Development of a self-administered web-based test for longitudinal cognitive assessment

Area of Science:

• Neuroscience
• Gerontology
• Psychometrics

Background:

• Current cognitive screening tools often require external evaluators and periodic clinic visits.
• There is a need for accessible, self-administered tools for longitudinal cognitive monitoring.
• Existing brief cognitive tools have limitations in independent use and frequent assessment.

Purpose of the Study:

• To develop and validate a self-administered computerized cognitive testing tool for longitudinal monitoring.
• To assess the internal consistency, discriminative ability, and test-retest reliability of the 'Brain on Track' test.
• To evaluate the utility of a home-based cognitive assessment for individuals with cognitive impairment.

Main Methods:

• Development of a computerized, self-administered cognitive test ('Brain on Track') with random elements to minimize learning effects.
• Administration of an initial (A) and refined (B) test version to patients with mild cognitive impairment/early dementia (n=88) and controls.
• Evaluation of test-retest reliability in a population-based cohort (n=113) performing the test at home every three months.

Main Results:

• The refined test version demonstrated high internal consistency (Cronbach's alpha = 0.90).
• Significant differences in test scores were observed between patients and controls (p=0.001), with an AUC of 0.75.
• Test-retest reliability was good, with 9/10 subtests showing intraclass correlation coefficients >0.70, and the smallest real difference was below the clinically relevant difference.

Conclusions:

• The 'Brain on Track' test exhibits good internal consistency, discriminative ability, and reliability for home-based use.
• The self-administered nature and psychometric properties support its use in longitudinal cognitive monitoring.
• Findings encourage further clinical and population-based studies using this novel cognitive assessment tool.