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. 2022;86(3):1131-1136.
doi: 10.3233/JAD-220015.

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

P Murali Doraiswamy  1   2 , Terry E Goldberg  3 , Min Qian  4 , Alexandra R Linares  1 , Adaora Nwosu  1 , Izael Nino  3 , Jessica D'Antonio  3 , Julia Phillips  3 , Charlie Ndouli  3 , Caroline Hellegers  1 , Andrew M Michael  2 , Jeffrey R Petrella  5 , Howard Andrews  4 , Joel Sneed  6   7 , Davangere P Devanand  3
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Validity of the Web-Based, Self-Directed, NeuroCognitive Performance Test in Mild Cognitive Impairment

P Murali Doraiswamy et al. J Alzheimers Dis. 2022.

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.

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