Remotely administered computerized cognitive test battery with older adults

Abstract

AbstractBackgroundComputerized cognitive assessments are an efficient and sensitive method of identifying cognitive impairments in aging and cognitively impaired populations. The current study examines the feasibility and reliability of remote, home testing with a new tool, the California Cognitive Assessment Battery (CCAB).MethodThe CCAB runs on a remote tablet platform (Figure 1) and includes telemedical interaction with an examiner via video chat (Figure 2). Examiners administer a comprehensive set of cognitive tests, including verbal, visual, memory, and processing speed tasks, as well as psychological questionnaires (Figure 3). The tasks are scored automatically, including consensus automated speech recognition (CASR) for the transcription of responses on verbal tasks (e.g., list‐learning memory tasks, picture description, verbal fluency). For the current study, the CCAB was administered remotely to 185 healthy older military veterans (aged 60–89; 18% women) in their homes, with testing sessions under video and audio supervision and assistance. The battery was administered three times within one week to assess test‐retest reliability.ResultReaction times, word onset latency, response accuracy, error types, and speech samples were collected and analyzed. Participant experience was generally favorable: 98% of participants completed all three testing sessions, with 99% of all tests in those sessions completed successfully. Additionally, after a mid‐year software and examiner procedure reformulation of a small subset of CCAB tests, there was a 42% decrease in test failures and a 6% decrease in repeated tests. Individual test times were overall highly uniform across participants (Figure 4), with an entire CCAB battery having low daily test time variability. Also, compared to home noise levels, recorded speech levels were sufficient to support CASR transcript generation for scoring verbal tasks (Figure 5). Finally, in a subset of 50 participants, similar test battery characteristics were found when a CCAB session was repeated later under laboratory conditions.ConclusionThe CCAB shows promise as an objective, reliable automated digital assessment tool to evaluate cognitive functioning in adults both at home and in the laboratory or clinic.