The Cognition Battery of the NIH Toolbox for Assessment of Neurological and Behavioral Function: Validation in an Adult Sample

Weıntraub, Sandra; Dikmen, Sureyya; Heaton, Robert K.; Tulsky, David S.; Zelazo, Philip David; Slotkin, Jerry; Carlozzi, Noelle E.; Bauer, Patricia J.; Wallner-Allen, Kathleen; Fox, Nathan A.; Havlik, Richard J.; Beaumont, Jennifer L.; Mungas, Dan M; Manly, Jennifer J.; Moy, Claudia S.; Conway, Kevin P.; Edwards, Emmeline; Nowinski, Cindy J.; Gershon, Richard

doi:10.1017/s1355617714000320

Cited by 283 publications

(242 citation statements)

References 49 publications

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“…The Cogstate Brief Battery is well-validated, and has been shown to capture AD-related cognitive changes in older adults (18), and those with MCI and AD (19). The desktop version of the NIHTB-CB has been validated against standard neuropsychological measures, and in a large and demographically diverse population ranging in age from 3 to 85 years (6, 14). The NIHTB-CB is intended to serve as a ‘common currency’ among longitudinal and epidemiological studies, however, it is yet to be tested in clinical trials or longitudinal observational studies of aging and dementia.…”

Section: Introductionmentioning

confidence: 99%

Computerized Cognitive Testing for Use in Clinical Trials: A Comparison of the Nih Toolbox and Cogstate C3 Batteries

Buckley¹,

Sparks²,

Papp³

et al. 2017

J Prev Alz Dis

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Background: As prevention trials for Alzheimer’s disease move into asymptomatic populations, identifying older individuals who manifest the earliest cognitive signs of Alzheimer’s disease is critical. Computerized cognitive testing has the potential to replace current gold standard paper and pencil measures and may be a more efficient means of assessing cognition. However, more empirical evidence about the comparability of novel computerized batteries to paper and pencil measures is required. Objectives: To determine whether two computerized IPad batteries, the NIH Toolbox Cognition Battery and Cogstate-C3, similarly predict subtle cognitive impairment identified using the Preclinical Alzheimer Cognitive Composite (PACC). Design, Setting, Participants: A pilot sample of 50 clinically normal older adults (Mage=68.5 years±7.6, 45% non-Caucasian) completed the PACC assessment, and the NIH Toolbox and Cogstate-C3 at research centers of Massachusetts General and Brigham and Women’s Hospitals. Participants made 3-4 in-clinic visits, receiving the PACC first, then the NIH Toolbox, and finally the Cogstate-C3. Measurements: Performance on the PACC was dichotomized by typical performance (>= 0.5SD), versus subtle cognitive impairment (<0.5SD). Composites for each computerized battery were created using principle components analysis, and compared with the PACC using non-parametric Spearman correlations. Logistic regression analyses were used to determine which composite was best able to classify subtle cognitive impairment from typical performance. Results: The NIH Toolbox formed one composite and exhibited the strongest within-battery alignment, while the Cogstate-C3 formed two distinct composites (Learning-Memory and Processing Speed-Attention). The NIH Toolbox and C3 Learning-Memory composites exhibited positive correlations with the PACC (ρ=0.49, p<0.001; ρ=0.58, p<0.001, respectively), but not the C3 Processing Speed-Attention composite, ρ=-0.18, p=0.22. The C3 Learning-Memory was the only composite that classified subtle cognitive impairment, and demonstrated the greatest sensitivity (62%) and specificity (81%) for that subtle cognitive impairment. Conclusions: Preliminary findings suggest that the NIH Toolbox has the advantage of showing the strongest overall clustering and alignment with standardized paper-and-pencil tasks. By contrast, Learning-Memory tasks within the Cogstate-C3 battery have the greatest potential to identify cross-sectional, subtle cognitive impairment as defined by the PACC.

