title: Performance of a computer-based assessment of cognitive function measures in two cohorts of seniors.
abstract: BACKGROUND
  Computer-administered assessment of cognitive function is being increasingly incorporated in clinical trials; however, its performance in these settings has not been systematically evaluated.
  
  
  METHODS
  The Seniors Health and Activity Research Program pilot trial (N = 73) developed a computer-based tool for assessing memory performance and executive functioning. The Lifestyle Interventions and Independence for Elders investigators incorporated this battery in a full-scale multicenter clinical trial (N = 1635). We describe relationships that test scores have with those from interviewer-administered cognitive function tests and risk factors for cognitive deficits and describe performance measures (completeness, intraclass correlations [ICC]).
  
  
  RESULTS
  Computer-based assessments of cognitive function had consistent relationships across the pilot and full-scale trial cohorts with interviewer-administered assessments of cognitive function, age, and a measure of physical function. In the Lifestyle Interventions and Independence for Elders cohort, their external validity was further demonstrated by associations with other risk factors for cognitive dysfunction: education, hypertension, diabetes, and physical function. Acceptable levels of data completeness (>83%) were achieved on all computer-based measures; however, rates of missing data were higher among older participants (odds ratio = 1.06 for each additional year; p < 0.001) and those who reported no current computer use (odds ratio = 2.71; p < 0.001). ICCs among clinics were at least as low (ICC < 0.013) as for interviewer measures (ICC < 0.023), reflecting good standardization. All cognitive measures loaded onto the first principal component (global cognitive function), which accounted for 40% of the overall variance.
  
  
  CONCLUSIONS
  Our results support the use of computer-based tools for assessing cognitive function in multicenter clinical trials of older individuals.
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Katula
authors.forename: Julia
authors.initials: J
authors.lastname: Rushing
authors.forename: Arthur F
authors.initials: AF
authors.lastname: Kramer
authors.forename: Janine M
authors.initials: JM
authors.lastname: Jennings
authors.forename: Kaycee M
authors.initials: KM
authors.lastname: Sink
authors.forename: Neelesh K
authors.initials: NK
authors.lastname: Nadkarni
authors.forename: Kieran F
authors.initials: KF
authors.lastname: Reid
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Castro
authors.forename: Timothy
authors.initials: T
authors.lastname: Church
authors.forename: Diana R
authors.initials: DR
authors.lastname: Kerwin
authors.forename: Jeff D
authors.initials: JD
authors.lastname: Williamson
authors.forename: Richard A
authors.initials: RA
authors.lastname: Marottoli
authors.forename: Scott
authors.initials: S
authors.lastname: Rushing
authors.forename: Michael
authors.initials: M
authors.lastname: Marsiske
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Rapp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D015928:Cognitive Behavioral Therapy; D015331:Cohort Studies; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D010865:Pilot Projects; D012307:Risk Factors
keywords: clinical trial; cognitive function; performance measures