- Email: [email protected]
THE SURVEY FOR MEMORY, ATTENTION, AND REACTION TIME (SMART): A BRIEF ONLINE PERSONAL COMPUTING-BASED COGNITIVE ASSESSMENT FOR HEALTHY AGING AND MILD COGNITIVE IMPAIRMENT
P596
Podium Presentations: Monday, July 17, 2017 MONDAY, JULY 17, 2017 ORAL SESSIONS O2-16 NEUROPSYCHOLOGY: COMPUTERIZED NEUROPSYCHOLOGICAL ASSESSMENT
frequent cognitive evaluations to identify and quantify subtle changes associated with developing MCI in community dwelling older adults.
O2-16-02 O2-16-01
THE SURVEY FOR MEMORY, ATTENTION, AND REACTION TIME (SMART): A BRIEF ONLINE PERSONAL COMPUTING-BASED COGNITIVE ASSESSMENT FOR HEALTHY AGING AND MILD COGNITIVE IMPAIRMENT
Adriana Seelye1,2,3,4, Nora Mattek1,2,3, Christina Reynolds1,3,5,6, Nicole Sharma1,2,3, Katherine Wild1,2,3, Jeffrey Kaye1,2,3, 1Oregon Center for Aging & Technology (ORCATECH), Portland, OR, USA; 2NIA-Layton Aging & Alzheimer’s Disease Center, Portland, OR, USA; 3Oregon Health & Science University, Portland, OR, USA; 4Minneapolis VA Health Care System, Minneapolis, MN, USA; 5Oregon Center for Aging and Technology (ORCATECH), Portland, OR, USA; 6Oregon Health and Science University, Portland, OR, USA. Contact e-mail: [email protected] Background: The SMART was developed to allow for frequent (daily to monthly) in-home assessment of everyday cognition in older adults. SMART contains three face-valid cognitive items in the domains of episodic memory, visual attention, and information processing speed, while also capturing passive aspects of cognitive task engagement such as mouse cursor movement efficiency, typing speed, time to complete the task, time of day started, and task adherence. Methods: Participants were 85 cognitively intact older adults (mean age ¼ 83.8 years; 80% female) and 7 with MCI (mean age¼81.4 years; 71% female) who were part of a longitudinal cohort study. All participants had rudimentary computer use experience (able to regularly receive and send email). SMART was emailed to all participants on the same day and time. Data were collected using commercially available software on participants’ home computers. Each participant’s baseline SMART data were used to compare cognitively intact and MCI older adults and correlate with conventional cognitive tests (e.g., MMSE, CERAD word-list recall, TMT-B). Results: Sixty-five percent of the cognitively intact group completed their baseline SMART in one session (8 6 5 minutes on average). Of the MCI participants, only 29% completed the task in one session (within a time frame similar to the intact group), while 71% had delays, took multiple sessions or didn’t finish at all. MCI participants started their first SMART later in the day than cognitively intact participants, 4:30 PM vs. 1:24 PM on average, p¼0.06. Faster SMART completion time was associated with higher MMSE and CERAD word list recall scores, and faster TMT-B scores, p<.05. Answering the SMART memory recall item incorrectly was associated with lower CERAD word-list recall score, p¼0.02. SMART trails times were positively correlated with TMT-B (r¼0.26, p¼0.02). Only 14% of older adults with MCI answered the SMART word search item correctly compared to 67% of cognitively intact participants, p<0.01. Conclusions: The SMART is a brief personal computing experienced-based online assessment that can be easily integrated into longitudinal protocols for
ACCEPTABILITY, USABILITY, VALIDITY AND SENSITIVITY OF COGNITION ASSESSED IN UNSUPERVISED SETTINGS
Paul Maruff1, Adrian Schembri2, Ronald C. Petersen3, Paul S. Aisen4, Michael Weiner5, Bruce Albala6, ADNI, 1The Florey Institute of Neuroscience and Mental Health, Parkville, Australia; 2CogState Ltd., Melbourne, Australia; 3Mayo Clinic, Rochester, MN, USA; 4Alzheimer’s Therapeutic Research Institute, San Diego, CA, USA; 5University of California, San Francisco, San Francisco, CA, USA; 6Eisai Inc., Woodcliff Lake, NJ, USA. Contact e-mail: [email protected] Background: Dementia research and care can be improved
