Development and validation of a brief digital cognitive test based on the paradigm of stimulus equivalence in a sample of older adults

Abstract

With the technological advancement and democratization of electronic devices, computerized cognitive tests have been increasingly used in the clinical context to evaluate cognitive performance in individuals. Objective: This study aimed to propose a brief digital cognitive test based on the paradigm of stimulus equivalence and assess its convergent validity by comparing it with traditionally applied tests. Methods: The study was carried out with a non-probabilistic sample of 50 older adults selected from a public call through the communication media, health units, and day centers of a city in the countryside of São Paulo. Participants were assessed by the brief digital cognitive test, Mini-Mental State Examination, Brief Cognitive Screening Battery, and the Five Digit Test. Results: Participants had a mean age of 71.23 years (standard deviation [SD]: ±9.36) and a mean of 7.15 years of schooling (SD: ±5.34). The mean time to answer the test was 5.33 minutes (SD: ±1.92). There were statistically significant correlations between traditional and digital tests in most domains evaluated. In addition, considering the total score of the digital test, the test could discriminate participants with and without cognitive impairment: area under the ROC curve=0.765; 95%CI 0.630–0.901. Conclusion: The brief digital cognitive test, using the stimulus equivalence paradigm, is an easy-to-apply and valid instrument for the investigation of cognitive impairment in older adults.