi.org/10.3389/fpsyt.2022.910896
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author Atkins, Alexandra S.
Kraus, Michael S.
Welch, Matthew
Yuan, Zhenhua
Stevens, Heather
Welsh-Bohmer, Kathleen A.
Keefe, Richard S. E.
author_facet Atkins, Alexandra S.
Kraus, Michael S.
Welch, Matthew
Yuan, Zhenhua
Stevens, Heather
Welsh-Bohmer, Kathleen A.
Keefe, Richard S. E.
author_sort Atkins, Alexandra S.
collection PubMed
description Cognitive impairment is a common and pervasive feature of etiologically diverse disorders of the central nervous system, and a target indication for a growing number of symptomatic and disease modifying drugs. Remotely acquired digital endpoints have been recognized for their potential in providing frequent, real-time monitoring of cognition, but their ultimate value will be determined by the reliability and sensitivity of measurement in the populations of interest. To this end, we describe initial validation of remote self-administration of cognitive tests within a regulatorily compliant tablet-based platform. Participants were 61 older adults (age 55+), including 20 individuals with subjective cognitive decline (SCD). To allow comparison between remote (in-home) and site-based testing, participants completed 2 testing sessions 1 week apart. Results for three of four cognitive domains assessed demonstrated equivalence between remote and site-based tests, with high cross-modality ICCs (absolute agreement) for Symbol Coding (ICC = 0.75), Visuospatial Working Memory (ICC = 0.70) and Verbal Fluency (ICC > 0.73). Group differences in these domains were significant and reflected sensitivity to objective cognitive impairment in the SCD group for both remote and site-based testing (p < 0.05). In contrast, performance on tests of verbal episodic memory suggested inflated performance during unmonitored testing and indicate reliable use of remote cognitive assessments may depend on the construct, as well as the population being tested.
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spelling pubmed-94488972022-09-08 Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline Atkins, Alexandra S. Kraus, Michael S. Welch, Matthew Yuan, Zhenhua Stevens, Heather Welsh-Bohmer, Kathleen A. Keefe, Richard S. E. Front Psychiatry Psychiatry Cognitive impairment is a common and pervasive feature of etiologically diverse disorders of the central nervous system, and a target indication for a growing number of symptomatic and disease modifying drugs. Remotely acquired digital endpoints have been recognized for their potential in providing frequent, real-time monitoring of cognition, but their ultimate value will be determined by the reliability and sensitivity of measurement in the populations of interest. To this end, we describe initial validation of remote self-administration of cognitive tests within a regulatorily compliant tablet-based platform. Participants were 61 older adults (age 55+), including 20 individuals with subjective cognitive decline (SCD). To allow comparison between remote (in-home) and site-based testing, participants completed 2 testing sessions 1 week apart. Results for three of four cognitive domains assessed demonstrated equivalence between remote and site-based tests, with high cross-modality ICCs (absolute agreement) for Symbol Coding (ICC = 0.75), Visuospatial Working Memory (ICC = 0.70) and Verbal Fluency (ICC > 0.73). Group differences in these domains were significant and reflected sensitivity to objective cognitive impairment in the SCD group for both remote and site-based testing (p < 0.05). In contrast, performance on tests of verbal episodic memory suggested inflated performance during unmonitored testing and indicate reliable use of remote cognitive assessments may depend on the construct, as well as the population being tested. Frontiers Media S.A. 2022-08-24 /pmc/articles/PMC9448897/ /pubmed/36090378 http://dx.doi.org/10.3389/fpsyt.2022.910896 Text en Copyright © 2022 Atkins, Kraus, Welch, Yuan, Stevens, Welsh-Bohmer and Keefe. 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). 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 Psychiatry
Atkins, Alexandra S.
Kraus, Michael S.
Welch, Matthew
Yuan, Zhenhua
Stevens, Heather
Welsh-Bohmer, Kathleen A.
Keefe, Richard S. E.
Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline
title Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline
title_full Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline
title_fullStr Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline
title_full_unstemmed Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline
title_short Remote self-administration of digital cognitive tests using the Brief Assessment of Cognition: Feasibility, reliability, and sensitivity to subjective cognitive decline
title_sort remote self-administration of digital cognitive tests using the brief assessment of cognition: feasibility, reliability, and sensitivity to subjective cognitive decline
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448897/
https://www.ncbi.nlm.nih.gov/pubmed/36090378
http://dx.doi.org/10.3389/fpsyt.2022.910896
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