Cognition assessment using the NIH Toolbox

TLDR

The NIH Toolbox assesses cognition as one of four domains, with key subdomains including executive function, episodic memory, language, processing speed, working memory, and attention. The study develops the NIH‑TB Cognition Battery to provide a brief, convenient set of measures for epidemiologic, longitudinal, and clinical research, and reports on its test‑retest reliability, age effects, and construct validity. The battery comprises seven measures targeting the identified subdomains and was validated in a diverse sample of 476 participants aged 3–85 years. The battery demonstrated good test‑retest reliability, age‑related performance patterns, and convergent and discriminant validity, and its computerized, nationally standardized format offers a common currency for cross‑study comparisons.

Abstract

Cognition is 1 of 4 domains measured by the NIH Toolbox for the Assessment of Neurological and Behavioral Function (NIH-TB), and complements modules testing motor function, sensation, and emotion. On the basis of expert panels, the cognition subdomains identified as most important for health, success in school and work, and independence in daily functioning were Executive Function, Episodic Memory, Language, Processing Speed, Working Memory, and Attention. Seven measures were designed to tap constructs within these subdomains. The instruments were validated in English, in a sample of 476 participants ranging in age from 3 to 85 years, with representation from both sexes, 3 racial/ethnic categories, and 3 levels of education. This report describes the development of the Cognition Battery and presents results on test-retest reliability, age effects on performance, and convergent and discriminant construct validity. The NIH-TB Cognition Battery is intended to serve as a brief, convenient set of measures to supplement other outcome measures in epidemiologic and longitudinal research and clinical trials. With a computerized format and national standardization, this battery will provide a "common currency" among researchers for comparisons across a wide range of studies and populations.