through exploitation of technology, though such development must remain scientifically valid. Internet technology allows cognitive assessment outside clinical settings. however, it is important to determine the acceptability, reliability and sensitivity of unsupervised assessments, given those being assessed are older, may have low familiarity with computers and diminished cognitive abilities. We compared the acceptability, reliability and validity of in-clinic and unsupervised cognitive assessment within the ADNI study. Methods: Data from the first 100 participants enrolled in this study (mean age ¼ 75.6, SD ¼ 16 years) were examined. All were recruited from ADNI and had known amyloid (AB) and clinical status. All were trained and assessed on the Cogstate Brief Battery (CBB) in a supervised in-clinic assessment and in three subsequent unsupervised sessions six months apart. Performance was compared between in-clinic and unsupervised assessments for rates of completion, age and gender effects, effect of diagnoses and stability over time. Results: 98 participants completed baseline in-clinic assessment [cognitive normal (CN) ¼51, mild cognitive impairment (MCI) ¼ 41, Alzheimer’s disease dementia (AD) ¼ 6]. 94% required a single attempt (average time for assessment ¼ 17.5 min, SD ¼ 4.1), The second unsupervised assessment was completed by 78 with 92% requiring one attempt (average time for completion 16.8 min, SD¼6.5). Data for the third (25 completers) and fourth (5 completers) were not analyzed here. Reliability between in-clinic and the first unsupervised assessment was >r¼0.61. In CN adults, CBB performance was associated negatively with age, but unrelated to gender in both in-clinic and unsupervised assessments. Performance on the working memory (One Back) and episodic memory tests (One Card Learning) was worse in MCI than CN with equivalent magnitudes of impairment between in-clinic and unsupervised assessments (Table 1). CN AB+ adults performed worse than CN AB- adults in both in-clinic and unsupervised assessments. Conclusions: In CN and MCI adults, unsupervised, internet-based assessment of cognition has high acceptability, acceptable reliability, high validity and possibly high sensitivity to clinical disease state. These data provide a strong foundation for assessment of cognition in people at risk of dementia in unsupervised settings.
Podium Presentations: Monday, July 17, 2017 MONDAY, JULY 17, 2017 ORAL SESSIONS O2-16 NEUROPSYCHOLOGY: COMPUTERIZED NEUROPSYCHOLOGICAL ASSESSMENT
frequent cognitive evaluations to identify and quantify subtle changes associated with developing MCI in community dwelling older adults.
O2-16-02 O2-16-01
THE SURVEY FOR MEMORY, ATTENTION, AND REACTION TIME (SMART): A BRIEF ONLINE PERSONAL COMPUTING-BASED COGNITIVE ASSESSMENT FOR HEALTHY AGING AND MILD COGNITIVE IMPAIRMENT
Adriana Seelye1,2,3,4, Nora Mattek1,2,3, Christina Reynolds1,3,5,6, Nicole Sharma1,2,3, Katherine Wild1,2,3, Jeffrey Kaye1,2,3, 1Oregon Center for Aging & Technology (ORCATECH), Portland, OR, USA; 2NIA-Layton Aging & Alzheimer’s Disease Center, Portland, OR, USA; 3Oregon Health & Science University, Portland, OR, USA; 4Minneapolis VA Health Care System, Minneapolis, MN, USA; 5Oregon Center for Aging and Technology (ORCATECH), Portland, OR, USA; 6Oregon Health and Science University, Portland, OR, USA. Contact e-mail: [email protected] Background: The SMART was developed to allow for frequent (daily to monthly) in-home assessment of everyday cognition in older adults. SMART contains three face-valid cognitive items in the domains of episodic memory, visual attention, and information processing speed, while also capturing passive aspects of cognitive task engagement such as mouse cursor movement efficiency, typing speed, time to complete the task, time of day started, and task adherence. Methods: Participants were 85 cognitively intact older adults (mean age ¼ 83.8 years; 80% female) and 7 with MCI (mean age¼81.4 years; 71% female) who were part of a longitudinal cohort study. All participants had rudimentary computer use experience (able to regularly receive and send email). SMART was emailed to all participants on the same day and time. Data were collected using commercially available software on participants’ home computers. Each participant’s baseline SMART data were used to compare cognitively