A short screening tool opens the door to better understanding the cognitive health needs of people with schizophrenia

Obstacles and future opportunities for effectively measuring cognition in psychosis.

Background: Recent advances in cognitive digital assessment methodology, including high-frequency, ambulatory assessments, promise to improve the detection of subtle cognitive changes. Computational modeling approaches may further improve the sensitivity of digital cognitive assessments to detect subtle cognitive changes by capturing features that map onto core cognitive processes. Objective: We explored the validity of a brief smartphone-based adaptation of a visual working memory task that has shown sensitivity for detecting preclinical Alzheimer disease risk. We aimed to optimize properties of the task for computational cognitive feature extraction with drift diffusion modeling. Methods: We analyzed data from 68 participants (n=47, 69% women; n=55, 81% White; mean age 49, SD 14; range 24-80 years) who completed 60 trials for each of 16 variations of a visual working memory binding task (the Color Shapes task) on smartphones, over an 8-day period. A drift diffusion model was fit to the response time and accuracy data from the task. We experimentally manipulated 3 properties of the Color Shapes task (study time, probability of change, and choice urgency) to test how they yielded differences in key drift diffusion model parameters (drift rate, initial bias toward a response option, and caution in decision-making). We also evaluated how an additional task property, the test array size, impacted responses across all conditions. For array size, we tested a whole display of 3 shapes against a single probe of 1 shape only. Results: The 3 task property manipulations yielded the following results: (1) increasing the ratio of different responses was credibly associated with higher initial bias toward the different response (mean 0.06, SD 0.02 for the whole display; mean 0.15, SD 0.02, for the single probe condition); (2) increasing the choice urgency during the test phase was credibly associated with decreased caution in decision-making in the single probe condition (mean −0.04, SD 0.02) but not in the whole display (mean −0.01, SD 0.02); and (3) contrary to expectation, longer study times did not yield a credibly faster drift rate but produced credibly slower ones for the whole display condition (mean −0.28, SD 0.05) and a null effect for the single probe condition (mean 0.01, SD 0.05). In addition, as expected, we found that individual differences in drift rate were associated with age in both array sizes (r=−0.45 with Bayes factor=191), with older participants having a slower drift rate. Older participants also showed higher caution (r=0.42 with Bayes factor=80.76) in the single probe condition. Conclusions: We identified a version of the Color Shapes task optimized for smartphone-based cognitive assessments in real-world settings, with data designed for analysis through computational cognitive modeling. Our proposed approach can advance the development of tools for efficient and effective early detection and monitoring of risk for Alzheimer disease.

Kurt is joined by Dr Jeffrey Wozniak; a clinical paediatric neuropsychologist at the University of Minnesota and Dr Blake Gimbel; also a paediatric

Background: Elective surgeries for older adults are increasing. Machine learning could enhance risk assessment, influencing surgical planning and postoperative care. Preoperative cognitive assessment may facilitate early detection and management of postoperative delirium (POD). Objective: This study aims to assess machine learning models' predictive ability for POD, focusing on added predictive value of the neuropsychological assessments before elective surgery. Methods: This retrospective cohort study analyzed data from the multicenter PAWEL and PAWEL-R studies, encompassing older patients (≥70 years) undergoing elective surgeries from July 2017 to April 2019. A total of 1624 patients (52.3% male, N = 850; mean age [SD], 77.9 [4.9] years) were included, with POD diagnosis made before discharge. Sociodemographic, clinical, surgical, and neuropsychological features were collected pre- and intraoperatively by care providers. Machine learning model performance was evaluated using the area under the receiver operating characteristic curve (AUC), with permutation testing for significance and SHapley Additive exPlanations to identify effective neuropsychological assessments. Results: Predicting POD before surgery with a random forest model achieved an AUC of 0.760. Incorporating all pre- and intraoperative features into the model yielded a slightly higher AUC of 0.783, with no statistically significant difference observed (P= .243). While cognitive factors alone were not strong predictors (AUC=0.617), specific tests within neuropsychological assessments, such as the Montreal Cognitive Assessment and Trail Making Tests, showed high feature attribution and play a crucial role in further enhancing prediction before surgery. Conclusions: Preoperative risk prediction for POD can increase risk awareness in presurgical assessment and improve perioperative management in older patients at a high risk for delirium. Clinical Trial: The study was registered with the German Clinical Trials Register under the identifiers DRKS12797 and DRKS13311.

