The Cognitive Online Self-Test Amsterdam (COST-A): Establishing norm scores in a community-dwelling population

Leonie N.C. Visser; Mark A. Dubbelman; Merike Verrijp; Lisa Wanders; Sophie Pelt; Marissa D. Zwan; Dick H.J. Thijssen; Hans Wouters; Sietske A.M. Sikkes; Hein P.J. van Hout; Wiesje M. van der Flier

doi:10.1002/dad2.12234

The Cognitive Online Self-Test Amsterdam (COST-A): Establishing norm scores in a community-dwelling population

Leonie N.C. Visser, Mark A. Dubbelman^*, Merike Verrijp, Lisa Wanders, Sophie Pelt, Marissa D. Zwan, Dick H.J. Thijssen, Hans Wouters, Sietske A.M. Sikkes, Hein P.J. van Hout, Wiesje M. van der Flier

^*Corresponding author for this work

Clinical Neuropsychology

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Heightened public awareness about Alzheimer's disease and dementia increases the need for at-home cognitive self-testing. We offered Cognitive Online Self-Test Amsterdam (COST-A) to independent groups of cognitively normal adults and investigated the robustness of a norm-score formula and cutoff. Methods: Three thousand eighty-eight participants (mean age ± standard deviation = 61 ± 12 years, 70% female) completed COST-A and evaluated it. Demographically adjusted norm scores were the difference between expected COST-A scores, based on age, gender, and education, and actual scores. We applied the resulting norm-score formula to two independent cohorts. Results: Participants evaluated COST-A to be of adequate difficulty and duration. Our norm-score formula was shown to be robust: ≈8% of participants in two cognitively normal cohorts had abnormal scores. A cutoff of -1.5 standard deviations proved optimal for distinguishing normal from impaired cognition. Conclusion: With robust norm scores, COST-A is a promising new tool for research and clinical practice, providing low cost and minimally invasive remote assessment of cognitive functioning.

Original language	English
Article number	e12234
Journal	Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume	13
Issue number	1
DOIs	https://doi.org/10.1002/dad2.12234
Publication status	Published - 2021

Bibliographical note

Funding Information:
Funding for the data collection and research on which this study is based was provided by the Stichting Stoffels‐Hornstra. Hersenonderzoek.nl was used to contact potential participants and is supported by a grant from ZonMW Memorabel (#73305095003).

Funding Information:
We would like to thank our participants for their involvement, valuable time, and effort. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds.

Funding Information:
We would like to thank our participants for their involvement, valuable time, and effort. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. Researchers who are interested in using COST-A should contact the authors for further details. Funding for the data collection and research on which this study is based was provided by the Stichting Stoffels-Hornstra. Hersenonderzoek.nl was used to contact potential participants and is supported by a grant from ZonMW Memorabel (#73305095003). WMF and LNCV are recipients of ABOARD, a public-private partnership receiving funding from ZonMw (#73305095007) and Health?Holland, Topsector Life Sciences & Health (PPP-allowance; #LSHM20106). LNCV is supported by a fellowship grant received from Alzheimer Nederland (WE.15-2019-05). LW is supported by a grant from the Netherlands Organization for Scientific Research (grant number: ALWTF.2016.032). SAMS is recipient of public-private funding from Health?Holland, Topsector Life Sciences & Health (PPP-allowance; LSHM20084-SGF, project DEFEAT-AD), and the National Institutes of Health, as well as license fees from Green Valley, VtV Therapeutics, Alzheon, Vivoryon, and Roche, and honoraria from Boehringer and Toyama. All funding is paid to her institution. WMF has received further funding from NWO, EU-FP7, EU-JPND, Alzheimer Nederland, CardioVascular Onderzoek Nederland, stichting Dioraphte, Gieskes-Strijbis fund, stichting Equilibrio, Pasman stichting, Biogen MA Inc, Boehringer Ingelheim, Life-MI, AVID, Roche BV, Fujifilm, and Combinostics. WMF holds the Pasman chair, has performed contract research for Biogen MA Inc. and Boehringer Ingelheim, is a consultant to Oxford Health Policy Forum CIC, Roche and Biogen MA Inc., and has been an invited speaker at Boehringer Ingelheim, Biogen MA Inc., Danone, Eisai, WebMD Neurology (Medscape). All funding is paid to her institution. HPJH received grants from European Committee, and Care Institute Netherlands, which were paid to his institution. The other authors have no relevant disclosures.

