Test-Retest Reliability of a Computerized Cognitive Test Battery: Examining Effect of Age and Stroke

Dual-task methodologies are widely utilized to measure sharing of attentional resources between motor and cognitive functions. The traditional paper-pencil tasks although are valid and reliable, require specialized training, are prone to manual error and are not feasible to use in a dual-task paradigm, limiting its overall usability particularly in clinical settings. This warrants the need for sensitive, accurate, reliable, yet affordable options of computerized testing. The purpose of this study was to establish the test- retest reliability of a computerized custom-designed cognitive test battery (CCT), examining effects of age and stroke which was achieved by establishing test-retest reliability and concurrent validity of the CCT primarily in healthy young adults (n=15) (first study) followed by assessing the same across three different groups including stroke survivors (n=15), healthy older (n=15) and young adults (n=15) (second study). Additionally, we conducted a pilot study to assess whether the developed CCT is sensitive to reported subtle changes in the cognitive performance of chronic stroke survivors (n=13) followed by a novel cognitive-motor intervention (third study). The battery was administered using the DirectRT Empirisoft™ which included tasks that measured 1) visuo-motor function, 2) associated memory, 3) phonemic memory; 4) executive function; 5) discriminant decision-making, and 6) visual working memory,;7) problem solving, 8) information processing speed. The outcome variables consisted of reaction time; accuracy; total time of completion and total number of responses. The average time to implement this battery was 30minutes. Criterion validity was studied against the Delis Kaplan Executive Function System™ (D-KEFS). The results suggested that the custom designed CCT’s administered were moderately reliable tool to assess cognitive function across different age groups and population. A good- moderate concurrent validity was observed on comparing the CCT’s and conventional paper-pencil tests. CCT’S may be a good tool to capture more subtle changes in cognitive functioning along with assessing change is cognition post intervention. To conclude, the CCT’s used in this study was highly reproducible and reliable for several domains of cognitive function. Such testing could be easily implemented by clinicians for assessing cognition and could also be incorporated for in the dual-task testing and training paradigms.