The Survey for Memory, Attention, and Reaction Time (SMART): Development and Validation of a Brief Web-Based Measure of Cognition for Older Adults

Abstract

<b><i>Introduction:</i></b> Brief, Web-based, and self-administered cognitive assessments hold promise for early detection of cognitive decline in individuals at risk for dementia. The current study describes the design, implementation, and convergent validity of a fWeb-based cognitive assessment tool, the Survey for Memory, Attention, and Reaction Time (SMART), for older adults. <b><i>Methods:</i></b> A community-dwelling sample of older adults (<i>n</i> = 69) was included, classified as cognitively intact (<i>n</i> = 44) or diagnosed with mild cognitive impairment (MCI, <i>n</i> = 25). Participants completed the SMART at home using their computer, tablet, or other Internet-connected device. The SMART consists of 4 face-valid cognitive tasks available in the public domain assessing visual memory, attention/processing speed, and executive functioning. Participants also completed a battery of standardized neuropsychological tests, a cognitive screener, and a daily function questionnaire. Primary SMART outcome measures consisted of subtest completion time (CT); secondary meta-metrics included outcomes indirectly assessed or calculated within the SMART (e.g., click count, total CT, time to complete practice items, and time of day the test was completed). <b><i>Results:</i></b> Regarding validity, total SMART CT, which includes time to complete test items, practice items, and directions, had the strongest relationship with global cognition (β = −0.47, <i>p</i> < 0.01). Test item CT was significantly greater for the MCI group (<i>F =</i> 5.20, <i>p</i> = 0.026). Of the SMART tasks, the executive functioning subtests had the strongest relationship with cognitive status as compared to the attention/processing speed and visual memory subtests. The primary outcome measures demonstrated fair to excellent test-retest reliability (intraclass correlation coefficient = 0.50–0.76). <b><i>Conclusions:</i></b> This study provides preliminary evidence for the use of the SMART protocol as a feasible, reliable, and valid assessment method to monitor cognitive performance in cognitively intact and MCI older adults.

Unsupervised mobile cognitive testing for use in preclinical Alzheimer's disease

“…BRANCH exhibited convergent validity with memory measures (i.e., LMDR, FCSRT) and discriminant validity with processing speed measures (i.e., TMTA). Correlations between BRANCH versus traditional memory tests ranged from r = 0.302 to 0.472, which is comparable, if not higher, compared to correlations observed in other studies with digital assessments 45,46 . For example, correlations between Cambridge Neuropsychological Test Automated Battery (CANTAB) memory measures and traditional memory measures ranged from 0.14 to 0.39 47 whereas a digital version of a list‐learning test showed somewhat stronger correlations with the traditional task, exhibiting correlations ranging from .37 to .62 48 .…”

“…Correlations between BRANCH versus traditional memory tests ranged from r = 0.302 to 0.472, which is comparable, if not higher, compared to correlations observed in other studies with digital assessments. 45,46 Finally, worse BRANCH performance was associated with greater global amyloid (r = -0.205, P = .007) and entorhinal tau (r = -0.178, P = .026). These findings suggest that BRANCH captures memory performance that corresponds with biomarker burden in CN individuals who may be at risk for future disease progression.…”

“…Correlations between BRANCH versus traditional memory tests ranged from r = 0.302 to 0.472, which is comparable, if not higher, compared to correlations observed in other studies with digital assessments. 45 , 46 For example, correlations between Cambridge Neuropsychological Test Automated Battery (CANTAB) memory measures and traditional memory measures ranged from 0.14 to 0.39 47 whereas a digital version of a list‐learning test showed somewhat stronger correlations with the traditional task, exhibiting correlations ranging from .37 to .62. 48 However, it appears that the Signs Test, in its current configuration as a continuous learning paradigm, was not as strongly associated with gold standard cognitive measures; as such, we are considering modifying the paradigm in the future.…”

Memory advantage for untrustworthy faces: Replication across lab- and web-based studies

“…Given the striking similarity in memory accuracy, our data, therefore, suggest that data quality was not affected when moving from laboratory to web-based testing, which is in line with several previous studies testing other psychological processes [ 14 , 15 , 17 , 18 , 35 – 39 ]. Our study further extends the validity of online experimental procedures to memory paradigms (e.g., [ 16 , 40 – 43 ]).…”

Digital Cognitive Biomarker for Mild Cognitive Impairments and Dementia: A Systematic Review

“…Table S5: Diagnostic performance of digital cognitive biomarkers for cognitive impairments (CI). Table S6: Quality assessment based on The Newcastle–Ottawa Scale (NOS) [ 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 ]. Figure S1: Between-group mean difference in cognitive outcomes measured by computerized tests in mild cognitive impairments (MCI) and normal controls.…”