title: Development of a self-administered web-based test for longitudinal cognitive assessment.
abstract: Sequential testing with brief cognitive tools has been recommended to improve cognitive screening and monitoring, however the few available tools still depend on an external evaluator and periodic visits. We developed a self-administered computerized test intended for longitudinal cognitive testing (Brain on Track). The test can be performed from a home computer and is composed of several subtests, expected to evaluate different cognitive domains, all including random elements to minimize learning effects. An initial (A) and a refined version of the test (B) were applied to patients with mild cognitive impairment or early dementia (n = 88) and age and education-matched controls. A subsample of a population-based cohort (n = 113) performed the test at home every three months to evaluate test-retest reliability. The test's final version Cronbach's alpha was 0.90, test scores were significantly different between patients and controls (p = 0.001), the area under the receiver operating characteristic curve was 0.75 and the smallest real difference (43.04) was lower than the clinical relevant difference (56.82). In the test-retest reliability analysis 9/10 subtests showed two-way mixed single intraclass consistency correlation coefficient >0.70. These results imply good internal consistency, discriminative ability and reliability when performed at home, encouraging further longitudinal clinical and population-based studies.
authors.affiliation: Department of Neurology, São Sebastião Hospital, Entre Douro e Vouga Hospital Center, 4520-211 Santa Maria da Feira, Portugal.|Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, 4200-319 Porto, Portugal.|EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal.
authors.forename: Luis
authors.initials: L
authors.lastname: Ruano
authors.affiliation: Department of Neurology, São Sebastião Hospital, Entre Douro e Vouga Hospital Center, 4520-211 Santa Maria da Feira, Portugal.
authors.forename: Andreia
authors.initials: A
authors.lastname: Sousa
authors.affiliation: Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, 4200-319 Porto, Portugal.|EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal.
authors.forename: Milton
authors.initials: M
authors.lastname: Severo
authors.affiliation: Department of Neurology, São Sebastião Hospital, Entre Douro e Vouga Hospital Center, 4520-211 Santa Maria da Feira, Portugal.
authors.forename: Ivânia
authors.initials: I
authors.lastname: Alves
authors.affiliation: Clinical Research Office, Health Sciences Department, University of Aveiro, 3810-193, Aveiro, Portugal.
authors.forename: Márcio
authors.initials: M
authors.lastname: Colunas
authors.affiliation: Department of Neurology, São Sebastião Hospital, Entre Douro e Vouga Hospital Center, 4520-211 Santa Maria da Feira, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Barreto
authors.affiliation: Department of Neurology, São Sebastião Hospital, Entre Douro e Vouga Hospital Center, 4520-211 Santa Maria da Feira, Portugal.
authors.forename: Cátia
authors.initials: C
authors.lastname: Mateus
authors.affiliation: Department of Neurology, São Sebastião Hospital, Entre Douro e Vouga Hospital Center, 4520-211 Santa Maria da Feira, Portugal.
authors.forename: Sandra
authors.initials: S
authors.lastname: Moreira
authors.affiliation: Clinical Research Office, Health Sciences Department, University of Aveiro, 3810-193, Aveiro, Portugal.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Conde
authors.affiliation: University Institute of Maia - ISMAI, 4475-690, Maia, Portugal.
authors.forename: Virgílio
authors.initials: V
authors.lastname: Bento
authors.affiliation: Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, 4200-319 Porto, Portugal.|EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Lunet
authors.affiliation: Department of Neurology, São Sebastião Hospital, Entre Douro e Vouga Hospital Center, 4520-211 Santa Maria da Feira, Portugal.|EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Pais
authors.affiliation: Department of Neurology, São Sebastião Hospital, Entre Douro e Vouga Hospital Center, 4520-211 Santa Maria da Feira, Portugal.|EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal.|Clinical Research Office, Health Sciences Department, University of Aveiro, 3810-193, Aveiro, Portugal.
authors.forename: Vítor
authors.initials: V
authors.lastname: Tedim Cruz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000503:physiopathology; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology; D004522:Educational Status; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D025341:Principal Component Analysis; D011594:Psychometrics / Q000379:methods* / Q000706:statistics & numerical data; D012372:ROC Curve; D015203:Reproducibility of Results; D012107:Research Design; D011795:Surveys and Questionnaires