Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study

Roos J. Jutten; Emily H. Ho; Tatiana Karpouzian-Rogers; Carol van Hulle; Cynthia Carlsson; Hiroko H. Dodge; Cindy J. Nowinski; Richard Gershon; Sandra Weintraub; Dorene M. Rentz

doi:10.1002/dad2.70046

Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study

Roos J. Jutten, Emily H. Ho, Tatiana Karpouzian-Rogers, Carol van Hulle, Cynthia Carlsson, Hiroko H. Dodge, Cindy J. Nowinski, Richard Gershon, Sandra Weintraub, Dorene M. Rentz^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

INTRODUCTION: Timely detection and tracking of Alzheimer's disease (AD) -related cognitive decline has become a public health priority. We investigated whether the NIH Toolbox for Assessment of Neurological and Behavioral Function—Cognition Battery (NIHTB-CB) detects AD-related cognitive decline. METHODS: N = 171 participants (age 76.5 ± 8; 53% female, 34% Aβ-positive) from the ARMADA study completed the NIHTB-CB at baseline, 12 months, and 24 months. Linear mixed-effect models correcting for demographics were used to examine cross-sectional and longitudinal NIHTB-CB scores in individuals across the clinical AD spectrum. RESULTS: Compared to Aβ-negative healthy controls, Aβ-positive individuals with amnestic MCI or mild AD performed worse on all NIHTB-CB measures and showed an accelerated decline in processing speed, working memory, and auditory word comprehension tests. DISCUSSION: These findings support the use of the NIHTB-CB in early AD, but also imply that the optimal NIHTB-CB composite score to detect change over time may differ across clinical stages of AD. Future directions include replication of these findings in larger and more demographically diverse samples. Highlights: We examined NIH Toolbox—Cognition Battery scores across the clinical AD spectrum. All NIH Toolbox tests detected cross-sectional cognitive impairment in MCI-to-mild AD. Three NIH Toolbox tests captured further decline over time in MCI-to-mild AD. The NIH Toolbox can facilitate timely detection of AD-related cognitive decline.

Original language	English (US)
Article number	e70046
Journal	Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume	17
Issue number	1
DOIs	https://doi.org/10.1002/dad2.70046
State	Published - Jan 1 2025

Funding

We thank the study participants and their family members for their participation, along with the research staff across all sites who helped administer this study. Dr. Jutten is supported by an Alzheimer's Association Research Fellowship (AARF\u201022\u2010967786). Funding for the ARMADA study was provided by: (1) Mayo Clinic Florida: NIA P50 AG016574 Mayo Clinic Alzheimer's Disease Research Center; Florida Department of Health Ed & Ethel Moore Alzheimer's Disease Research Program grant 8AZ08 Evaluating The Impact of a Dementia\u2010Caring Community Model on African Americans with Alzheimer's Disease and Their Care Partners; (2) Emory University: NIA 1P30AG066511 Goizueta Alzheimer's Disease Research Center at Emory University; (3) University of California, San Diego: NIA P30AG062429 UCSD Alzheimer's Disease Research Center; (4) NACC NIA U01 AG16976, National Alzheimer's Coordinating Center; (5) Northwestern University: NIA P30 AG013854, Northwestern Alzheimer's Disease Center; NIA R01AG045571, R56AG045571, and R01AG067781, Cognitive SuperAging studies; (6) University of Pittsburgh: NIA P50 AG005133, Alzheimer's Disease Research Center, NIA P01 AG025204, Imaging Pathophysiology in Aging and Neurodegeneration, NIA R01 AG052446, Role of Midlife Cardiovascular Disease on Alzheimer's Pathology and Cerebrovascular Reactivity in the Young\u2010Old; (7) Massachusetts General Hospital: NIA P30AG062421, Massachusetts ADRC; NCBI P01AG036694\u2010 Harvard Aging Brain Study; (8) University of Michigan: NIA P30 AG053760, Michigan Alzheimer's Disease Research Center; NIA R01 AG054484, Community Based Approach to Early Detection of Transitions to Mild Cognitive Impairment and Alzheimer's Disease in African Americans (ELECTRA); NIA R01 AG058724, Treating Mild Cognitive Impairment with High Definition Transcranial Direct Current Stimulation (STIM); NIH RF1 AG047866, Impact of Disclosing Amyloid Imaging Results to Cognitively Normal Individuals (REVEAL SCAN); Cure Alzheimer's Fund, Deep Phenotyping of Older African Americans at Risk of Dementia; (9) Columbia University: Washington Heights\u2010Inwood Columbia Aging Project (WHICAP), NIA PO1AG07232, R01AG037212, RF1AG054023, National Center for Advancing Translational Sciences, National Institutes of Health, through Grant Number UL1TR001873; (10) University of Wisconsin: NIA P50 AG033514 and NIA P30 AG062715 Wisconsin Alzheimer's Disease Research Center; (11) Oregon Health & Science University: Layton Aging and Alzheimer's Disease Center, NIA P30 AG066518; and (12) the ARMADA: Advancing Reliable Measurement in Alzheimer's Disease and cognitive Aging, NIA U2C AG057441.