Background: Cognitive tasks are essential tools in psychology and neuroscience research, offering insights into various mental processes such as attention, perception, and memory. These tasks often involve simple stimuli, such as alphanumeric characters and shapes, and a large number of trials, a deliberate design choice aimed at controlling for extraneous variables and ensuring the reliability of the results. While this methodological approach is crucial for maintaining experimental rigor and validity, it may inadvertently lead to issues regarding participant engagement. Objective: The main objective of the present empirical study was to investigate whether gamified versions of 3 established cognitive tasks, namely the Visual Search, the Whack-the-Mole, and the Corsi block tasks yield the same patterns of results as their traditional counterparts. These three tasks were chosen because they are commonly used to assess attention and visual short-term memory, which are crucial for many everyday tasks. Methods: Participants executed our gamified versions of the Visual Search, the Whack-the-Mole, and the Corsi Block in one of three conditions: in Immersive Virtual Reality (VR-Lab), in a desktop VR environment presented in the lab (Desktop-Lab), and in a desktop VR environment experienced at home (Desktop-Remote). Results: The pattern of results from these gamified tasks replicated those reported in the literature about their traditional counterparts that typically employ simple stimuli and are longer in duration. Notably, some differences in findings were observed across the three administration conditions (VR-Lab, Desktop-Lab, and Desktop-Remote). In the Visual Search and the Whack-the-Mole tasks participants were 250ms and 70ms faster to respond in the VR-Lab than in the Desktop-Lab condition. Moreover, in the Whack-the-Mole task, participants were 160ms faster when carrying out the task in the Desktop-Lab than in the Desktop-Remote condition. Conclusions: Despite these differences, overall, the findings of the study confirm the potential of VR technology as a tool for assessing cognitive performance with tasks that can potentially increase participant engagement.

Background: Age-related differences in motor skills have been extensively studied, with growing interest in using behavioral data for cognitive assessment. Compared to traditional tools like the Mini-Mental State Examination or Cognitive Impairment Screening Test, behavior-based methods offer the advantage of shorter testing durations, less learning effects, and continuous data tracking. Hand movements, in particular, provide a practical way to gather motor performance data with fewer spatial constraints. This study aims to explore whether hand rotation movement can effectively distinguish age-related motor skill differences, with future applications potentially extending to cognitive assessments, including early detection of mild cognitive impairment. Objective: This study investigates whether hand rotation movements can be used to distinguish 2 age groups, young adults (aged 20-29 years) and older adults (aged 65-80 years). We hypothesize that differences in hand motion control ability will exist between the 2 groups. In total, 7 hand motion measurement indicators related to single hand test indicators, time comparison indicators between rotations, and angle comparison indicators between rotations were defined to test this hypothesis, aiming to identify meaningful indicators for older adults experiencing normal aging before conducting experiments on patients with mild cognitive impairment or dementia. Methods: A total of 68 participants, 39 older adults (aged 65-80 years) and 29 young adults (aged 20-29 years), all capable of normal arm, hand, and finger movements, participated in the experiment. Participants sat facing a webcam and were asked to perform hand rotation movements as quickly and accurately as possible with both hands for 10 seconds. They performed 3 trials with a 30-second break in between. For statistical verification, we set the significance level at .05 and analyzed the data using the generalized estimation equations model to assess the effects of the between-subject factor (age group: younger vs older) and the within-subject factors (hand: left vs right, and trials 1, 2, and 3). Results: Among the 7 measured indicators, 3 (total rotation count, angle, and time) showed statistically significant differences between age groups. Younger participants performed more rotations (B=5.29, P=.002), demonstrated a greater range of motion (B=1334.37, P=.007), and completed the task in less time (B=0.99, P=.003), indicating age-related differences in upper limb motor function. Trial order also had a significant main effect on rotation count and angle. Trial 1 differed significantly from trials 2 and 3, while no difference was observed between trials 2 and 3, suggesting that trial 1 may reflect a practice effect. Conclusions: The findings revealed that the older adult group demonstrated statistically significant differences compared to the young adult group in their ability to control hand rotation movements. A learning effect was observed across the 3 trials, suggesting that the first trial should be discarded for use as a stable measurement. Trial Registration:

