A Tablet-PC-Based Cancellation Test Assessing Executive Functions in Older Adults.

OBJECTIVE To examine older adults' performance on a newly developed tablet-PC-based cancellation test (e-CT) and to study its psychometric properties. METHODS 94 older adults with normal cognitive functioning were recruited. The effects of age, education, sex, and experience with computer-based devices on the e-CT were examined. Construct validity was tested by correlating the e-CT with established measures of executive functions (EF) and episodic memory. Correlation coefficients were used to assess short-term test-retest reliablity. RESULTS The mean age of participants was 74.6 (SD: 7.3) years and 78% were women. Sixty-nine percent had higher education level (> high school) and 76% used computer-based devices daily. The correct cancellations (CC) on the e-CT ranged from 18 to 56, with a mean (SD) of 40.3 (5.7). The CC was inversely correlated with advancing age (rs = -0.59, N = 94, p <0.001) and positively associated with higher education level (U(94) = 646.5, p = 0.02). No relationship was observed between the e-CT and sex or computer-based device experience. In multivariate analysis, only age remained significantly associated with CC (β = -0.46, SE = 0.07, t = -6.47, df = 93, p <0.001). The e-CT correlated significantly with most of measures of EF. Highest correlations were found between the e-CT and the K-T test, a paper-and-pencil cancellation test (rs = 0.63, N = 90, p <0.001) and TMT-B (rs = -0.41, N = 85, p <0.001). The e-CT did not correlate with the RL-RI 16 episodic memory test. The correlation between the first and second e-CT indicated good reliability (rs = 0.89, N = 13, p <0.001). CONCLUSIONS Results suggested that e-CT has good psychometric properties and may be useful for assessing EF in older adults.

[1]  J. Becker,et al.  Ecological assessment of executive functions in mild cognitive impairment and mild Alzheimer’s disease , 2009, Journal of the International Neuropsychological Society.

[2]  Corby K. Martin,et al.  Feasibility, Reliability, and Validity of a Smartphone Based Application for the Assessment of Cognitive Function in the Elderly , 2013, PloS one.

[3]  M. Tierney,et al.  Computerized cognitive assessment in primary care to identify patients with suspected cognitive impairment. , 2010, Journal of Alzheimer's disease : JAD.

[4]  F. Craik,et al.  The handbook of aging and cognition (3rd ed.). , 2008 .

[5]  H. Amièva,et al.  Cognitive slowing and learning of target detection skills in pre-demented subjects , 2004, Brain and Cognition.

[6]  N. Raz.  Aging of the brain and its impact on cognitive performance: Integration of structural and functional findings. , 2000 .

[7]  G. Iverson,et al.  Does familiarity with computers affect computerized neuropsychological test performance? , 2009, Journal of clinical and experimental neuropsychology.

[8]  R. Reitan,et al.  The Halstead-Reitan neuropsychological test battery: Theory and clinical interpretation , 1993 .

[9]  Carol Jagger,et al.  A Comparison of Computerized and Pencil‐and‐Paper Tasks in Assessing Cognitive Function in Community‐Dwelling Older People in the Newcastle 85+ Pilot Study , 2007, Journal of the American Geriatrics Society.

[10]  O. Hanon,et al.  The K-T cancellation test in the older adults: Normative data and construct validity , 2013, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[11]  Grant L Iverson,et al.  Computerized Neuropsychological Assessment Devices: Joint Position Paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology , 2012, The Clinical neuropsychologist.

[12]  Jeffrey L. Cummings,et al.  Practicality of a computerized system for cognitive assessment in the elderly , 2008, Alzheimer's & Dementia.

[13]  Gary Naglie,et al.  Feasibility and Validity of the Self-administered Computerized Assessment of Mild Cognitive Impairment With Older Primary Care Patients , 2014, Alzheimer disease and associated disorders.

[14]  Martial Van der Linden,et al.  L'épreuve de rappel libre / rappel indicé à 16 items (RL/RI-16) , 2004 .

[15]  David E Vance,et al.  The relationship between computer experience and computerized cognitive test performance among older adults. , 2013, The journals of gerontology. Series B, Psychological sciences and social sciences.

[16]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[17]  J. Henry,et al.  Verbal fluency performance in dementia of the Alzheimer’s type: a meta-analysis , 2004, Neuropsychologia.

[18]  Arthur F Kramer,et al.  Performance of a computer‐based assessment of cognitive function measures in two cohorts of seniors , 2013, International journal of geriatric psychiatry.

[19]  H. Chertkow,et al.  The Profile of Executive Functioning in Amnestic Mild Cognitive Impairment: Disproportionate Deficits in Inhibitory Control , 2012, Journal of the International Neuropsychological Society.

[20]  J. Manly,et al.  Cancellation test performance in African American, Hispanic, and White elderly , 2004, Journal of the International Neuropsychological Society.

[21]  A. Slachevsky,et al.  The Technology – Activities of Daily Living Questionnaire: A Version with a Technology-Related Subscale , 2012, Dementia and Geriatric Cognitive Disorders.

[22]  L. Koski,et al.  Computerized testing augments pencil‐and‐paper tasks in measuring HIV‐associated mild cognitive impairment * , 2011, HIV medicine.

[23]  Celeste A de Jager,et al.  Detection of MCI in the clinic: evaluation of the sensitivity and specificity of a computerised test battery, the Hopkins Verbal Learning Test and the MMSE. , 2009, Age and ageing.

[24]  Catharine Trustram Eve,et al.  Piloting and validation of a novel self‐administered online cognitive screening tool in normal older persons: the Cognitive Function Test , 2014, International journal of geriatric psychiatry.

[25]  H. Buschke,et al.  Genuine memory deficits in dementia , 1987 .

[26]  M. Schmitter-Edgecombe,et al.  Applications of Technology in Neuropsychological Assessment , 2013, The Clinical neuropsychologist.

[27]  M. Tsolaki,et al.  Computerized Cognitive Testing for Older Adults , 2015, American journal of Alzheimer's disease and other dementias.

[28]  Adriana M. Seelye,et al.  Status of computerized cognitive testing in aging: A systematic review , 2008, Alzheimer's & Dementia.

[29]  F. Barceló,et al.  Construct validity of the Trail Making Test: Role of task-switching, working memory, inhibition/interference control, and visuomotor abilities , 2009, Journal of the International Neuropsychological Society.

[30]  Daniel Austin,et al.  Unobtrusive measurement of daily computer use to detect mild cognitive impairment , 2014, Alzheimer's & Dementia.

[31]  M. Lachman,et al.  The association between computer use and cognition across adulthood: use it so you won't lose it? , 2010, Psychology and aging.

[32]  Martial Van der Linden,et al.  L'évaluation des troubles de la mémoire , 2000 .

[33]  T. Fritsch,et al.  Effects of Stimulus Properties and Age on Random-Array Letter Cancellation Tasks , 2000 .

[34]  N. Charness,et al.  Factors Predicting the Use of Technology: Findings From the Center for Research and Education on Aging and Technology Enhancement (CREATE) , 2006 .

[35]  D. Wechsler,et al.  Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV) , 2010 .

[36]  Ruben C. Gur,et al.  Normative Data for the Symbol Cancellation Test in Young Healthy Adults , 2004, Applied neuropsychology.

[37]  R. Nitrini,et al.  Cancellation task in very low educated people. , 2008, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[38]  S. Weintraub,et al.  NIH Toolbox Cognition Battery (CB): Validation of Executive Function Measures in Adults , 2014, Journal of the International Neuropsychological Society.