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Section: Introductionmentioning

confidence: 99%

Computerized Cognitive Testing for Use in Clinical Trials: A Comparison of the Nih Toolbox and Cogstate C3 Batteries

Buckley¹,

Sparks²,

Papp³

et al. 2017

J Prev Alz Dis

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“…The NIHTB-Cognition Battery (NIHTB-CB) was designed for use with individuals 3 to 85 years of age and takes less than 30 minutes to administer. Developers obtained iterative feedback from research scientists and clinicians (Weintraub et al, 2013; Weintraub et al, 2014). Previous investigations have supported the validity of the NIHTB-CB measures of episodic memory (Bauer et al, 2013; Dikmen et al, 2014), working memory (Tulsky et al, 2014; Tulsky et al, 2013), reading (Gershon et al, 2014; Gershon, Slotkin, et al, 2013), vocabulary (Gershon et al, 2014; Gershon, Slotkin, et al, 2013), inhibitory control (Zelazo et al, 2013; Zelazo et al, 2014), cognitive flexibility (Zelazo et al, 2013; Zelazo et al, 2014), and processing speed (Carlozzi et al, 2014).…”

mentioning

confidence: 99%

Factor structure of the NIH Toolbox Cognition Battery in individuals with acquired brain injury.

Tulsky¹,

Holdnack²,

Cohen³

et al. 2017

Rehabilitation Psychology

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Objective The National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) measures reading, vocabulary, episodic memory, working memory, executive functioning and processing speed. While previous research has validated the factor structure in healthy adults, the factor structure has not been examined in adults with neurological impairments. Thus, this study evaluated the NIHTB-CB factor structure in individuals with acquired brain injury. Method A sample of 392 individuals (ages 18-84) with acquired brain injury (n =182 TBI, n = 210 stroke) completed the NIHTB-CB along with neuropsychological tests as part of a larger, multi-site research project. Results Confirmatory factor analyses supported a 5-factor solution that included reading, vocabulary, episodic memory, working memory, and processing speed/executive functioning. This structure generally held in TBI and stroke subsamples as well as in subsamples of those with severe TBI and stroke injuries. Conclusions The factor structure of the NIHTB-CB is similar in adults with acquired brain injury to adults from the general population. We discuss the implications of these findings for clinical practice and clinical research.

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“…While some investigators have argued that values of at least .7 are ‘minimally acceptable’ (Cicchetti, 2001; Satler, 2001; Strauss, Sherman, & Spreen, 2006), others suggest lower cut-offs of .4 to .6 (Altman, 1991; Weintraub et al, 2014). Furthermore, Charter and Feldt (2001) recognize the importance of considering reliability in clinical evaluation, but argue against specific cutoffs for reliability coefficients.…”

Section: Discussionmentioning

confidence: 99%

Long-term test-retest reliability of the California Verbal Learning Test – second edition

Alioto

Kramer

Borish

et al. 2017

The Clinical Neuropsychologist

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Objective Aging is often associated with declines in episodic memory. Reliable tracking of memory requires assessment instruments that are stable over time to better understand changes potentially attributable to neurodegenerative disease. While prior studies support the test–retest reliability of memory instruments over brief intervals, follow-up testing in clinical settings typically occurs at least one-year later. The present study evaluated the long-term test–retest reliability of the California Verbal Learning Test – second edition (CVLT-2), a widely used measure of episodic learning and memory. Method One hundred and fifty seven healthy older adults (mean age = 68.47 years; education = 17.28 years) underwent repeat assessment at an average of 1.30 years apart. Participants underwent repeat assessment using either parallel or alternate forms at follow-up. We utilized a standardized regression-based (SRB) approach to determine statistically significant changes in test scores over time. Results This study revealed modest 1-year test–retest correlation coefficients for the primary CVLT-2 measures (range = .57–.69) Results of SRB formulae are provided to assist clinicians with defining clinically relevant cognitive change on the CVLT-2 while controlling for confounding factors. Conclusions Findings from this study support repeat test administration of the CVLT-2 over longer periods, and may enhance its applicability in determining longitudinal change in memory performance.

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The Cognition Battery of the NIH Toolbox for Assessment of Neurological and Behavioral Function: Validation in an Adult Sample

Cited by 283 publications

References 49 publications

Computerized Cognitive Testing for Use in Clinical Trials: A Comparison of the Nih Toolbox and Cogstate C3 Batteries

Computerized Cognitive Testing for Use in Clinical Trials: A Comparison of the Nih Toolbox and Cogstate C3 Batteries

Factor structure of the NIH Toolbox Cognition Battery in individuals with acquired brain injury.

Long-term test-retest reliability of the California Verbal Learning Test – second edition

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