Assessing cognitive impairment using PROMIS(®) applied cognition-abilities scales in a medical outpatient sample

Having a brief, standardized, reliable, and valid self-rated test of perceived cognitive functioning could be beneficial in psychiatry clinical practice, research, and clinical trials. The PROMIS(®) Applied Cognition-Abilities scales were developed, evaluated, and distributed by the National Institutes of Health to measure perceived cognitive functioning. This study examines several aspects of the reliability and validity of the PROMIS(®) Applied Cognition-Abilities eight and four-item scales in a sample of adult and older adult medical outpatients (N = 148). Internal consistency reliability was high for both PROMIS(®) cognition scales. The brief four-item scale was highly correlated with the full eight-item scale (rs = 0.98). There was a moderate correlation between the PROMIS(®) Applied Cognition-Abilities scales and measures of depression (PHQ-9) and anxiety (GAD-7). Subgroups of participants screening positively for depression or anxiety reported significantly worse cognitive functioning than medical controls, with large effect sizes. The base rates of individual items endorsed by depressed, anxious, and control participants are reported. More than 42% of depressed and anxious participants reported problems with their memory and concentration compared with fewer than 8% of medical controls. The field would benefit from studies using the PROMIS(®) Applied Cognition-Abilities scales in more demographically diverse samples and with other established measures of cognition.