Validation of Video Administration of a Modified UDSv3 Cognitive Battery

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Project Summary This multi-site R01 aims to validate video-administered cognitive assessments for use by the Alzheimer’s Disease Research Centers (ADRCs) and other research programs whose activities have been interrupted by the COVID-19 pandemic, as well as for use in future initiatives when remote testing will enhance achievement of scientific goals. While face-to-face administration is the gold standard for cognitive assessments, conditions often arise that prevent participants from attending in-person visits. These barriers include transportation challenges, limited mobility, and financial hardship. There is also evidence that underserved populations, including rural populations and racial/ethnic minorities, are less likely to enroll in studies that require travel to an academic medical center for face-to-face testing. The proposed study will address these challenges by utilizing a video-adapted battery incorporating the Uniform Data Set version 3 (UDSv3) measures with additional measures that may serve as alternatives for UDSv3 measures not adaptable to video administration. We propose to fully validate these assessment tools for remote administration in partnership with the NIA and the National Alzheimer’s Coordinating Center (NACC), and carried out by a consortium of 12 ADRCs. Pilot data was gathered from 88 Wake Forest ADRC participants, deemed by in-person testing and adjudication to have normal cognition, MCI, or dementia, who were tested either by phone or video. Data show high participant ratings of tolerability, feasibility, and preference for video versus telephone assessment. There is also high concordance between video-administered and in- person test scores. Based on this collective data, we plan to fully validate a video-version of the UDSv3 battery in a range of cognitively, ethnically, and geographically diverse participants. We propose to administer remote video cognitive assessments, paired alongside annual in-person cognitive assessments, in counterbalanced order, to 500 existing participants from 12 ADRCs utilizing a computer tablet device, including those previously adjudicated as having normal cognition, MCI and dementia. Participants’ ratings of satisfaction with test condition and preference of test modality will be obtained, in addition to the psychometric characteristics of the video battery relative to face-to-face administration, including concurrent validity, and estimates of relative bias overall and across important subgroups (age, ethnicity, cognitive status) and mode of administration of individual tests. Concordance between adjudication outcomes will also be examined to assess the ability of the battery to distinguish normal cognition, MCI and dementia. We will assess the sensitivity of the video battery to detect longitudinal change in cognition in ADRC participants by repeating counterbalanced, in-person and remote assessments 2 years following initial evaluation. Completion of this project is critical to the ongoing success of cognitive assessment in the ADRC network.