Validity of Web-based, Self-directed, NeuroCognitive Performance Test in MCI

TL;DR

This study evaluates the validity of a web-based, self-directed neurocognitive test (NCPT) in mild cognitive impairment, finding it correlates well with established assessments and predicts daily functioning, supporting its clinical utility.

Contribution

It provides evidence that the NCPT has high concurrent validity with traditional tests in MCI, demonstrating its potential as a convenient clinical and research tool.

Findings

NCPT correlates strongly with established cognitive tests (r=0.78)

NCPT predicts daily functioning measures (p<0.01)

Similar factor structure to traditional paper-pencil tests

Abstract

Digital cognitive tests offer several potential advantages over established paper-pencil tests but have not yet been fully evaluated for the clinical evaluation of mild cognitive impairment. The NeuroCognitive Performance Test (NCPT) is a web-based, self-directed, modular battery intended for repeated assessments of multiple cognitive domains. Our objective was to examine its relationship with the ADAS-Cog and MMSE as well as with established paper-pencil tests of cognition and daily functioning in MCI. We used Spearman correlations, regressions and principal components analysis followed by a factor analysis (varimax rotated) to examine our objectives. In MCI subjects, the NCPT composite is significantly correlated with both a composite measure of established tests (r=0.78, p<0.0001) as well as with the ADAS-Cog (r=0.55, p<0.0001). Both NCPT and paper-pencil test batteries had a similar factor structure that included a large g component with a high eigenvalue. The correlation for the analogous tests (e.g. Trails A and B, learning memory tests) were significant (p<0.0001). Further, both the NCPT and established tests significantly (p< 0.01) predicted the University of California San Diego Performance-Based Skills Assessment and Functional Activities Questionnaire, measures of daily functioning. The NCPT, a web-based, self-directed, computerized test, shows high concurrent validity with established tests and hence offers promise for use as a research or clinical tool in MCI. Despite limitations such as a relatively small sample, absence of control group and cross-sectional nature, these findings are consistent with the growing literature on the promise of self-directed, web-based cognitive assessments for MCI.