A-022 Brief Test of Adult Cognition by Telephone to Examine Changes in Cognitive Functioning

Objective The purpose of this study was to examine changes in cognitive function over time as measured by a telephone-delivered cognitive assessment. Method Cognitive and biomarker data from the Midlife in the United States (MIDUS) study were used. Missing data were excluded through listwise deletion resulting in a final sample of 2,378 adult respondents with MIDUS 2: Cognition data available at baseline (T1; Mage = 53.49, SD = 10.63) and 9-year follow up (T2; Mage = 63.64, SD = 11.35). Cognition was measured using Brief Test of Adult Cognition by Telephone (BTACT) composite z-scores (“severe” = <−2.01 SD; “mild” = −1.01 to −2.00 SD; “normal”= > −1.00 SD). Results A Two-Way Repeated Measures ANOVA revealed main effects for time (F1, 2,375 = 46.73, p < .001) and group (F2, 2,375 = 499.34, p < .001). BTACT scores at T1 (M = -1.06, 95% CI[−1.21, −0.92]) were significantly lower than scores at T2 (M = -0.70, 95% CI[−0.82, −0.59]). As expected, BTACT scores for the normal group (M = 0.39, 95% CI[0.35, 0.42]) were significantly greater than both the mild (M = -1.33, 95% CI[−1.36, −1.30]) and severe (M = -2.25, 95% CI[−2.33, −2.16]) groups. A significant interaction effect was observed between time and group (F2, 2,375 = 204.10, p < .001). Bonferroni post-hoc comparisons indicated that cognitive function scores significantly declined for those in the normal group, but significantly improved for those in the mild and severe groups (all ps < .001). A regression model using biomarkers as predictors of cognitive change for the impaired groups was nonsignificant. Conclusion(s) Improvement in the mild and severe groups was unexpected and could not be explained by cardiovascular or metabolic risk factors at T1. These findings suggest cautious interpretation of cognition scores obtained via telephone measures.

A-112 Validity of In-Person Assessment of Traumatic Brain Injury Inpatients Using the Brief Test of Adult Cognition by Telephone

Objective Examine the correlation of the Brief Test of Adult Cognition by Telephone (BTACT) with established neuropsychological tests in an inpatient traumatic brain injury (TBI) population. Method Participants were 55 patients aged 18–76 years (M age = 37 years; 69% male) receiving inpatient rehabilitation for new-onset TBI at a level I trauma center, acute inpatient rehabilitation hospital. The BTACT is a brief cognitive test battery consisting of the following subtests: Word List Immediate and Delayed Recall (episodic verbal memory), Digits Backward (working memory), Number Series (inductive reasoning), Animal Fluency (verbal fluency), and Backward Counting (processing speed). With the intention of mirroring cognitive functions measured by the BTACT, the neuropsychological battery was comprised of the California Verbal Learning Test-2 (CVLT-2), Wechsler Adult Intelligence Scale-IV (WAIS-IV) Digit Span, Trail Making Test (TMT), semantic fluency, phonemic fluency, Symbol Digit Modalities Test, and Wisconsin Card Sorting Test. Results The BTACT was related to established neuropsychological tests across composite scores of overall cognition (r = .64, p < .001), episodic verbal memory (r = .66, p < .001), and executive function (r = .56, p < .001). For BTACT subtests, Word List Immediate Recall and Word List Delayed Recall were correlated with CVLT-2 learning trials total (r = .57, p < .01) and long delay free recall (r = .60, p < .001), respectively. BTACT Digits Backward correlated with WAIS-IV Digit Span (r = .51, p < .01). BTACT Animal Fluency was related to semantic fluency (r = .65, p < .01), phonemic fluency (r = .60, p < .01), and TMT-B (r = .39, p < .01). Conclusion BTACT composite scores of overall cognition, verbal memory, and executive function are valid measures in a TBI inpatient population.