Reliability of the NACC Telephone-administered Neuropsychological Battery (T-cog) and Montreal Cognitive Assessment for participants in the USC ADRC - PubMed (original) (raw)

. 2023 Mar 8;15(1):e12406.

doi: 10.1002/dad2.12406. eCollection 2023 Jan-Mar.

Affiliations

Reliability of the NACC Telephone-administered Neuropsychological Battery (T-cog) and Montreal Cognitive Assessment for participants in the USC ADRC

Rebecca Sitra Howard et al. Alzheimers Dement (Amst). 2023.

Abstract

Introduction: Restrictions during the COVID-19 pandemic necessitated remote administration of neuropsychological testing. We assessed the test-retest reliability for a telephone-administered cognitive battery, recommended for use in the National Institute on Aging Alzheimer's Disease Research Center (ADRC).

Methods: 64 participants in the University of Southern California ADRC clinical core underwent repeat telephone evaluation using the T-cog Neuropsychological Battery. Reliability was measured by intraclass correlation coefficient (ICC) for continuous variables and weighted Kappa coefficient for categorical variables. Mean scores for Montreal Cognitive Assessment (MoCA) total and Craft Story 21 Immediate and Delayed Recall were compared using paired t tests.

Results: Mean age was 74.8 (8.3 standard deviation); 73.4% were female. ICCs ranged from 0.52 to 0.84, indicating moderate test-retest reliability except for number span backward, which showed poor reliability. Weighted Kappa for MoCA items ranged from -0.016 to 0.734; however, relatively good observed agreement was seen across all items (70.3% to 98.4%). Although MoCA total scores did not significantly change, Craft Story 21 Immediate and Delayed Recall mean scores increased between first and second administrations (P < 0.0001).

Discussion: Test-retest reliability for the T-cog Neuropsychological Battery is adequate. The variation seen in testing is similar to results seen from face-to-face testing, with Craft Story 21 recall showing modest and expected practice effects.

Highlights: Moderate test-retest reliability is seen in most measures of the National Alzheimer's Coordinating Center Neuropsychological Test Battery and the Montreal Cognitive Assessment (MoCA).Intraclass correlation coefficients ranged from 0.52 to 0.84, except for number Span backward.Weighted Kappa for MoCA items varied, but good observed agreement was seen.MoCA total mean score did not change significantly between administrations.Craft Story 21 Immediate and Delayed Recall means increased on repeat testing (P < 0.0001).

Keywords: Alzheimer's Disease Research Center; Alzheimer's disease; Montreal Cognitive Assessment; category fluency; cognitive impairment; craft story; neuropsychological testing; number span; story recall; test–retest reliability; verbal fluency.

© 2023 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.

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Conflict of interest statement

Rebecca Sitra Howard, James Luo, Cynthia Munoz have no disclosures. Terry E. Goldberg reports royalties from VeraSci for use of the BACS cognitive screening instrument in clinical trials. Lon S. Schneider reports personal fees from AC Immune, Alpha‐cognition, Athira, Corium, Cortexyme, BioVie, Eli Lilly, GW Research, Lundbeck, Merck, Neurim, Ltd, Novo‐Nordisk, Otsuka, Roche/Genentech. Cognition Therapeutics, Takeda; grants from Biohaven, Biogen, Eisai, Eli Lilly, Novartis. Author disclosures are available in the supporting information.

Figures

FIGURE 1

FIGURE 1

A, Distribution of MoCA total scores by first and second administrations. B, The difference in MoCA total scores between first and second administrations follows a relatively normal distribution. With a t test statistic = 1.74 and _P_‐value = 0.09, the difference in MoCA total raw scores between initial and repeat T‐cog is not significantly different from 0. MoCA, Montreal Cognitive Assessment; T‐cog, Telephone‐administered Neuropsychological Battery.

FIGURE 2

FIGURE 2

The difference in Craft Story 21 Immediate (A) and Delayed (B) total story units recalled, paraphrase scoring, between first and second administrations, follows relatively normal distributions with a t test = 6.38, P < 0.0001, the difference in Immediate total story units recalled, and a t test = 6.44, P < 0.0001, the difference in Delayed total story units recalled are both significantly different from 0.

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