Performance of a computer-based assessment of cognitive function measures in two cohorts of seniors

Mark A. Espeland, Jeffrey A. Katula, Julia Rushing, Arthur F. Kramer, Janine M. Jennings, Kaycee M. Sink, Neelesh K. Nadkarni, Kieran F. Reid, Cynthia M. Castro, Timothy Church, Diana R. Kerwin, Jeff D. Williamson, Richard A. Marottoli, Scott Rushing, Michael Marsiske, Stephen R. Rapp

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


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. Design: 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. Conclusion: Our results support the use of computer-based tools for assessing cognitive function in multicenter clinical trials of older individuals.

Original languageEnglish (US)
Pages (from-to)1239-1250
Number of pages12
JournalInternational Journal of Geriatric Psychiatry
Issue number12
StatePublished - Dec 2013


  • clinical trial
  • cognitive function
  • performance measures

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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