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Utility of the iPad NIH Toolbox Cognition Battery in a clinical trial of older adults

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Parsey, Carolyn M., Bagger, Justina E., Trittschuh, Emily H., Hanson, Angela J.·2021·Journal of the American Geriatrics Society
DOI 10.1111/jgs.17382PMC PMC8648969
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Abstract

Background: To demonstrate feasibility and utility of the iPad version of the NIH Toolbox Cognition Battery (NIHTB‐CB) in a clinical trial of older adults. Methods: 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. Results: 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. Conclusions: 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.

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  • Prior studies found a small 2.7-point gain on the Fluid Cognition Composite standard scores with 3-5 weeks between administrations, but no practice effects with 15 months between administrations.

    “Findings revealed a small 2.7-point gain with 3–5 weeks between administrations [44], yet no practice effects with 15 months between administrations [45].”

    From Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial (2023) · cites this paper as [44]

    The Results > Test-Retest Characteristics section reports a significant increase in Fluid Composite scores between visits averaging 28.4 days apart, consistent with a gain after roughly four weeks. Our copy does not give the claimed 2.7-point gain. The 15-month finding is attached to a different citation in the citing sentence and is not judged here; page numbers are unavailable in our copy. (LLM, conf=0.82)

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Cited by

Sorted by citations

Authors
Parsey, C. M., Bagger, J. E., Trittschuh, E. H., & Hanson, A. J.
Affiliations
University of Washington (US)
Corresponding author
Hanson, Angela J.
ORCID
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
2021-08-03
Volume
69
Issue
12
Pages
3519-3528
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
DOI
10.1111/jgs.17382
PMC
PMC8648969
OpenAlex
W3190267294
Cited by
14
References
4
Citations by year
2025: 3 · 2024: 3 · 2023: 4 · 2022: 4
FWCI
1.97
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (K23AG047978)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
  • Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
Keywords
NIH Toolbox Cognition Battery, older adults, fluid intelligence, crystallized intelligence, reaction time (psychology), test-retest stability, neuropsychological measures, clinical trial feasibility
MeSH terms
Aged, Cognition Disorders, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Psychometrics, Reaction Time, User-Computer Interface, Reproducibility of Results, Geriatric Assessment, Computers, Handheld

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