Cognition assessment using the NIH Toolbox

Neurology (Impact Factor: 8.29). 03/2013; 80(11):S54-64. DOI: 10.1212/WNL.0b013e3182872ded


Cognition is 1 of 4 domains measured by the NIH Toolbox for the Assessment of Neurological and Behavioral Function (NIH-TB), and complements modules testing motor function, sensation, and emotion. On the basis of expert panels, the cognition subdomains identified as most important for health, success in school and work, and independence in daily functioning were Executive Function, Episodic Memory, Language, Processing Speed, Working Memory, and Attention. Seven measures were designed to tap constructs within these subdomains. The instruments were validated in English, in a sample of 476 participants ranging in age from 3 to 85 years, with representation from both sexes, 3 racial/ethnic categories, and 3 levels of education. This report describes the development of the Cognition Battery and presents results on test-retest reliability, age effects on performance, and convergent and discriminant construct validity. The NIH-TB Cognition Battery is intended to serve as a brief, convenient set of measures to supplement other outcome measures in epidemiologic and longitudinal research and clinical trials. With a computerized format and national standardization, this battery will provide a "common currency" among researchers for comparisons across a wide range of studies and populations. Neurology (R) 2013; 80 (Suppl 3):S54-S64

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Available from: Joanne Deocampo, Aug 08, 2014
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    • "Education was measured via self-report in years, from 0 to 20. Reading ability was measured with the NIH Toolbox Oral Reading Recognition Test, which shows good test–retest reliability (intraclass correlation coefficient = 0.90) and convergent validity (r = 0.86) with the Wide Range Achievement Test 4 – reading subtest (Weintraub et al., 2013). Testing language was recorded as English or Spanish. "
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    ABSTRACT: Previous studies showed that control beliefs are more strongly related to global cognition and mortality among adults with low education, providing preliminary evidence that self-efficacy buffers against the negative impact of educational disadvantage on physical and cognitive health. The current study extends these findings to a nationally representative sample of men and women aged 30 to 85 and explores which cognitive domains are most strongly associated with self-efficacy, educational attainment, and their interaction. Data were obtained from 1032 adult (30–85) participants in the United States norming study for the NIH Toolbox. Self-efficacy, executive functioning, working memory, processing speed, episodic memory, and vocabulary were assessed with the NIH Toolbox. Multivariate analysis of covariance and follow-up regressions tested the hypothesis that self-efficacy would be more strongly related to cognitive performance among individuals with lower education, controlling for age, sex, race, ethnicity, education, reading level, testing language, and depressive symptoms. Higher education was associated with higher self-efficacy and better performance on all cognitive tests. Higher self-efficacy was associated with better set-switching and attention/inhibition. Significant self-efficacy by education interactions indicated that associations between self-efficacy and executive abilities were stronger for individuals with lower education. Specifically, individuals with low education but high self-efficacy performed similarly to individuals with high education. This study provides evidence that self-efficacy beliefs buffer against the negative effects of low educational attainment on executive functioning. These results have implications for future policy and/or intervention work aimed at reducing the deleterious effects of educational disadvantage on later cognitive health. ( JINS , 2015, 21 , 297–304)
    Full-text · Article · Apr 2015 · Journal of the International Neuropsychological Society
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    • "The version of the DTT used in UK Biobank, like the original telephone test, has a high frequency limit of 4.0 kHz, so is a suitable test for comparison with those historical data. Cognitive function is most commonly measured using IQ, processing speed and working memory tests [23]. In UK Biobank, cognition is assessed using visually delivered measures of fluid intelligence, processing speed, executive function, number storage (digit span), and visuospatial working memory (shape pairs matching). "
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    ABSTRACT: Background: Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40-69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition.
    Full-text · Article · Sep 2014 · PLoS ONE
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    • "The present study analyzed data from tests of executive functioning (Flanker Inhibitory Control & Attention, Dimensional Change Card Sort), working memory (List Sorting), processing speed (Pattern Comparison), and episodic memory (Picture Sequence Memory) due to the known sensitivity of these cognitive domains to age-related cognitive differences (e.g., Salthouse, 2010). Specific details of the NIH Toolbox Cognition module, including evaluation of its psychometric properties, are available elsewhere (Weintraub et al., 2013). In brief, test–retest reliability of each instrument is good, with intraclass correlation coefficients ranging from 0.72 (Pattern Comparison) to 0.94 (Flanker) in adults. "
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    ABSTRACT: Negative affect (e.g., depression) is associated with accelerated age-related cognitive decline and heightened dementia risk. Fewer studies examine positive psychosocial factors (e.g., emotional support, self-efficacy) in cognitive aging. Preliminary reports suggest that these variables predict slower cognitive decline independent of negative affect. No reports have examined these factors in a single model to determine which best relate to cognition. Data from 482 individuals 55 and older came from the normative sample for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Negative and positive psychosocial factors, executive functioning, working memory, processing speed, and episodic memory were measured with the NIH Toolbox Emotion and Cognition modules. Confirmatory factor analysis and structural equation modeling characterized independent relations between psychosocial factors and cognition. Psychosocial variables loaded onto negative and positive factors. Independent of education, negative affect and health status, greater emotional support was associated with better task-switching and processing speed. Greater self-efficacy was associated with better working memory. Negative affect was not independently associated with any cognitive variables. Findings support the conceptual distinctness of negative and positive psychosocial factors in older adults. Emotional support and self-efficacy may be more closely tied to cognition than other psychosocial variables. (JINS, 2014, 20, 1-9).
    Full-text · Article · Mar 2014 · Journal of the International Neuropsychological Society
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