Background: Executive function encompasses a set of higher-order cognitive processes, including planning, cognitive flexibility, and inhibitory control, that are essential for goal-directed behavior. These abilities are adversely affected by age with executive dysfunction ultimately impairing performance on activities of daily living. Objective: This study aimed to assess the validity of a computerized cognitive assessment in predicting executive function performance in healthy older adults. Methods: This retrospective analysis utilized baseline data from the Improving Neurological Health in Aging via Neuroplasticity-based Computerized Exercise (INHANCE) trial. The study provides normative data for cognitively healthy older adults (aged 65 years and above) and evaluates the #usability and validity of Freeze Frame, a cognitive assessment available on the BrainHQ platform. Performance on Freeze Frame was analyzed in relation to self-reported demographic variables and neuropsychological function, using a standardized measure of executive function, the National Institutes of Health Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (NIH EXAMINER). Results: The intent-to-treat analysis included 92 cognitively healthy older adults (mean age = 71.9 years, SD = 4.86, range: 65–83), of whom 66% were female (61/92), with a mean education level of 16.45 years (SD = 3.40, range: 9–27). Performance on Freeze Frame was modestly associated with executive function scores on NIH EXAMINER (P = .019), accounting for 6.8% of the variance. The assessment showed a small but statistically significant relationship to age (ρ = -0.22, P = .046) and gender, with no significant influence of education. Psychometric evaluation supported its #usability, with an average completion time of 4 minutes (SD = 0.16). Conclusions: Freeze Frame is a brief, scalable, and accessible computerized cognitive assessment with demonstrated concurrent validity for executive function. Its efficiency and ease of administration across internet-connected devices suggests potential applications for cognitive screening. Future research should explore its utility in detecting executive dysfunction in clinical populations and its potential role in predicting functional performance across activities of daily living. Clinical Trial: The study was registered on November 4, 2019 before participant enrollment under the name “Improving Neurological Health in Aging Via Neuroplasticity-based Computerized Exercise (INHANCE)” with identification number NCT04149457. See https://clinicaltrials.gov/study/NCT04149457 for details.

Background: Computerized cognitive assessments are most often validated against standard neuropsychological measures with limited validation against biological indices of brain health. Objective: To evaluate whether a self-administered computerized cognitive assessment can predict cholinergic neurotransmission using the vesicular acetylcholine transporter ligand [18F]fluoroethoxybenzovesamicol (FEOBV) and positron-emission tomography (PET). Methods: In a retrospective analysis, we report baseline data from the Improving Neurological Health in Aging via Neuroplasticity-based Computerized Exercise (INHANCE) trial. The current study provides normative data for healthy older adults aged 65 and above. We evaluate the predictive validity of the Double Decision cognitive assessment (from the BrainHQ assessment platform) by examining its association with tracer binding in the anterior cingulate cortex, as measured by FEOBV-PET. We also assess concurrent validity with neuropsychological performance using standardized measures of executive function and global cognition. Results: The intent-to-treat population from the INHANCE trial analyzed in this study included 92 healthy adults with a mean age of 71.9 years (SD = 4.86; range 65-83), the majority of whom were female (66%, 61/92), with an average of 16.45 years of education (SD = 3.40; range 9-27). The Double Decision assessment predicted FEOBV binding in the anterior cingulate cortex, explaining 8% of the variance; and was associated with neuropsychological performance measures. The assessment was sensitive to age and was not influenced by education level or gender. Psychometric properties supported its #usability and the assessment showed an average completion time of 3 minutes (SD 1.12). Conclusions: We present the first brief, self-administered computerized cognitive assessment capable of predicting cholinergic network health. This tool is scalable and accessible to any individual with an internet-connected device, offering a practical and cost-efficient approach to cognitive screening. The findings provide valuable insights into brain health, particularly for early detection of cognitive decline, and hold significant potential for broad applications across both clinical and non-clinical contexts. Clinical Trial: https://clinicaltrials.gov/study/NCT04149457

