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Clinical Manifestations.

Y Catherine Han1, Cindy J Nowinski1, Elizabeth M Dworak1

  • 1Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

New scores from the NIH Mobile Toolbox (MTB) executive function (EF) measures show promise for tracking age-related cognitive changes. These expanded EF assessments are valid and reliable for use in clinical and pharmaceutical studies.

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Area of Science:

  • Cognitive Neuroscience
  • Psychometrics
  • Gerontology

Background:

  • Executive Function (EF) comprises multiple components (e.g., attention, inhibitory control) that can be differentially impacted by Alzheimer's Disease and Related Dementias (AD/ADRD).
  • Early identification of specific EF deficits can indicate cognitive impairment, offering insights into etiology and disease progression.
  • The NIH Mobile Toolbox (MTB) provides brief, sensitive, and user-friendly smartphone-based cognitive assessments, adapted from the NIH Toolbox® (NIHTB).

Purpose of the Study:

  • To investigate secondary scores (anticipation errors, error rate, median response time) from MTB EF measures (Arrow Matching, Shape-Color Sorting) for a more comprehensive cognitive assessment.
  • To expand on the existing rate-based scores (correct responses per time) of the MTB EF measures.
  • To evaluate the validity and reliability of these expanded scores for assessing cognitive functioning across the lifespan.

Main Methods:

  • Study 1 (n=92) involved in-person administration of MTB on iOS smartphones and NIHTB on iPads, alongside convergent and divergent validity measures.
  • Study 2 (n=1021) involved in-person NIHTB and remote MTB administration on participants' own smartphones within 14 days.
  • Participants completed external measures including D-KEFS, WCST, PPVT-5, and NIHTB PV to assess convergent and divergent validity.

Main Results:

  • All novel scores demonstrated significant relationships with age, with older individuals exhibiting more errors and slower response times.
  • Most novel scores showed significant correlations with concurrent measures, supporting convergent validity (absolute value ρ = [.13,.77]).
  • Scores exhibited strong internal reliability (split-half correlations), with Shape-Color Sorting median at .94 and Arrow Matching median at .98.

Conclusions:

  • Expanded scores from the MTB EF measures are valid and demonstrate potential for clinical and pharmaceutical research, especially concerning age-related cognitive decline.
  • These enhanced scores may be valuable for tracking cognitive changes in aging populations.
  • Further clinical validation is ongoing, including studies with populations at risk for or diagnosed with cognitive impairment or AD/ADRD.