Publisher Copyright:
© 2021 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association

Funding

Funding for the data collection and research on which this study is based was provided by the Stichting Stoffels‐Hornstra. Hersenonderzoek.nl was used to contact potential participants and is supported by a grant from ZonMW Memorabel (#73305095003). We would like to thank our participants for their involvement, valuable time, and effort. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. We would like to thank our participants for their involvement, valuable time, and effort. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. Researchers who are interested in using COST-A should contact the authors for further details. Funding for the data collection and research on which this study is based was provided by the Stichting Stoffels-Hornstra. Hersenonderzoek.nl was used to contact potential participants and is supported by a grant from ZonMW Memorabel (#73305095003). WMF and LNCV are recipients of ABOARD, a public-private partnership receiving funding from ZonMw (#73305095007) and Health?Holland, Topsector Life Sciences & Health (PPP-allowance; #LSHM20106). LNCV is supported by a fellowship grant received from Alzheimer Nederland (WE.15-2019-05). LW is supported by a grant from the Netherlands Organization for Scientific Research (grant number: ALWTF.2016.032). SAMS is recipient of public-private funding from Health?Holland, Topsector Life Sciences & Health (PPP-allowance; LSHM20084-SGF, project DEFEAT-AD), and the National Institutes of Health, as well as license fees from Green Valley, VtV Therapeutics, Alzheon, Vivoryon, and Roche, and honoraria from Boehringer and Toyama. All funding is paid to her institution. WMF has received further funding from NWO, EU-FP7, EU-JPND, Alzheimer Nederland, CardioVascular Onderzoek Nederland, stichting Dioraphte, Gieskes-Strijbis fund, stichting Equilibrio, Pasman stichting, Biogen MA Inc, Boehringer Ingelheim, Life-MI, AVID, Roche BV, Fujifilm, and Combinostics. WMF holds the Pasman chair, has performed contract research for Biogen MA Inc. and Boehringer Ingelheim, is a consultant to Oxford Health Policy Forum CIC, Roche and Biogen MA Inc., and has been an invited speaker at Boehringer Ingelheim, Biogen MA Inc., Danone, Eisai, WebMD Neurology (Medscape). All funding is paid to her institution. HPJH received grants from European Committee, and Care Institute Netherlands, which were paid to his institution. The other authors have no relevant disclosures.

Keywords

Alzheimer's disease
cognition
normative data
remote assessment
screener
self-testing

Access to Document

10.1002/dad2.12234

Persistent URL (handle)

Persistent link

Cite this

Visser, L. N. C., Dubbelman, M. A., Verrijp, M., Wanders, L., Pelt, S., Zwan, M. D., Thijssen, D. H. J., Wouters, H., Sikkes, S. A. M., van Hout, H. P. J., & van der Flier, W. M. (2021). The Cognitive Online Self-Test Amsterdam (COST-A): Establishing norm scores in a community-dwelling population. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, 13(1), Article e12234. https://doi.org/10.1002/dad2.12234

@article{8cbdd277d634435293b9d688f5b139df,

title = "The Cognitive Online Self-Test Amsterdam (COST-A): Establishing norm scores in a community-dwelling population",

abstract = "Background: Heightened public awareness about Alzheimer's disease and dementia increases the need for at-home cognitive self-testing. We offered Cognitive Online Self-Test Amsterdam (COST-A) to independent groups of cognitively normal adults and investigated the robustness of a norm-score formula and cutoff. Methods: Three thousand eighty-eight participants (mean age ± standard deviation = 61 ± 12 years, 70% female) completed COST-A and evaluated it. Demographically adjusted norm scores were the difference between expected COST-A scores, based on age, gender, and education, and actual scores. We applied the resulting norm-score formula to two independent cohorts. Results: Participants evaluated COST-A to be of adequate difficulty and duration. Our norm-score formula was shown to be robust: ≈8% of participants in two cognitively normal cohorts had abnormal scores. A cutoff of -1.5 standard deviations proved optimal for distinguishing normal from impaired cognition. Conclusion: With robust norm scores, COST-A is a promising new tool for research and clinical practice, providing low cost and minimally invasive remote assessment of cognitive functioning.",

keywords = "Alzheimer's disease, cognition, normative data, remote assessment, screener, self-testing",

