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Validity of a short computerized assessment battery for moderate cognitive impairment and dementia

Published online by Cambridge University Press:  03 June 2010

Tzvi Dwolatzky ,
Luba Dimant ,
Ely S. Simon  and
Glen M. Doniger
Tzvi Dwolatzky*
Affiliation:
Department of Geriatrics and Memory Clinic, Mental Health Center, Beersheva, Israel Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheva, Israel
Luba Dimant
Affiliation:
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheva, Israel
Ely S. Simon
Affiliation:
Department of Clinical Science, NeuroTrax Corporation, Fresh Meadows, NY, U.S.A. Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, U.S.A.
Glen M. Doniger
Affiliation:
Department of Clinical Science, NeuroTrax Corporation, Fresh Meadows, NY, U.S.A.
*
Correspondence should be addressed to: Dr. Tzvi Dwolatzky, Department of Geriatrics and Memory Clinic, Mental Health Center, P.O. Box 4600, Beersheva 84170Israel. Phone: +972 8 640 1520; Fax: +972 8 640 1462. Email: tzvidov@bgu.ac.il.
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Abstract

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.

Keywords

computerized cognitive assessmentdementiaelderly
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 5 , August 2010 , pp. 795 - 803
Copyright
Copyright © International Psychogeriatric Association 2010

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