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Principal Investigator: STEPHEN R RAPP
Organization: WAKE FOREST UNIVERSITY HEALTH SCIENCES
Fiscal Year: 2024
Award: $1,288,706
Funding agency: National Institute on Aging
Project Summary
This multi-site R01 aims to validate video-administered cognitive assessments for use by the
Alzheimer’s Disease Research Centers (ADRCs) and other research programs whose activities have been
interrupted by the COVID-19 pandemic, as well as for use in future initiatives when remote testing will enhance
achievement of scientific goals. While face-to-face administration is the gold standard for cognitive
assessments, conditions often arise that prevent participants from attending in-person visits. These barriers
include transportation challenges, limited mobility, and financial hardship. There is also evidence that
underserved populations, including rural populations and racial/ethnic minorities, are less likely to enroll in
studies that require travel to an academic medical center for face-to-face testing. The proposed study will
address these challenges by utilizing a video-adapted battery incorporating the Uniform Data Set version 3
(UDSv3) measures with additional measures that may serve as alternatives for UDSv3 measures not
adaptable to video administration. We propose to fully validate these assessment tools for remote
administration in partnership with the NIA and the National Alzheimer’s Coordinating Center (NACC), and
carried out by a consortium of 12 ADRCs. Pilot data was gathered from 88 Wake Forest ADRC participants,
deemed by in-person testing and adjudication to have normal cognition, MCI, or dementia, who were tested
either by phone or video. Data show high participant ratings of tolerability, feasibility, and preference for video
versus telephone assessment. There is also high concordance between video-administered and in-
person test scores. Based on this collective data, we plan to fully validate a video-version of the UDSv3
battery in a range of cognitively, ethnically, and geographically diverse participants. We propose to administer
remote video cognitive assessments, paired alongside annual in-person cognitive assessments, in
counterbalanced order, to 500 existing participants from 12 ADRCs utilizing a computer tablet device, including
those previously adjudicated as having normal cognition, MCI and dementia. Participants’ ratings of
satisfaction with test condition and preference of test modality will be obtained, in addition
to the psychometric characteristics of the video battery relative to face-to-face administration, including
concurrent validity, and estimates of relative bias overall and across important subgroups (age, ethnicity,
cognitive status) and mode of administration of individual tests. Concordance between adjudication
outcomes will also be examined to assess the ability of the battery to distinguish normal cognition, MCI and
dementia. We will assess the sensitivity of the video battery to detect longitudinal change in cognition in ADRC
participants by repeating counterbalanced, in-person and remote assessments 2 years following initial
evaluation. Completion of this project is critical to the ongoing success of cognitive assessment in the ADRC
network.
Terms: <AD dementia><ARDS><Academic Medical Centers><Achievement><Achievement Attainment><Acute Respiratory Distress><Acute Respiratory Distress Syndrome><Adult ARDS><Adult RDS><Adult Respiratory Distress Syndrome><Advisory Committees><Affect><Age><Agreement><Alzheimer Type Dementia><Alzheimer disease dementia><Alzheimer sclerosis><Alzheimer syndrome><Alzheimer's><Alzheimer's Disease><Alzheimers Dementia><Amentia><Amyotrophic Lateral Sclerosis><Amyotrophic Lateral Sclerosis Motor Neuron Disease><Assessment instrument><Assessment tool><Attention><Brain Trauma><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Characteristics><Classification><Clinical><Cognition><Cognitive><Da Nang Lung><Data><Data Collection><Data Set><Dementia><Devices><Education><Educational aspects><Enrollment><Episodic memory><Ethnic Origin><Ethnicity><Evaluation><Failure><Financial Hardship><Frail Elderly><Frail Elders><Frail Older Adults><Frail Seniors><Future><Gehrig's Disease><Geographic Area><Geographic Locations><Geographic Region><Geographical Location><Geography><Goals><Immediate Memory><Individual><Interruption><Language><Lou Gehrig Disease><Measures><Medical center><Minority><Modality><NIH><National Institutes of Health><Neuropsychologies><Neuropsychology><Outcome><Participant><Persons><Phone><Population><Primary Senile Degenerative Dementia><Protocol><Protocols documentation><Psychometrics><Race><Races><Research><Rural Population><Rural group><Rural people><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Shock Lung><Short-Term Memory><Shortterm Memory><Site><Standardization><Stiff lung><Subgroup><Systematics><Tablet Computer><Task Forces><Telephone><Testing><Transportation><Traumatic Brain Injury><Travel><Underserved Population><United States National Institutes of Health><University Medical Centers><Update><Validation><Visit><adjudication><adjudicative process and procedure><advisory team><ages><clinical care><cognitive assessment><cognitive testing><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><enroll><ethnic minority><executive control><executive function><financial adversity><financial burden><financial distress><financial insecurity><financial strain><financial stress><frail older adult><geographic site><meeting><meetings><metropolitan><mild cognitive disorder><mild cognitive impairment><neuropsychologic><older adult><older adulthood><preference><prevent><preventing><primary degenerative dementia><programs><racial><racial background><racial minority><racial origin><recruit><remote administration><remote assessment><remote evaluation><remote grading><remote review><remote testing><response><rural individual><satisfaction><senile dementia of the Alzheimer type><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><success><tablet device><tool><traumatic brain damage><under served group><under served individual><under served people><under served population><underserved group><underserved individual><underserved people><validations><verbal><virtual><wet lung><work group><working group><working memory>