Web-Based Cognitive Testing of Older Adults in Person Versus at Home: Within-Subjects Comparison Study (Preprint)

Cyr, Andrée-Ann; Romero, Kristoffer; Galin-Corini, Laura · 2020 · Crossref

DOI: 10.2196/preprints.23384

archive: archived pipeline: cataloged verified

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Summary

This study addresses the growing need for valid remote cognitive assessment methods for older adults, a population often underrepresented in web-based research due to lower technology adoption rates and potential performance differences between supervised and unsupervised settings. The authors aimed to determine whether healthy older adults perform comparably on computerized cognitive tasks when tested at home versus in a laboratory, and whether computer familiarity or attitudes influence these outcomes. This comparison is critical for validating web-based tools for clinical screening and research, particularly given the limitations of convenience sampling in traditional aging studies. The researchers employed a within-subjects design involving 32 community-dwelling adults aged 65 and older. Participants completed computerized versions of the word-color Stroop task, paired associates learning (PAL), and verbal and matrix reasoning tasks in two environments: unsupervised at home using personal devices and supervised in a laboratory. The order of testing environments was counterbalanced, with sessions spaced 24 hours apart. To assess validity and participant characteristics, the study also administered standardized paper-and-pencil neuropsychological equivalents (WMS-IV Verbal Paired Associates, D-KEFS Color Word Interference, MoCA, and Shipley Verbal subtest) and questionnaires measuring computer anxiety, attitudes, and familiarity. Statistical analyses included mixed analyses of variance and Bayesian inferential testing to evaluate performance differences across environments and correlations with traditional measures. The results indicated no significant effect of the testing environment on performance for any of the computerized cognitive tasks. Analyses of variance showed no differences in reaction times or accuracy for the Stroop task, no differences in learning or delayed memory scores for the PAL task, and no differences in reasoning accuracy between home and laboratory settings. These null findings were supported by Bayesian analyses, which provided evidence for the equivalence of performance across conditions. Furthermore, there were no significant correlations between task performance and participants’ computer familiarity or attitudes. However, performance on the computerized tasks correlated positively with scores on their corresponding paper-and-pencil neuropsychological counterparts, confirming the validity of the web-based measures. The study concludes that older adults can reliably complete computerized cognitive assessments in unsupervised home settings with performance comparable to supervised laboratory conditions. These findings challenge concerns that lack of supervision or lower technological fluency compromises data quality in this demographic. The results support the use of web-based testing for collecting meaningful cognitive data from older adults, offering a cost-effective method to enhance sample diversity and accessibility in both research and clinical contexts. This validation is particularly significant for advancing tele-neuropsychology and remote monitoring of cognitive health.

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• cognitive capacity variation