intact and MCI older adults and correlate with conventional cognitive tests (e.g., MMSE, CERAD word-list recall, TMT-B). Results: Sixty-five percent of the cognitively intact group completed their baseline SMART in one session (8 6 5 minutes on average). Of the MCI participants, only 29% completed the task in one session (within a time frame similar to the intact group), while 71% had delays, took multiple sessions or didn’t finish at all. MCI participants started their first SMART later in the day than cognitively intact participants, 4:30 PM vs. 1:24 PM on average, p¼0.06. Faster SMART completion time was associated with higher MMSE and CERAD word list recall scores, and faster TMT-B scores, p<.05. Answering the SMART memory recall item incorrectly was associated with lower CERAD word-list recall score, p¼0.02. SMART trails times were positively correlated with TMT-B (r¼0.26, p¼0.02). Only 14% of older adults with MCI answered the SMART word search item correctly compared to 67% of cognitively intact participants, p<0.01. Conclusions: The SMART is a brief personal computing experienced-based online assessment that can be easily integrated into longitudinal protocols for
ACCEPTABILITY, USABILITY, VALIDITY AND SENSITIVITY OF COGNITION ASSESSED IN UNSUPERVISED SETTINGS
Paul Maruff1, Adrian Schembri2, Ronald C. Petersen3, Paul S. Aisen4, Michael Weiner5, Bruce Albala6, ADNI, 1The Florey Institute of Neuroscience and Mental Health, Parkville, Australia; 2CogState Ltd., Melbourne, Australia; 3Mayo Clinic, Rochester, MN, USA; 4Alzheimer’s Therapeutic Research Institute, San Diego, CA, USA; 5University of California, San Francisco, San Francisco, CA, USA; 6Eisai Inc., Woodcliff Lake, NJ, USA. Contact e-mail: [email protected] Background: Dementia research and care can be improved
through exploitation of technology, though such development must remain scientifically valid. Internet technology allows cognitive assessment outside clinical settings. however, it is important to determine the acceptability, reliability and sensitivity of unsupervised assessments, given those being assessed are older, may have low familiarity with computers and diminished cognitive abilities. We compared the acceptability, reliability and validity of in-clinic and unsupervised cognitive assessment within the ADNI study. Methods: Data from the first 100 participants enrolled in this study (mean age ¼ 75.6, SD ¼ 16 years) were examined. All were recruited from ADNI and had known amyloid (AB) and clinical status. All were trained and assessed on the Cogstate Brief Battery (CBB) in a supervised in-clinic assessment and in three subsequent unsupervised sessions six months apart. Performance was compared between in-clinic and unsupervised assessments for rates of completion, age and gender effects, effect of diagnoses and stability over time. Results: 98 participants completed baseline in-clinic assessment [cognitive normal (CN) ¼51, mild cognitive impairment (MCI) ¼ 41, Alzheimer’s disease dementia (AD) ¼ 6]. 94% required a single attempt (average time for assessment ¼ 17.5 min, SD ¼ 4.1), The second unsupervised assessment was completed by 78 with 92% requiring one attempt (average time for completion 16.8 min, SD¼6.5). Data for the third (25 completers) and fourth (5 completers) were not analyzed here. Reliability between in-clinic and the first unsupervised assessment was >r¼0.61. In CN adults, CBB performance was associated negatively with age, but unrelated to gender in both in-clinic and unsupervised assessments. Performance on the working memory (One Back) and episodic memory tests (One Card Learning) was worse in MCI than CN with equivalent magnitudes of impairment between in-clinic and unsupervised assessments (Table 1). CN AB+ adults performed worse than CN AB- adults in both in-clinic and unsupervised assessments. Conclusions: In CN and MCI adults, unsupervised, internet-based assessment of cognition has high acceptability, acceptable reliability, high validity and possibly high sensitivity to clinical disease state. These data provide a strong foundation for assessment of cognition in people at risk of dementia in unsupervised settings.