Measurement Invariance of the NIH Toolbox‐Cognition Battery Across Demographic Characteristics

Abstract

AbstractBackgroundThe tablet‐based NIH Toolbox‐Cognition Battery (NIHTB‐CB) was compared against the established NACC Uniform Data Set 3.0 (UDS 3.0) neuropsychological battery (used across Alzheimer’s Disease Research Centers). NIHTB‐CB factor invariance is critical for drawing appropriate cross‐demographic conclusions. Invariance was assessed across both batteries for consensus‐driven clinical diagnosis, sex, and age in a large sample of participants from the Advancing Reliable Measurement in Alzheimer’s Disease and Cognitive Aging (ARMADA) study. Goals of this project were to establish the factor relationship of these two batteries and examine their invariance across the aforementioned demographic characteristics.MethodNIHTB‐CB tasks measure Crystalized and Fluid ability. Tests were administered to 571 participants aged 65 to 99 years (mean age 77.2±7.8, 41% female) with normal cognition or amnestic mild cognitive impairment. Groups were classified for age (< = 85 and > 85), gender, and diagnosis. Exploratory Factor Analysis (EFA) was tested for each group with confirmatory factor analysis. If the model fit sufficiently between groups for the configural model, then metric, scalar, and strict invariance models were also examined. Uncorrected standard scores were used for analyses.ResultA four‐factor model emerged as the best fitting model and was invariant across all demographic groups through adjustments. Factor 1: Language (MINT Total, Oral Reading, Picture Vocabulary); Factor 2: Auditory retention (Digits Forward Total and Digits Backward Total); Factor 3: Learning/Memory (List Sorting Working Memory, Picture Sequence Memory, Craft Story 21 Immediate Recall, Craft Story 21 Delayed Recall, Benson Delayed Recall, Animals Category, Vegetables Category, and MoCA Total Score); Factor 4: Attention/Executive Functioning (Dimensional Card Sort, Flanker, Trails A, Trails B, Pattern Comparison Processing Speed, and Benson Recall). We found strong support for strict invariance across the assessed demographic characteristics.ConclusionA four‐factor structure comprised of NIHTB‐CB and UDS 3.0 tests supports the validity of the NIHTB‐CB by matching both UDS 3.0 and NIHTB‐CB measures as expected. Strong support for strict invariance reflects the psychometric equivalence of the NIHTB‐CB construct across the groups. The psychometric properties of the NIHTB‐CB subtests therefore are generalizable across samples. By satisfying the assumption of measurement invariance, inferences made using the NIHTB‐CB about between‐group differences are presumed valid.