author = "Visser, {Leonie N.C.} and Dubbelman, {Mark A.} and Merike Verrijp and Lisa Wanders and Sophie Pelt and Zwan, {Marissa D.} and Thijssen, {Dick H.J.} and Hans Wouters and Sikkes, {Sietske A.M.} and {van Hout}, {Hein P.J.} and {van der Flier}, {Wiesje M.}",

note = "Funding Information: Funding for the data collection and research on which this study is based was provided by the Stichting Stoffels‐Hornstra. Hersenonderzoek.nl was used to contact potential participants and is supported by a grant from ZonMW Memorabel (#73305095003). Funding Information: We would like to thank our participants for their involvement, valuable time, and effort. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. Funding Information: We would like to thank our participants for their involvement, valuable time, and effort. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. Researchers who are interested in using COST-A should contact the authors for further details. Funding for the data collection and research on which this study is based was provided by the Stichting Stoffels-Hornstra. Hersenonderzoek.nl was used to contact potential participants and is supported by a grant from ZonMW Memorabel (#73305095003). WMF and LNCV are recipients of ABOARD, a public-private partnership receiving funding from ZonMw (#73305095007) and Health?Holland, Topsector Life Sciences & Health (PPP-allowance; #LSHM20106). LNCV is supported by a fellowship grant received from Alzheimer Nederland (WE.15-2019-05). LW is supported by a grant from the Netherlands Organization for Scientific Research (grant number: ALWTF.2016.032). SAMS is recipient of public-private funding from Health?Holland, Topsector Life Sciences & Health (PPP-allowance; LSHM20084-SGF, project DEFEAT-AD), and the National Institutes of Health, as well as license fees from Green Valley, VtV Therapeutics, Alzheon, Vivoryon, and Roche, and honoraria from Boehringer and Toyama. All funding is paid to her institution. WMF has received further funding from NWO, EU-FP7, EU-JPND, Alzheimer Nederland, CardioVascular Onderzoek Nederland, stichting Dioraphte, Gieskes-Strijbis fund, stichting Equilibrio, Pasman stichting, Biogen MA Inc, Boehringer Ingelheim, Life-MI, AVID, Roche BV, Fujifilm, and Combinostics. WMF holds the Pasman chair, has performed contract research for Biogen MA Inc. and Boehringer Ingelheim, is a consultant to Oxford Health Policy Forum CIC, Roche and Biogen MA Inc., and has been an invited speaker at Boehringer Ingelheim, Biogen MA Inc., Danone, Eisai, WebMD Neurology (Medscape). All funding is paid to her institution. HPJH received grants from European Committee, and Care Institute Netherlands, which were paid to his institution. The other authors have no relevant disclosures. Publisher Copyright: {\textcopyright} 2021 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association",

year = "2021",

doi = "10.1002/dad2.12234",

language = "English",

volume = "13",

journal = "Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring",

issn = "2352-8729",

publisher = "Elsevier BV",

number = "1",

}

Visser, LNC, Dubbelman, MA, Verrijp, M, Wanders, L, Pelt, S, Zwan, MD, Thijssen, DHJ, Wouters, H, Sikkes, SAM, van Hout, HPJ & van der Flier, WM 2021, 'The Cognitive Online Self-Test Amsterdam (COST-A): Establishing norm scores in a community-dwelling population', Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, vol. 13, no. 1, e12234. https://doi.org/10.1002/dad2.12234

TY - JOUR

T1 - The Cognitive Online Self-Test Amsterdam (COST-A)

T2 - Establishing norm scores in a community-dwelling population

AU - Visser, Leonie N.C.

AU - Dubbelman, Mark A.

AU - Verrijp, Merike

AU - Wanders, Lisa

AU - Pelt, Sophie

AU - Zwan, Marissa D.

AU - Thijssen, Dick H.J.

AU - Wouters, Hans

AU - Sikkes, Sietske A.M.

AU - van Hout, Hein P.J.

AU - van der Flier, Wiesje M.

