Validity of Web-based, Self-directed, NeuroCognitive Performance Test in MCI

Digital cognitive tests offer several potential advantages over established paper-pencil tests but have not yet been fully evaluated for the clinical evaluation of mild cognitive impairment. The NeuroCognitive Performance Test (NCPT) is a web-based, self-directed, modular battery intended for repeated assessments of multiple cognitive domains. Our objective was to examine its relationship with the ADAS-Cog and MMSE as well as with established paper-pencil tests of cognition and daily functioning in MCI. We used Spearman correlations, regressions and principal components analysis followed by a factor analysis (varimax rotated) to examine our objectives. In MCI subjects, the NCPT composite is significantly correlated with both a composite measure of established tests (r=0.78, p<0.0001) as well as with the ADAS-Cog (r=0.55, p<0.0001). Both NCPT and paper-pencil test batteries had a similar factor structure that included a large g component with a high eigenvalue. The correlation for the analogous tests (e.g. Trails A and B, learning memory tests) were significant (p<0.0001). Further, both the NCPT and established tests significantly (p< 0.01) predicted the University of California San Diego Performance-Based Skills Assessment and Functional Activities Questionnaire, measures of daily functioning. The NCPT, a web-based, self-directed, computerized test, shows high concurrent validity with established tests and hence offers promise for use as a research or clinical tool in MCI. Despite limitations such as a relatively small sample, absence of control group and cross-sectional nature, these findings are consistent with the growing literature on the promise of self-directed, web-based cognitive assessments for MCI.