Moore Raeanne C, Ackerman Robert A, Russell Madisen T, Campbell Laura M, Depp Colin A, Harvey Philip D, Pinkham Amy E
Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.
Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States.
Front Digit Health. 2022 Aug 5;4:946685. doi: 10.3389/fdgth.2022.946685. eCollection 2022.
It is critical to intervene early in the mild cognitive impairment (MCI) stage of the Alzheimer's disease trajectory, but traditional cognitive testing methods are costly, burdensome, and difficult to access. We examined adherence and validity data to a 30-day self-administered ecological momentary cognitive testing protocol among a sample of older adults with MCI and cognitively normal controls to evaluate feasibility, tolerability, and initial validity in comparison to standard neuropsychological tests. Participants included 48 participants with MCI (Mean age = 72 years, SD = 7 years) and 46 demographically-matched cognitively normal (NC) control participants (Mean age = 70 years, SD = 7 years). Participants completed traditional neuropsychological testing to determine MCI status, followed by 30 days of remote ecological momentary cognitive testing. Ecological momentary assessment (EMA) surveys were administered 3 times per day for 30 days (possible total = 90), and mobile cognitive tests were administered every other day (for a total of 15 administrations). Mobile cognitive tests included the Variable Difficulty List Memory Test (VLMT; measure of learning and memory), Memory Matrix (measure of visual working memory), and the Color Trick Test (measure of executive function). EMA and mobile cognitive test adherence, fatigue effects, mobile cognitive test performance and group differences, and psychometrics (reliability, convergent validity, ceiling effects, and practice effects) were examined. Overall mean-level adherence to the mobile cognitive tests was 85% and did not differ by MCI status. The reliability of stable between-person individual differences for the VLMT and Memory Matrix were very high. Moreover, although the reliability of within-person change for Memory Matrix was adequate, the corresponding reliability for VLMT was somewhat low. Averaged performance on the mobile cognitive tests was correlated with lab-based tests measuring the same construct. Participants with MCI performed worse than NCs on the VLMT and Color Trick Test, and there was no evidence of fatigue effects for these two tests. These findings support the feasibility and potential for ecological momentary cognitive testing to support clinical trials and for measuring cognitive changes over time in persons with increased risk for Alzheimer's disease such as those with MCI.
在阿尔茨海默病发展轨迹的轻度认知障碍(MCI)阶段尽早进行干预至关重要,但传统的认知测试方法成本高昂、负担沉重且难以实施。我们在一组患有MCI的老年人和认知正常的对照组样本中,研究了一项为期30天的自我管理的生态瞬时认知测试方案的依从性和有效性数据,以评估其与标准神经心理学测试相比的可行性、耐受性和初步有效性。参与者包括48名患有MCI的参与者(平均年龄 = 72岁,标准差 = 7岁)和46名人口统计学匹配的认知正常(NC)对照参与者(平均年龄 = 70岁,标准差 = 7岁)。参与者完成传统的神经心理学测试以确定MCI状态,随后进行30天的远程生态瞬时认知测试。生态瞬时评估(EMA)调查每天进行3次,共30天(可能的总数 = 90次),移动认知测试每隔一天进行一次(总共15次)。移动认知测试包括可变难度列表记忆测试(VLMT;学习和记忆测量)、记忆矩阵(视觉工作记忆测量)和颜色技巧测试(执行功能测量)。我们检查了EMA和移动认知测试的依从性、疲劳效应、移动认知测试表现和组间差异以及心理测量学指标(可靠性、收敛效度、天花板效应和练习效应)。移动认知测试的总体平均水平依从率为85%,且不因MCI状态而异。VLMT和记忆矩阵的个体间稳定差异的可靠性非常高。此外,虽然记忆矩阵的个体内变化可靠性足够,但VLMT的相应可靠性有点低。移动认知测试的平均表现与基于实验室的测量相同结构的测试相关。患有MCI的参与者在VLMT和颜色技巧测试中的表现比NC组差,并且这两项测试没有疲劳效应的证据。这些发现支持了生态瞬时认知测试在支持临床试验以及测量阿尔茨海默病风险增加人群(如患有MCI的人)随时间的认知变化方面的可行性和潜力。
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