Comparison of PC and iPad administrations of the Cogstate Brief Battery in the Mayo Clinic Study of Aging: Assessing cross-modality equivalence of computerized neuropsychological tests

Abstract

Objective: Computerized neuropsychological assessments are increasingly used in clinical practice, population studies of cognitive aging and clinical trial enrichment. Subtle, but significant, performance differences have been demonstrated across different modes of test administration and require further investigation.

Method: Participants included cognitively unimpaired adults aged 50 and older from the Mayo Clinic Study of Aging who completed the Cogstate Brief Battery and Cogstate’s Groton Maze Learning Test (GMLT) on an iPad or a personal computer (PC) in the clinic. Mode of administration differences and test–retest reliability coefficients were examined across 3 cohorts: a demographically matched test–retest cohort completing PC and iPad administrations the same day (N = 168); a test naïve cohort comparing baseline PC (n = 1820) and iPad (n =605) performance; and a demographically matched longitudinal cohort completing 3 Cogstate visits over 15 months on either the PC (n =63) or iPad (n =63).

Results: Results showed a small but statistically significant and consistent finding for faster performance on PC relative to iPad for several Cogstate Brief Battery measures. Measures of accuracy generally did not differ or differences were very small. The GMLT showed faster performance and higher total errors on iPad. Most Cogstate variables showed no difference in the rate of change across PC and iPad administrations.

Conclusions: There are small, but significant, differences in performance when giving the same cognitive tests on a PC or an iPad. Future studies are needed to better understand if these small differences impact the clinical interpretation of results and research outcomes.

Keywords:

• Neuropsychology
• computerized testing
• cognitively unimpaired
• reliability
• Groton Maze Learning Test (GMLT)

Acknowledgments

The authors thank the participants and staff at the Mayo Clinic Study of Aging. The authors also thank Adrian Schembri, DPsych, Director of Clinical Science at Cogstate for his responsiveness to questions about Cogstate data and variables.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Rochester Epidemiology Project [grant number R01 AG034676], the National Institutes of Health [grant number R01 AG49810], [grant number P50 AG016574], [grant number U01 AG006786], [grant number R01 AG041851]; the Alzheimer’s Association [grant number AARG-17-531322]; the Robert Wood Johnson Foundation; the Elsie and Marvin Dekelboum Family Foundation; and the Mayo Foundation for Education and Research.