The Mobile Toolbox for monitoring cognitive change

Abstract

AbstractBackgroundThe NIH Mobile Toolbox (MTB) includes adapted self‐administered versions of the NIH Toolbox® measures in an expanding library of other brief, sensitive, and easy‐to‐use tasks. Investigators can use the MTB to design smartphone‐based test batteries, develop custom surveys, deploy and manage data collection, and aggregate results. Ease of deployment enables use of the measures in targeted studies, as well as for use in large‐scale surveillance of adults ages 18+ (e.g., to track cognitive functioning across many ages to better understand the life‐course development of Alzheimer’s Disease and ADRD). We describe MTB and demonstrate use of the platform.MethodMTB was created through an NIA‐funded, multi‐institutional effort led by teams based at Northwestern University, Sage Bionetworks, UCSF, and Penn State. All MTB measures were developed for use on Apple and Android smartphones, and then fully validated and then normed in a large national sample.ResultThe MTB library includes eight core cognitive tests assessing language (Spelling; Word Meaning), executive functioning (Arrow Matching; Shape‐Color Sorting), associative memory (Faces and Names), episodic memory (Arranging Pictures), working memory (Sequences) and processing speed (Numbers and Symbols). The system can also passively collect contextual factors that might influence performance. Additional cognitive and non‐cognitive assessments from the International Cognitive Ability Resource (ICAR), Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS), Test My Brain, NIH Toolbox Emotion and the Patient‐Reported Outcomes Measurement Information System (PROMIS) will be available later this yearConclusionThe MTB addresses many scientific, practical, and technical challenges to cognitive assessment by capitalizing on advances in technology, measurement, and cognitive research. Additional clinical validation is underway in clinical and healthy populations, including those at risk for or diagnosed with cognitive impairment or AD/ADRD. MTB is suitable for use in research incorporating point‐in‐time and burst designs as well as ecological momentary assessment (EMA). Guided by the principles of open science, the platform supports data sharing and many components are open source to allow researchers and developers to integrate externally‐developed measures. The MTB is available for use in clinical research and pharmaceutical studies.