Validity of a short computerized assessment battery for moderate cognitive impairment and dementia.
BACKGROUND
Computerized cognitive assessment tools have been developed to make precise neuropsychological assessment readily available to clinicians. Mindstreams batteries for mild impairment have been validated previously. We examined the validity of a Mindstreams battery designed specifically for evaluating those with moderate cognitive impairment.


METHODS
170 participants over the age of 60 years performed the computerized battery in addition to standard clinical evaluation. The battery consists of six technician-administered tests and one patient-administered interactive test sampling the cognitive domains of orientation (to time and place), memory, executive function, visual spatial processing, and verbal function. Staging was according to the Clinical Dementia Rating Scale (CDR) on the basis of clinical data but independent of computerized cognitive testing results, thus serving as the gold standard for evaluating the discriminant validity of the computerized measures.


RESULTS
Seven participants received a global CDR score of 0 (not impaired), 76 were staged as CDR 0.5 (very mildly impaired), 58 as CDR 1 (mildly impaired), 26 as CDR 2 (moderately impaired), and 3 as CDR 3 (severely impaired). Mindstreams Global Score performance was significantly different across CDR groups (p < 0.001), reflecting poorer overall battery performance for those with greater impairment. This was also true for the domain summary scores, with Executive Function (d = 0.67) and Memory (d = 0.65) distinguishing best between CDR 0.5 and 1, and Orientation best differentiating among CDR 1 and 2 (d = 1.20).


CONCLUSIONS
The Mindstreams battery for moderate impairment differentiates among varying degrees of cognitive impairment in older adults, providing detailed and distinct cognitive profiles.
Department of Geriatrics and Memory Clinic, Mental Health Center, Beersheva, Israel. tzvidov@bgu.ac.il
Tzvi
T
Dwolatzky
Luba
L
Dimant
Ely S
ES
Simon
Glen M
GM
Doniger
D000203:Activities of Daily Living; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards; D015203:Reproducibility of Results; D013028:Space Perception; D018709:Statistics, Nonparametric; D014705:Verbal Behavior