Adaptive Testing Combines Precision with Brevity in the Grading of Cognitive Impairment

Abstract

In elderly patients, dementia severity and level of cognitive impairment are typically graded with total scores on fixed tests. We studied patients from a geriatric day clinic and their partners. In this study we examined the adaptive administration of (i) a set of 47 CAMCOG items (C-47) and (ii) a set of 51 items selected from the CAMCOG, the ADAS-cog and a neuropsychological test battery (C-Plus). Participants with impaired vision or hearing, illiteracy, functional problems of the dominant hand or who could not be tested for other reasons were excluded. Partners were also excluded if they were younger than 55 and if they had relevant memory complaints. Our findings suggest that long and precise cognitive tests can be administered much more efficiently by selecting only items of appropriate difficulty for individual patients using Computerized Adaptive Testing (CAT). Substantial reductions in the number of items and testing time needed by CAT were found compared to the whole tests (C-47 and C-Plus). The results are clinically relevant. CAT combines brevity with precision in the grading of dementia severity and cognitive impairment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)