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

Heaton, Robert K.; Akshoomoff, Natacha; Tulsky, David S.; Mungas, Dan M; Weıntraub, Sandra; Dikmen, Sureyya; Beaumont, Jennifer L.; Casaletto, Kaitlin B.; Conway, Kevin P.; Slotkin, Jerry; Gershon, Richard

doi:10.1017/s1355617714000241

Cited by 323 publications

(313 citation statements)

References 20 publications

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“…Previous investigations have supported the validity of the NIHTB-CB measures of episodic memory (Bauer et al, 2013; Dikmen et al, 2014), working memory (Tulsky et al, 2014; Tulsky et al, 2013), reading (Gershon et al, 2014; Gershon, Slotkin, et al, 2013), vocabulary (Gershon et al, 2014; Gershon, Slotkin, et al, 2013), inhibitory control (Zelazo et al, 2013; Zelazo et al, 2014), cognitive flexibility (Zelazo et al, 2013; Zelazo et al, 2014), and processing speed (Carlozzi et al, 2014). The NIHTB-CB produces T-scores for each measure as well as three composite T-scores – crystallized cognition, fluid cognition, and overall cognition (Akshoomoff et al, 2013; Heaton et al, 2014). These scores can be adjusted for age, sex, education, and race/ethnicity (Casaletto et al, 2015).…”

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confidence: 99%

Factor structure of the NIH Toolbox Cognition Battery in individuals with acquired brain injury.

Tulsky¹,

Holdnack²,

Cohen³

et al. 2017

Rehabilitation Psychology

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Objective The National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) measures reading, vocabulary, episodic memory, working memory, executive functioning and processing speed. While previous research has validated the factor structure in healthy adults, the factor structure has not been examined in adults with neurological impairments. Thus, this study evaluated the NIHTB-CB factor structure in individuals with acquired brain injury. Method A sample of 392 individuals (ages 18-84) with acquired brain injury (n =182 TBI, n = 210 stroke) completed the NIHTB-CB along with neuropsychological tests as part of a larger, multi-site research project. Results Confirmatory factor analyses supported a 5-factor solution that included reading, vocabulary, episodic memory, working memory, and processing speed/executive functioning. This structure generally held in TBI and stroke subsamples as well as in subsamples of those with severe TBI and stroke injuries. Conclusions The factor structure of the NIHTB-CB is similar in adults with acquired brain injury to adults from the general population. We discuss the implications of these findings for clinical practice and clinical research.

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confidence: 99%

Factor structure of the NIH Toolbox Cognition Battery in individuals with acquired brain injury.

Tulsky¹,

Holdnack²,

Cohen³

et al. 2017

Rehabilitation Psychology

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“…A total overall composite T score was calculated as the average of all the T scores. 6 Inflammation markers. Laboratory evaluations included fasting serum glucose, HbA 1c , and lipid and renal panels.…”

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Inflammation-associated declines in cerebral vasoreactivity and cognition in type 2 diabetes

et al. 2015

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Objective: The aim of this prospective study was to investigate the relationships between inflammation, cerebral vasoregulation, and cognitive decline in type 2 diabetes mellitus (T2DM) over a 2-year span.Methods: Sixty-five participants (aged 66 6 9.2 years, 35 with T2DM, 33 women) were enrolled for this 2-year prospective study. Continuous arterial spin labeling at 3-tesla MRI was used to measure global and regional cerebral perfusion and vasoreactivity. Neuropsychological measures were evaluated at the beginning and completion of the study. The associations between serum inflammatory markers, regional cerebral vasoreactivity, and cognitive functions were examined using least squares models.Results: After 2 years of follow-up, participants with T2DM had diminished global and regional cerebral vasoreactivity and a decline in multiple cognitive tasks compared with baseline (p , 0.0001-0.012). In the T2DM group, lower cerebral vasoreactivity was associated with a greater decrease in daily living activities score (r Type 2 diabetes mellitus (T2DM) has been recognized as an independent risk for development of cognitive impairment and dementia.1,2 Endothelial dysfunction and impaired cerebral vasoregulation associated with hyperglycemia and elevated proinflammatory cytokine levels have been linked to functional decline in T2DM.3-5 The aim of this study was to prospectively determine the associations between inflammation, cerebral vasoregulation, and cognitive performance over a 2-year span in older adults with and without T2DM. We hypothesized that (1) inflammation and hyperglycemia are associated with impaired vasoregulation in the brain, and (2) impaired vasoregulation is associated with cognitive decline in T2DM.

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“…The tests of crystallized cognitive abilities are Picture Vocabulary and Oral Reading, and they yield individual scores that may be combined into a Crystallized Cognition Composite Score. These tests correlate strongly with hold tests (Heaton, Akshoomoff, Tulsky et al, 2014) and are relatively resistant to the effects of TBI (Authors, under review). For the reading test, examinees read a series of words presented on a screen (e.g.…”

Section: Methodsmentioning

confidence: 99%

NIH toolbox premorbid ability adjustments: Application in a traumatic brain injury sample.

Holdnack¹,

Tulsky²,

Slotkin³

et al. 2017

Rehabilitation Psychology

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Purpose/Objective Metrics to estimate premorbid cognitive ability, such as word reading tests, are important for clinical determination of cognitive changes following brain injury. In the present study, reading adjusted scores for the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) fluid tests were developed and validated with a sample of individuals with traumatic brain injury (TBI), to evaluate the clinical utility of reading-adjusted scores. Research Method/Design The development sample included 843 adult participants, ages 20–85, from the NIHTB-CB standardization sample. A sample of 158 participants with complicated mild or moderate TBI (n = 74) or severe TBI (n = 84) were administered the NIHTB-CB, and comprised the validation sample. Scores were derived for the five fluid tests using four adjustment models: age-only, demographic-only, age-and-reading, and demographic-and-reading referenced scores. Results Estimated premorbid ability varies depending on the reference model. Scores from each of the four reference models differentiated the comparison and TBI samples at the group level. However, performance varied by premorbid ability. Conclusions/Implications Premorbid ability affects identification of cognitive difficulties after TBI. Reading referenced scores provide an individualized estimate of the effects of premorbid ability than demographic characteristics alone. Each model identified a similar number of individuals as having cognitive difficulties; however, the models differed on which individuals had cognitive difficulties. The models had higher disagreement rates in the clinical compared to the comparison sample, particularly for individuals with lower premorbid ability. Clinical use and caveats are discussed.

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

Cited by 323 publications

References 20 publications

Factor structure of the NIH Toolbox Cognition Battery in individuals with acquired brain injury.

Factor structure of the NIH Toolbox Cognition Battery in individuals with acquired brain injury.

Inflammation-associated declines in cerebral vasoreactivity and cognition in type 2 diabetes

NIH toolbox premorbid ability adjustments: Application in a traumatic brain injury sample.

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