Unsupervised assessment of cognition in the Healthy Brain Project: Implications for web-based registries of individuals at risk for Alzheimer's disease

Stephanie Perin; Rachel F Buckley; Matthew P Pase; Nawaf Yassi; Alexandra Lavale; Peter H Wilson; Adrian Schembri; Paul Maruff; Yen Ying Lim

doi:10.1002/trc2.12043

Unsupervised assessment of cognition in the Healthy Brain Project: Implications for web-based registries of individuals at risk for Alzheimer's disease

Alzheimers Dement (N Y). 2020 Jun 26;6(1):e12043. doi: 10.1002/trc2.12043. eCollection 2020.

Authors

Stephanie Perin^{1

2

3}, Rachel F Buckley^{1

4

5

6}, Matthew P Pase^{1

2

7}, Nawaf Yassi^{1

8

9}, Alexandra Lavale^{1

2}, Peter H Wilson³, Adrian Schembri¹⁰, Paul Maruff^{1

10}, Yen Ying Lim^{1

2}

Affiliations

¹ Melbourne Dementia Research Centre Florey Institute of Neuroscience and Mental Health and the University of Melbourne Parkville Victoria Australia.
² School of Psychological Sciences, Turner Institute for Brain and Mental Health Monash University Clayton Victoria Australia.
³ School of Psychology Faculty of Health Sciences Australian Catholic University Melbourne Victoria Australia.
⁴ Melbourne School of Psychological Sciences University of Melbourne Parkville Victoria Australia.
⁵ Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA.
⁶ Center for Alzheimer Research and Treatment Department of Neurology Brigham and Women's Hospital Boston Massachusetts USA.
⁷ Harvard T.H. Chan School of Public Health Boston Massachusetts USA.
⁸ Department of Medicine and Neurology Melbourne Brain Centre at The Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia.
⁹ Population Health and Immunity Division The Walter and Eliza Hall Institute of Medical Research Parkville Victoria Australia.
¹⁰ Cogstate Ltd Melbourne Victoria Australia.

Abstract

Introduction: Web-based platforms are used increasingly to assess cognitive function in unsupervised settings. The utility of cognitive data arising from unsupervised assessments remains unclear. We examined the acceptability, usability, and validity of unsupervised cognitive testing in middle-aged adults enrolled in the Healthy Brain Project.

Methods: A total of 1594 participants completed unsupervised assessments of the Cogstate Brief Battery. Acceptability was defined by the amount of missing data, and usability by examining error of test performance and the time taken to read task instructions and complete tests (learnability).

Results: Overall, we observed high acceptability (98% complete data) and high usability (95% met criteria for low error rates and high learnability). Test validity was confirmed by observation of expected inverse relationships between performance and increasing test difficulty and age.

Conclusion: Consideration of test design paired with acceptability and usability criteria can provide valid indices of cognition in the unsupervised settings used to develop registries of individuals at risk for Alzheimer's disease.

Keywords: Alzheimer's disease; acceptability; neuropsychological test; neuropsychology; neuroscience; online systems; psychological test; usability; validity.