THE FEASIBILITY OF AT-HOME IPAD COGNITIVE TESTING FOR USE IN CLINICAL TRIALS
D.M. Rentz, M. Dekhtyar, J. Sherman, S. Burnham, D. Blacker, S.L. Aghjayan, K.V. Papp, R.E. Amariglio, A. Schembri, T. Chenhall, P. Maruff, P. Aisen, B.T. Hyman, R.A. Sperling
J Prev Alz Dis 2016;3(1):8-12
Background: Technological advances now make it feasible to administer cognitive assessments at-home on mobile and touch-screen devices such as an iPad or tablet computer. Validation of these techniques is necessary to assess their utility in clinical trials.
Objectives: We used a Computerized Cognitive Composite for Preclinical Alzheimer’s Disease (C3-PAD) developed for iPad 1) to determine the feasibility of performing the C3-PAD at home by older individuals without the presence of a trained psychometrician; 2) to explore the reliability of in-clinic compared to at-home C3-PAD performance and 3) to examine the comparability of C3-PAD performance to standardized neuropsychological tests.
Design, Setting, Participants: Forty-nine cognitively normal older individuals (mean age, 71.46±7.7 years; 20% non-Caucasian) were recruited from research centers at the Massachusetts General Hospital and Brigham and Women’s Hospital. Participants made two in-clinic visits one-week apart and took five 30-minute alternate versions of the C3-PAD at-home measuring episodic memory, reaction time and working memory.
Measurements: A reliability analysis explored equivalence of the six alternate C3-PAD test versions. A feasibility assessment calculated the percentage of individuals who completed all at-home tests correctly, in contrast to incomplete assessments. Correlational analyses examined the association between C3-PAD-clinic compared to C3-PAD-home assessments and between C3-PAD performance and standardized paper and pencil tests.
Results: Excellent reliability was observed among the 6 C3-PAD alternate versions (Cronbach alpha coefficient=0.93). A total of 28 of 49 participants completed all at-home sessions correctly and 48 of 49 completed four out of five correctly. There were no significant differences in participant age, sex or education between complete and incomplete at-home assessments. A single in-clinic C3-PAD assessment and the at-home C3-PAD assessments were highly associated with each other (r2=0.508, p<0.0001), suggesting that at-home tests provide reliable data as in-clinic assessments. There was also a moderate association between the at-home C3-PAD assessments and the in-clinic standardized paper and pencil tests covering similar cognitive domains (r2= 0.168, p< 0.003).
Conclusions: Reliable and valid cognitive data can be obtained from the C3-PAD assessments in the home environment. With initial in-clinic training, a high percentage of older individuals completed at-home assessments correctly. At-home cognitive testing shows promise for inclusion into clinical trial designs.
D.M. Rentz ; M. Dekhtyar ; J. Sherman ; S. Burnham ; D. Blacker ; S.L. Aghjayan ; K.V. Papp ; R.E. Amariglio ; A. Schembri ; T. Chenhall ; P. Maruff ; P. Aisen ; B.T. Hyman ; R.A. Sperling (2015): The Feasibility of At-Home iPad Cognitive Testing For Use in Clinical Trials. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2015.78