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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.
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Study details
- Participants167
- Effect size14.7%; 62.5%; 71.4%
- Evidence strengthLow
How this study scored 50/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 32 of the 64 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 32 / 64 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 32 of the 64 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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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.094197
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.094197.
BibTeX
@article{stricker2024-6d09a656,
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.094197},
url = {https://doi.org/10.1002/alz.094197}
}
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