Home › Research › Risk factors
Mayo Normative Studies: regression‐based normative data for remote self‐administration of the Stricker Learning Span, Symbols Test and Mayo Test Drive Screening Battery Composite for ages 33‐100 and validation in MCI and dementia
Nikki H. Stricker, Ryan D. Frank, Elizabeth Anne Boots, Winnie Z. Fan, Teresa J. H. Christianson, Walter K. Kremers, John L. Stricker, Mary M. Machulda et al.. Alzheimer s & Dementia, 2024-12-01
Topic: Risk, prevention and care in population studies
Abstract Background Few normative data for computerized measures administered in unsupervised remote environments are available. We aimed to determine what variables to include in normative models for remote self‐administered assessments, develop normative data for measures administered through Mayo Test Drive (MTD, a multi‐device remote cognitive assessment platform) and evaluate application of norms. Method 1240 adults ages 33‐100 (96% White) from the Mayo Clinic Study of Aging and Mayo Alzheimer’s Disease Research Center met normative sample inclusion criteria that included a concordant Cognitively Unimpaired (CU) diagnosis (3 independent raters all diagnosed CU) and CDR = 0 (see Table 1 for sample characteristics). Raw test scores were converted to normalized scaled scores. We derived regression‐based normative data that adjusted for age, age2, sex and education (base model); alternative models are also provided (age+age2+sex; age+ age2). We evaluated whether additional model terms beyond the base model were needed using an a priori cut‐off of 1% variance improvement in adjusted R2 over and above the base model. We examined rates of low test performance defined as performance below ‐1 SD in independent validation samples (n = 167 concordant CU, n = 64 mild cognitive impairment (MCI), n = 14 dementia). Rates are considered significantly different than expected when 95% confidence intervals (CIs) do not include the expected 14.7% base rate frequency. Result No additional potential model terms met our a priori cut‐off for inclusion beyond the base model (see Table 2), including other quadratic and cubic terms or interactions, device type, response input type, potential session interference, and national area deprivation index (ADI available in subset; N = 776). Application of norms showed expected rates of low test performance among CU participants (95% CI includes expected base rate) and significantly greater than expected rates of low test performance for all variables in MCI (e.g., 62.5% for composite) and dementia (e.g., 71.4% for composite; see Table 3). Conclusion Typical normative models appear appropriate for remote self‐administered measures and are sensitive to cognitive impairment. Device type and response input did not explain enough variance to warrant inclusion in normative models but are important for individual level interpretation. Future work will improve representation of individuals from under‐represented groups.
Key findings
- Rates are considered significantly different than expected when 95% confidence intervals (CIs) do not include the expected 14.7% base rate frequency.
- Result No additional potential model terms met our a priori cut‐off for inclusion beyond the base model (see Table 2), including other quadratic and cubic terms or interactions, device type, response input type, potential session interference, and national area deprivation index (ADI available in subset; N = 776).
- Application of norms showed expected rates of low test performance among CU participants (95% CI includes expected base rate) and significantly greater than expected rates of low test performance for all variables in MCI (e.g., 62.5% for composite) and dementia (e.g., 71.4% for composite; see Table 3).
Why it matters
This study developed normative data for remote self-administered cognitive tests through Mayo Test Drive for adults ages 33 to 100. The base model adjusted for age, age2, sex and education, and no additional terms including device type or area deprivation index met the cutoff for inclusion.
New to this subject? Start with our plain-English guide: Risk factors, ranked →
Study details
- Participants167
- Effect size14.7%; 62.5%; 71.4%
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 167 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Ronald Carl Petersen: h-index 209 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39750656) |
| Free to read | 2 / 2 | Free to read |
| Total | 42 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Stricker, N. H., Frank, R. D., Boots, E. A., Fan, W. Z., Christianson, T. J. H., Kremers, W. K., et al. (2024). Mayo Normative Studies: regression‐based normative data for remote self‐administration of the Stricker Learning Span, Symbols Test and Mayo Test Drive Screening Battery Composite for ages 33‐100 and validation in MCI and dementia. Alzheimer s & Dementia. https://doi.org/10.1002/alz.085612
Vancouver
Stricker NH, Frank RD, Boots EA, Fan WZ, Christianson TJH, Kremers WK, et al. Mayo Normative Studies: regression‐based normative data for remote self‐administration of the Stricker Learning Span, Symbols Test and Mayo Test Drive Screening Battery Composite for ages 33‐100 and validation in MCI and dementia. Alzheimer s & Dementia. 2024. doi:10.1002/alz.085612. PMID: 39750656.
BibTeX
@article{stricker2024-39750656,
author = {Stricker, Nikki H. and Frank, Ryan D. and Boots, Elizabeth Anne and Fan, Winnie Z. and Christianson, Teresa J. H. and Kremers, Walter K. and Stricker, John L. and Machulda, Mary M. and others},
title = {{Mayo Normative Studies: regression‐based normative data for remote self‐administration of the Stricker Learning Span, Symbols Test and Mayo Test Drive Screening Battery Composite for ages 33‐100 and validation in MCI and dementia}},
journal = {Alzheimer s \& Dementia},
year = {2024},
doi = {10.1002/alz.085612},
pmid = {39750656},
url = {https://doi.org/10.1002/alz.085612}
}