Keywords

Alzheimer's disease
amyloid
cognition
computerized assessment
mild cognitive impairment

ASJC Scopus subject areas

Clinical Neurology
Psychiatry and Mental health

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10.1002/dad2.70046

Cite this

Jutten, R. J., Ho, E. H., Karpouzian-Rogers, T., van Hulle, C., Carlsson, C., Dodge, H. H., Nowinski, C. J., Gershon, R., Weintraub, S., & Rentz, D. M. (2025). Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, 17(1), Article e70046. https://doi.org/10.1002/dad2.70046

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title = "Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study",

abstract = "INTRODUCTION: Timely detection and tracking of Alzheimer's disease (AD) -related cognitive decline has become a public health priority. We investigated whether the NIH Toolbox for Assessment of Neurological and Behavioral Function—Cognition Battery (NIHTB-CB) detects AD-related cognitive decline. METHODS: N = 171 participants (age 76.5 ± 8; 53% female, 34% Aβ-positive) from the ARMADA study completed the NIHTB-CB at baseline, 12 months, and 24 months. Linear mixed-effect models correcting for demographics were used to examine cross-sectional and longitudinal NIHTB-CB scores in individuals across the clinical AD spectrum. RESULTS: Compared to Aβ-negative healthy controls, Aβ-positive individuals with amnestic MCI or mild AD performed worse on all NIHTB-CB measures and showed an accelerated decline in processing speed, working memory, and auditory word comprehension tests. DISCUSSION: These findings support the use of the NIHTB-CB in early AD, but also imply that the optimal NIHTB-CB composite score to detect change over time may differ across clinical stages of AD. Future directions include replication of these findings in larger and more demographically diverse samples. Highlights: We examined NIH Toolbox—Cognition Battery scores across the clinical AD spectrum. All NIH Toolbox tests detected cross-sectional cognitive impairment in MCI-to-mild AD. Three NIH Toolbox tests captured further decline over time in MCI-to-mild AD. The NIH Toolbox can facilitate timely detection of AD-related cognitive decline.",

keywords = "Alzheimer's disease, amyloid, cognition, computerized assessment, mild cognitive impairment",

author = "Jutten, {Roos J.} and Ho, {Emily H.} and Tatiana Karpouzian-Rogers and {van Hulle}, Carol and Cynthia Carlsson and Dodge, {Hiroko H.} and Nowinski, {Cindy J.} and Richard Gershon and Sandra Weintraub and Rentz, {Dorene M.}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals LLC on behalf of Alzheimer's Association.",

year = "2025",

month = jan,

day = "1",

doi = "10.1002/dad2.70046",

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Jutten, RJ, Ho, EH , Karpouzian-Rogers, T, van Hulle, C, Carlsson, C, Dodge, HH, Nowinski, CJ , Gershon, R , Weintraub, S & Rentz, DM 2025, 'Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study', Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, vol. 17, no. 1, e70046. https://doi.org/10.1002/dad2.70046

Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study. / Jutten, Roos J.; Ho, Emily H.; Karpouzian-Rogers, Tatiana et al.
In: Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, Vol. 17, No. 1, e70046, 01.01.2025.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Computerized cognitive testing to capture cognitive decline in Alzheimer's disease

T2 - Longitudinal findings from the ARMADA study

AU - Jutten, Roos J.

