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Randomized Controlled Trial
. 2013 Dec;28(12):1239-50.
doi: 10.1002/gps.3949. Epub 2013 Apr 16.

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

Mark A Espeland  1 , Jeffrey A Katula, Julia Rushing, Arthur F Kramer, Janine M Jennings, Kaycee M Sink, Neelesh K Nadkarni, Kieran F Reid, Cynthia M Castro, Timothy Church, Diana R Kerwin, Jeff D Williamson, Richard A Marottoli, Scott Rushing, Michael Marsiske, Stephen R Rapp; LIFE Study Group
Collaborators, Affiliations
Randomized Controlled Trial

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

Mark A Espeland et al. Int J Geriatr Psychiatry. 2013 Dec.

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.

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Figures

Figure 1
Figure 1
Correlation coefficients linking computer-administered test scores to interviewer-administered tests, age, and 400 meter walk times in SHARP versus LIFE.
See this image and copyright information in PMC

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