Background: Game-based cognitive assessments (GBCAs) have the potential to transform the field of cognitive testing by enabling more effective screening of age-related cognitive decline. However, we lack a strong understanding of the usability and overall user experience of these games. This is a risk because the primary target users for GBCAs, older people, are seldom involved in game design research and development. Objective: This study aims to address this gap by investigating the usability, acceptability, and enjoyability of GBCAs for older people. Methods: This study followed established practices for undertaking evidence-based systematic reviews. Results: The initial database search returned 15,232 records. After a thorough screening process, 8 studies remained for extraction and analysis. A synthesis of the included papers identified 2 overlapping yet distinct areas of focus: system usability and subjective user experience. Usability scores were mostly positive across the studies included. However, in several of the game studies, older adults and those with cognitive impairment tended to find GBCAs less usable. This trend was observed even when the games were explicitly designed for these populations, and the tasks were simplistic and representative of basic daily activities. In our second focus area, user experience, we identified the importance of perceived challenge in mediating gameplay experience across groups. That is, generating the appropriate level of difficulty for each user is important for positive user experiences, specifically enjoyment. Conclusions: On the basis of these findings, we identified key learnings for researchers interested in designing and developing GBCAs. These include (1) recognizing that validity is essential but not sufficient on its own; (2) clearly defining the intended user; (3) designing games that align with the unique preferences and needs of older people; and (4), whenever possible, providing each user with their optimal level of challenge. Clinical Trial: PROSPERO CRD42023433298; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023433298

Background: Game-based cognitive assessments (GBCAs) have the potential to transform the field of cognitive testing by enabling more effective screening of age-related cognitive decline. However, we lack a strong understanding of the usability and overall user experience of these games. This is a risk because the primary target users for GBCAs, older people, are seldom involved in game design research and development. Objective: This study aims to address this gap by investigating the usability, acceptability, and enjoyability of GBCAs for older people. Methods: This study followed established practices for undertaking evidence-based systematic reviews. Results: The initial database search returned 15,232 records. After a thorough screening process, 8 studies remained for extraction and analysis. A synthesis of the included papers identified 2 overlapping yet distinct areas of focus: system usability and subjective user experience. Usability scores were mostly positive across the studies included. However, in several of the game studies, older adults and those with cognitive impairment tended to find GBCAs less usable. This trend was observed even when the games were explicitly designed for these populations, and the tasks were simplistic and representative of basic daily activities. In our second focus area, user experience, we identified the importance of perceived challenge in mediating gameplay experience across groups. That is, generating the appropriate level of difficulty for each user is important for positive user experiences, specifically enjoyment. Conclusions: On the basis of these findings, we identified key learnings for researchers interested in designing and developing GBCAs. These include (1) recognizing that validity is essential but not sufficient on its own; (2) clearly defining the intended user; (3) designing games that align with the unique preferences and needs of older people; and (4), whenever possible, providing each user with their optimal level of challenge. Clinical Trial: PROSPERO CRD42023433298; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023433298

