Alzheimer's Disease Research Center, University of Washington, Seattle, Washington, USA.
School of Medicine (Neurology), University of Washington, Seattle, Washington, USA.
J Am Geriatr Soc. 2021 Dec;69(12):3519-3528. doi: 10.1111/jgs.17382. Epub 2021 Aug 3.
To demonstrate feasibility and utility of the iPad version of the NIH Toolbox Cognition Battery (NIHTB-CB) in a clinical trial of older adults.
Fifty-one adults, aged 55 and older without dementia were tested twice on NIHTB-CB and more traditional paper-and-pencil neuropsychological measures after meal ingestion, with approximately a 4-week interval. We also compared performances at Time 1 and Time 2 for significant change. We also extracted the response times and errors for available NIHTB-CB subtests to determine subtle changes in performance.
Over the interval, improvement in fluid cognitive measures was noted at Time 2 (t = -3.07, p = 0.004), whereas crystallized measures were unchanged. Tests of fluid cognition negatively correlated with age, particularly for the second visit. Analysis of the average speed per item showed that, for two of the tests, speed increased at Time 2. Traditional neuropsychological tests correlated with many of the NIHTB-CB measures. Response times for all five timed tests decreased at Time 2, although only statistically significant for Picture Sequence and Picture Vocabulary.
The iPad version of the NIH Toolbox Cognition Battery appears to be an adequate measure to assess cognitive functioning in a clinical trial of older adults. Psychometric analyses suggest stability in measures of crystallized functioning, whereas measures of fluid abilities revealed improvements over the short time frame of the study. Response times and errors for individual tests revealed intriguing relationships that should be further evaluated to determine the utility in clinical sample analysis, as this could aid identification of subtle cognitive change over short periods. Additional studies with larger sample sizes will be helpful to understanding the reliability, sensitivity, and specificity of the NIHTB-CB sub-scores in older adults. In addition, further evaluations with clinical populations, including individuals with cognitive impairment, are warranted.
为了在一项针对老年人的临床试验中证明 iPad 版 NIH 工具包认知电池（NIHTB-CB）的可行性和实用性。
51 名年龄在 55 岁及以上、无痴呆的成年人在进食后两次接受 NIHTB-CB 和更传统的纸笔神经心理学测试，两次测试间隔约 4 周。我们还比较了两次测试的表现，以确定是否有显著变化。我们还提取了可用的 NIHTB-CB 子测试的反应时间和错误，以确定性能的细微变化。
在间隔期间，在第二次测试时（t=-3.07，p=0.004），流体认知测量有所改善，而晶体认知测量没有变化。流体认知测试与年龄呈负相关，尤其是第二次测试。对每个项目的平均速度进行分析表明，对于两项测试，速度在第二次测试时有所增加。传统的神经心理学测试与许多 NIHTB-CB 测量结果相关。所有五个定时测试的反应时间在第二次测试时都有所下降，尽管只有图片序列和图片词汇测试的下降具有统计学意义。
iPad 版 NIH 工具包认知电池似乎是评估老年人群临床试验中认知功能的一种充分的测量方法。心理测量分析表明，晶体功能测量具有稳定性，而流体能力测量在研究的短时间内显示出改善。个别测试的反应时间和错误揭示了有趣的关系，这些关系需要进一步评估，以确定在临床样本分析中的实用性，因为这可以帮助识别短期的细微认知变化。更大样本量的进一步研究将有助于了解 NIHTB-CB 子分数在老年人中的可靠性、敏感性和特异性。此外，还需要对包括认知障碍患者在内的临床人群进行进一步评估。
