Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study

Abstract

INTRODUCTION: Timely detection and tracking of Alzheimer's disease (AD) -related cognitive decline has become a public health priority. We investigated whether the NIH Toolbox for Assessment of Neurological and Behavioral Function—Cognition Battery (NIHTB-CB) detects AD-related cognitive decline. METHODS: N = 171 participants (age 76.5 ± 8; 53% female, 34% Aβ-positive) from the ARMADA study completed the NIHTB-CB at baseline, 12 months, and 24 months. Linear mixed-effect models correcting for demographics were used to examine cross-sectional and longitudinal NIHTB-CB scores in individuals across the clinical AD spectrum. RESULTS: Compared to Aβ-negative healthy controls, Aβ-positive individuals with amnestic MCI or mild AD performed worse on all NIHTB-CB measures and showed an accelerated decline in processing speed, working memory, and auditory word comprehension tests. DISCUSSION: These findings support the use of the NIHTB-CB in early AD, but also imply that the optimal NIHTB-CB composite score to detect change over time may differ across clinical stages of AD. Future directions include replication of these findings in larger and more demographically diverse samples. Highlights: We examined NIH Toolbox—Cognition Battery scores across the clinical AD spectrum. All NIH Toolbox tests detected cross-sectional cognitive impairment in MCI-to-mild AD. Three NIH Toolbox tests captured further decline over time in MCI-to-mild AD. The NIH Toolbox can facilitate timely detection of AD-related cognitive decline.