AU - Ho, Emily H.

AU - Karpouzian-Rogers, Tatiana

AU - van Hulle, Carol

AU - Carlsson, Cynthia

AU - Dodge, Hiroko H.

AU - Nowinski, Cindy J.

AU - Gershon, Richard

AU - Weintraub, Sandra

AU - Rentz, Dorene M.

PY - 2025/1/1

Y1 - 2025/1/1

N2 - INTRODUCTION: Timely detection and tracking of Alzheimer's disease (AD) -related cognitive decline has become a public health priority. We investigated whether the NIH Toolbox for Assessment of Neurological and Behavioral Function—Cognition Battery (NIHTB-CB) detects AD-related cognitive decline. METHODS: N = 171 participants (age 76.5 ± 8; 53% female, 34% Aβ-positive) from the ARMADA study completed the NIHTB-CB at baseline, 12 months, and 24 months. Linear mixed-effect models correcting for demographics were used to examine cross-sectional and longitudinal NIHTB-CB scores in individuals across the clinical AD spectrum. RESULTS: Compared to Aβ-negative healthy controls, Aβ-positive individuals with amnestic MCI or mild AD performed worse on all NIHTB-CB measures and showed an accelerated decline in processing speed, working memory, and auditory word comprehension tests. DISCUSSION: These findings support the use of the NIHTB-CB in early AD, but also imply that the optimal NIHTB-CB composite score to detect change over time may differ across clinical stages of AD. Future directions include replication of these findings in larger and more demographically diverse samples. Highlights: We examined NIH Toolbox—Cognition Battery scores across the clinical AD spectrum. All NIH Toolbox tests detected cross-sectional cognitive impairment in MCI-to-mild AD. Three NIH Toolbox tests captured further decline over time in MCI-to-mild AD. The NIH Toolbox can facilitate timely detection of AD-related cognitive decline.

AB - INTRODUCTION: Timely detection and tracking of Alzheimer's disease (AD) -related cognitive decline has become a public health priority. We investigated whether the NIH Toolbox for Assessment of Neurological and Behavioral Function—Cognition Battery (NIHTB-CB) detects AD-related cognitive decline. METHODS: N = 171 participants (age 76.5 ± 8; 53% female, 34% Aβ-positive) from the ARMADA study completed the NIHTB-CB at baseline, 12 months, and 24 months. Linear mixed-effect models correcting for demographics were used to examine cross-sectional and longitudinal NIHTB-CB scores in individuals across the clinical AD spectrum. RESULTS: Compared to Aβ-negative healthy controls, Aβ-positive individuals with amnestic MCI or mild AD performed worse on all NIHTB-CB measures and showed an accelerated decline in processing speed, working memory, and auditory word comprehension tests. DISCUSSION: These findings support the use of the NIHTB-CB in early AD, but also imply that the optimal NIHTB-CB composite score to detect change over time may differ across clinical stages of AD. Future directions include replication of these findings in larger and more demographically diverse samples. Highlights: We examined NIH Toolbox—Cognition Battery scores across the clinical AD spectrum. All NIH Toolbox tests detected cross-sectional cognitive impairment in MCI-to-mild AD. Three NIH Toolbox tests captured further decline over time in MCI-to-mild AD. The NIH Toolbox can facilitate timely detection of AD-related cognitive decline.

KW - Alzheimer's disease

KW - amyloid

KW - cognition

KW - computerized assessment

KW - mild cognitive impairment

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ER -

Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study

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