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Psychometric Properties of the NIH Toolbox Cognition Battery in Healthy Older Adults: Reliability, Validity, and Agreement with Standard Neuropsychological Tests

Published online by Cambridge University Press:  01 July 2019

Emmi P. Scott ,
Anne Sorrell  and
Andreana Benitez
Emmi P. Scott*
Affiliation:
Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
Anne Sorrell
Affiliation:
Appalachian State University, Boone, NC, USA
Andreana Benitez
Affiliation:
Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA
*
*Correspondence and reprint requests to: Emmi P. Scott, Department of Neurology, Medical University of South Carolina, 96 Jonathan Lucas Street MSC 323, Charleston, SC 29425, USA. E-mail: scottemm@musc.edu
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Abstract

Objective:

Few independent studies have examined the psychometric properties of the NIH Toolbox Cognition Battery (NIHTB-CB) in older adults, despite growing interest in its use for clinical purposes. In this paper we report the test–retest reliability and construct validity of the NIHTB-CB, as well as its agreement or concordance with traditional neuropsychological tests of the same construct to determine whether tests could be used interchangeably.

Methods:

Sixty-one cognitively healthy adults ages 60–80 completed “gold standard” (GS) neuropsychological tests, NIHTB-CB, and brain MRI. Test–retest reliability, convergent/discriminant validity, and agreement statistics were calculated using Pearson’s correlations, concordance correlation coefficients (CCC), and root mean square deviations.

Results:

Test–retest reliability was acceptable (CCC = .73 Fluid; CCC = .85 Crystallized). The NIHTB-CB Fluid Composite correlated significantly with cerebral volumes (r’s = |.35−.41|), and both composites correlated highly with their respective GS composites (r’s = .58−.84), although this was more variable for individual tests. Absolute agreement was generally lower (CCC = .55 Fluid; CCC = .70 Crystallized) due to lower precision in fluid scores and systematic overestimation of crystallized composite scores on the NIHTB-CB.

Conclusions:

These results support the reliability and validity of the NIHTB-CB in healthy older adults and suggest that the fluid composite tests are at least as sensitive as standard neuropsychological tests to medial temporal atrophy and ventricular expansion. However, the NIHTB-CB may generate different estimates of performance and should not be treated as interchangeable with established neuropsychological tests.

Keywords

PsychometricsNeuropsychological testsAssessmentMagnetic resonance imagingComparative studyAging
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 8 , September 2019 , pp. 857 - 867
Copyright
Copyright © INS. Published by Cambridge University Press, 2019. 

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