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Reliability and Validity of Composite Scores from the NIH Toolbox Cognition Battery in Adults

Published online by Cambridge University Press:  24 June 2014

Robert K. Heaton ,
Natacha Akshoomoff ,
David Tulsky ,
Dan Mungas ,
Sandra Weintraub ,
Sureyya Dikmen ,
Jennifer Beaumont ,
Kaitlin B. Casaletto ,
Kevin Conway  and
Jerry Slotkin
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Robert K. Heaton*
Affiliation:
Department of Psychiatry, University of California, San Diego, California
Natacha Akshoomoff
Affiliation:
Department of Psychiatry, University of California, San Diego, California
David Tulsky
Affiliation:
Departments of Rehabilitation Medicine, Orthopedic Surgery, and General Medicine, New York University Langone Medical Center, New York; and Spinal Cord Injury, Kessler Foundation, West Orange, New Jersey
Dan Mungas
Affiliation:
Department of Neurology, University of California, Davis, California
Sandra Weintraub
Affiliation:
Cognitive Neurology and Alzheimer’s Disease Center and Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, Illinois
Sureyya Dikmen
Affiliation:
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
Jennifer Beaumont
Affiliation:
Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
Kaitlin B. Casaletto
Affiliation:
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
Kevin Conway
Affiliation:
National Institute on Drug Abuse, Rockville, Maryland
Jerry Slotkin
Affiliation:
Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
Richard Gershon
Affiliation:
Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
*
Correspondence and reprint requests to: Robert K. Heaton, Department of Psychiatry, UCSD School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093-0603. E-mail: rheaton@ucsd.edu
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Abstract

This study describes psychometric properties of the NIH Toolbox Cognition Battery (NIHTB-CB) Composite Scores in an adult sample. The NIHTB-CB was designed for use in epidemiologic studies and clinical trials for ages 3 to 85. A total of 268 self-described healthy adults were recruited at four university-based sites, using stratified sampling guidelines to target demographic variability for age (20–85 years), gender, education, and ethnicity. The NIHTB-CB contains seven computer-based instruments assessing five cognitive sub-domains: Language, Executive Function, Episodic Memory, Processing Speed, and Working Memory. Participants completed the NIHTB-CB, corresponding gold standard validation measures selected to tap the same cognitive abilities, and sociodemographic questionnaires. Three Composite Scores were derived for both the NIHTB-CB and gold standard batteries: “Crystallized Cognition Composite,” “Fluid Cognition Composite,” and “Total Cognition Composite” scores. NIHTB Composite Scores showed acceptable internal consistency (Cronbach’s alphas=0.84 Crystallized, 0.83 Fluid, 0.77 Total), excellent test–retest reliability (r: 0.86–0.92), strong convergent (r: 0.78–0.90) and discriminant (r: 0.19–0.39) validities versus gold standard composites, and expected age effects (r=0.18 crystallized, r=−0.68 fluid, r=−0.26 total). Significant relationships with self-reported prior school difficulties and current health status, employment, and presence of a disability provided evidence of external validity. The NIH Toolbox Cognition Battery Composite Scores have excellent reliability and validity, suggesting they can be used effectively in epidemiologic and clinical studies. (JINS, 2014, 20, 1–11)

Keywords

Neuropsychological assessmentMemoryExecutive FunctionAttentionCognitive assessmentCognitive screener
Type
Special Series
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 6 , July 2014 , pp. 588 - 598
Copyright
Copyright © The International Neuropsychological Society 2014 

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