N1 - Funding Information: Funding for the data collection and research on which this study is based was provided by the Stichting Stoffels‐Hornstra. Hersenonderzoek.nl was used to contact potential participants and is supported by a grant from ZonMW Memorabel (#73305095003). Funding Information: We would like to thank our participants for their involvement, valuable time, and effort. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. Funding Information: We would like to thank our participants for their involvement, valuable time, and effort. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. Researchers who are interested in using COST-A should contact the authors for further details. Funding for the data collection and research on which this study is based was provided by the Stichting Stoffels-Hornstra. Hersenonderzoek.nl was used to contact potential participants and is supported by a grant from ZonMW Memorabel (#73305095003). WMF and LNCV are recipients of ABOARD, a public-private partnership receiving funding from ZonMw (#73305095007) and Health?Holland, Topsector Life Sciences & Health (PPP-allowance; #LSHM20106). LNCV is supported by a fellowship grant received from Alzheimer Nederland (WE.15-2019-05). LW is supported by a grant from the Netherlands Organization for Scientific Research (grant number: ALWTF.2016.032). SAMS is recipient of public-private funding from Health?Holland, Topsector Life Sciences & Health (PPP-allowance; LSHM20084-SGF, project DEFEAT-AD), and the National Institutes of Health, as well as license fees from Green Valley, VtV Therapeutics, Alzheon, Vivoryon, and Roche, and honoraria from Boehringer and Toyama. All funding is paid to her institution. WMF has received further funding from NWO, EU-FP7, EU-JPND, Alzheimer Nederland, CardioVascular Onderzoek Nederland, stichting Dioraphte, Gieskes-Strijbis fund, stichting Equilibrio, Pasman stichting, Biogen MA Inc, Boehringer Ingelheim, Life-MI, AVID, Roche BV, Fujifilm, and Combinostics. WMF holds the Pasman chair, has performed contract research for Biogen MA Inc. and Boehringer Ingelheim, is a consultant to Oxford Health Policy Forum CIC, Roche and Biogen MA Inc., and has been an invited speaker at Boehringer Ingelheim, Biogen MA Inc., Danone, Eisai, WebMD Neurology (Medscape). All funding is paid to her institution. HPJH received grants from European Committee, and Care Institute Netherlands, which were paid to his institution. The other authors have no relevant disclosures. Publisher Copyright: © 2021 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association

PY - 2021

Y1 - 2021

N2 - Background: Heightened public awareness about Alzheimer's disease and dementia increases the need for at-home cognitive self-testing. We offered Cognitive Online Self-Test Amsterdam (COST-A) to independent groups of cognitively normal adults and investigated the robustness of a norm-score formula and cutoff. Methods: Three thousand eighty-eight participants (mean age ± standard deviation = 61 ± 12 years, 70% female) completed COST-A and evaluated it. Demographically adjusted norm scores were the difference between expected COST-A scores, based on age, gender, and education, and actual scores. We applied the resulting norm-score formula to two independent cohorts. Results: Participants evaluated COST-A to be of adequate difficulty and duration. Our norm-score formula was shown to be robust: ≈8% of participants in two cognitively normal cohorts had abnormal scores. A cutoff of -1.5 standard deviations proved optimal for distinguishing normal from impaired cognition. Conclusion: With robust norm scores, COST-A is a promising new tool for research and clinical practice, providing low cost and minimally invasive remote assessment of cognitive functioning.

AB - Background: Heightened public awareness about Alzheimer's disease and dementia increases the need for at-home cognitive self-testing. We offered Cognitive Online Self-Test Amsterdam (COST-A) to independent groups of cognitively normal adults and investigated the robustness of a norm-score formula and cutoff. Methods: Three thousand eighty-eight participants (mean age ± standard deviation = 61 ± 12 years, 70% female) completed COST-A and evaluated it. Demographically adjusted norm scores were the difference between expected COST-A scores, based on age, gender, and education, and actual scores. We applied the resulting norm-score formula to two independent cohorts. Results: Participants evaluated COST-A to be of adequate difficulty and duration. Our norm-score formula was shown to be robust: ≈8% of participants in two cognitively normal cohorts had abnormal scores. A cutoff of -1.5 standard deviations proved optimal for distinguishing normal from impaired cognition. Conclusion: With robust norm scores, COST-A is a promising new tool for research and clinical practice, providing low cost and minimally invasive remote assessment of cognitive functioning.

KW - Alzheimer's disease

KW - cognition

KW - normative data

KW - remote assessment

KW - screener

KW - self-testing

UR - http://www.scopus.com/inward/record.url?scp=85123077695&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85123077695&partnerID=8YFLogxK

U2 - 10.1002/dad2.12234

DO - 10.1002/dad2.12234

M3 - Article

AN - SCOPUS:85123077695

SN - 2352-8729

VL - 13

JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

IS - 1

M1 - e12234

ER -

The Cognitive Online Self-Test Amsterdam (COST-A): Establishing norm scores in a community-dwelling population

Abstract

Bibliographical note

Funding

Keywords

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Cite this