Background: Phenylketonuria (PKU) is a rare, hereditary disease that causes disruption in phenylalanine (Phe) metabolism. Despite early intervention, individuals with PKU may have difficulty in several different cognitive domains, including verbal fluency, processing speed, and executive functioning. Objective: The overarching goal of this study is to characterize the relationships among cognition, speech, mood, and blood-based biomarkers (Phe, tyrosine) in individuals with early treated PKU. We describe our initial optimization pilot results that are guiding this study while establishing the #feasibility and reliability of using ecological momentary assessment (EMA) in this clinical population. Methods: In total, 20 adults with PKU were enrolled in this study between December 2022 and March 2023 through the National PKU Alliance. Of the total, 18 participants completed an extended baseline assessment followed by 6 EMAs over 1 month. The EMAs included digital cognitive tests measuring processing speed, sustained attention, and executive functioning, as well as speech (semantic fluency) and mood measures. Participants had 60 minutes to complete the assessment. Results: Completion rates of EMAs were above 70% (on average 4.78 out of 6 EMAs), with stable performances across baseline measures and EMAs. Between-person reliability (BPR) of the EMAs, representing the variance due to differences between individuals versus within individuals, is satisfactory with values close to (semantic fluency BPR: 0.7, sustained attention BPR: 0.72) or exceeding (processing speed: 0.93, executive functioning: 0.88) data collected from a large normative database (n=5039-10,703), as well as slightly below or matching a previous study using a clinical group (n=18). As applicable, within-person reliability was also computed; we demonstrated strong reliability for processing speed (0.87). A control analysis ensured that time of day (ie, morning, afternoon, and evening) did not impact performance; performance on tasks did not decrease if tested earlier versus later in the day (all P values >.09). Similarly, to assess variability in task performance over the course of all EMAs, the coefficient of variability was computed; 28% for the task measuring sustained attention, 37% for semantic fluency, 15.8% for the task measuring executive functioning, and 17.6% for processing speed. Performance appears more stable in tasks measuring processing speed and executive functioning than on tasks of sustained attention and semantic fluency. Conclusions: Preliminary results of this study demonstrate strong reliability of cognitive EMA, indicating that EMA is a promising tool for evaluating fluctuations in cognitive status in this population. Future work should refine and expand the utility of these digital tools, determine how variable EMA frequencies might better characterize changes in functioning as they relate to blood-based biomarkers, and validate a singular battery that could be rapidly administered at scale and in clinical trials to determine the progression of disease.

Master Southern Africa launches Namibia specific cognitive assessment norm  The Namibian -

Master Southern Africa has officially launched the Core Namibia Norm, a psychometric benchmarking tool specifically designed for the Namibian workforce. The new tool is set to make hiring more fair and inclusive by changing the way employers assess cognitive abilities during recruitment and talent development. Previously, assessments were done that relied on South African or international standards, which failed to capture Namibia’s distinct cultural, educational and socio-economic context. “This isn’t just a technical upgrade – it’s a major step forward in making assessments fair and meaningful for Namibian professionals,” said Master Southern Africa chief executive Max Mörtl during the launch last week. “We’re proud to lead the way in creating tools that truly reflect the people they’re designed for.” Cognitive assessments are used in the corporate world to test general mental ability, a key predictor of job performance. But according to Mörtl, applying norms from other countries can result in biased outcomes, excluding qualified candidates and leading to costly hiring mistakes. “While there are some similarities between Namibia and South Africa, the two countries are fundamentally different,” said Mörtl. He said using South African norms risk skewing results and reinforcing systemic bias. “A Namibian-specific benchmark is essential,” said Mörtl. This new norm will now mean that when candidates undergo the core general mental ability assessment they are compared to a dataset that reflects Namibian performance norms. “This will result in fairer screening, more accurate results and stronger talent decisions,” said Mörtl. The post Master Southern Africa launches Namibia specific cognitive assessment norm appeared first on The Namibian.

Background: Dementia is characterized by impairments in an individual’s cognitive and functional abilities. Digital cognitive assessments have been shown to be effective in detecting mild cognitive impairment and dementia but whether they can stage the…

Background: Cognitive assessment is an important component of applied psychology, but limited access and high costs make these evaluations challenging. Objective: This study aimed to examine the #feasibility of using large language models (LLMs) to create…

Unlock your cognitive potential with CogniFit's brain training tools! Improve memory, focus, and thinking skills through engaging puzzles and games.

We help researchers administer remote, digital cognitive assessments on smartphones, tablets, and desktop/laptop computers. Our digital cognitive testing platform provides access to raw and summary score data in real-time through a secure data portal.