• CAMCI Pediatric Assessment of Traumatic Brain Injury (Submitted to NIH April 2009)

Principal Investigator: A. Eschman, MS, Psychology Software Tools, Inc.
Pediatric traumatic brain injury (TBI) is a significant health problem in the United States, with an estimated 500,000 emergency department visits, 37,000 hospitalizations, and 3,000 deaths annually, resulting in a cost exceeding $12 billion a year. Our work will aid in the identification of cognitive alterations in children with mild to moderate TBI at the earliest signs of cognitive change, to maximize the rehabilitation of cognitive function through therapeutic intervention.

• Pilot study on Moderate to Severe Traumatic Brain Injury

Principal Investigator: L. Morrow, Ph.D., University of Pittsburgh School of Medicine
Brain Trauma Research Center collecting pilot data on moderate to severe TBI subjects (ages 20-60 to add to the current database of ages 60+).

• Cognitive Assessment of Primary Care Patients (NIA)

Principal Investigator: J. Saxton, Ph.D., University of Pittsburgh
The major goal of this study is to investigate the utility of cognitive testing in the Primary Care setting using CAMCI. Both clinical outcomes and clinical practice are being investigated in this five-year study involving 1,000 subjects over age 65 and 24 community Primary Care Physicians.

• Detection, Diagnosis and Intervention in Dementia in Rural and Urban Elderly (Pennsylvania State funded Center for Excellence-4100027294)

Principal Investigator: J. Saxton, Ph.D., University of Pittsburgh
Investigating the utility of computerized testing as a screening tool for identification of persons with MCI, the stability of performance on a computerized test over 2 years, the agreement between performance on a computerized test and comprehensive diagnostic assessment at the ADRC ("gold standard"), and whether level of diagnostic certainty, as measured by computerized testing, increases with additional information, specifically results of caregiver interview and/or PCP medical chart review. Preliminary data analysis indicates we can successfully recruit rural and African American elderly to participate in research but preferably if they do not have to travel to a university setting, about 25% of individuals will be lost to follow-up each year, and a brief cognitive assessment correctly identifies ~ 80% of individuals with normal cognition and ~ 80% of individuals with borderline functioning.

• HIV-related Cognitive Assessment Study

Principal Investigator: N. Sacktor, Ph.D., Johns Hopkins University
An HIV cognitive assessment study, with 85 HIV positive patients and 45 HIV negative controls currently enrolled, to evaluate the utility of the CAMCI for functional performance. Analysis of the baseline data is underway to investigate the relationship between CAMCI test scores and the original American Academy of Neurology (AAN) criteria for HIV associated neurocognitive disorders (HAND).

• Pilot Study of an Internet-based Cognitive Stimulation Program in AIDS (NIMH- NCT00619567)

Principal Investigator: J.T. Becker, Ph.D., University of Pittsburgh
The neurocognitive manifestations of HIV/AIDS have long been recognized as important for the management, survival, and quality of life of affected patients and their families. Following the advent of Highly active anti-retroviral therapy (HAART) the incidence of HIV-associated dementia (HAD) has fallen, but the prevalence of the milder forms of HIV-related cognitive disorders has risen. This is important because alterations in cognitive function can have significant impact on work and social activities, mood, and perceived quality of life. To date, pharmacological management of HIV-associated cognitive disorders - apart from HAART - have met with limited success (e.g., Peptide T, Ritalin). Therefore, it appears reasonable to ask whether the use of non-pharmacological tools might help alleviate or ameliorate the symptoms of the milder forms of cognitive impairment, and thus improve mood and activities of daily living. The purpose of this application is to request funds to allow us to complete a feasibility/pilot study of the merits of using an internet-based cognitive stimulation program (CSP) to improve the cognitive functions and quality of life of individuals with HIV/AIDS, and, secondarily, to detect such changes using a computerized assessment tool designed for use in a health care practitioner's office (Computer-Based Assessment of Mild Cognitive Impairment (CAMCI)).

• Increasing Minority Participation in Mobility Assessment and Exercise Interventions (Claude Pepper Center)

Principal Investigator: S. Albert, Ph.D., GSPH, University of Pittsburgh
In the Boosting Minority Involvement study, 96 African-American men and women aged 60 and older completed performance tests of physical and cognitive function. The mean age was 73, 78% were female, and 67% lived alone. Physical function was assessed with the Short Physical Performance Battery (SPPB), a test of gait, balance, and leg strength. Cognition was assessed with standard paper and pencil tests as well as the CAMCI. Z-score composite measures were developed from the CAMCI to assess the domains of attention, verbal memory, and executive function. In adjusted analyses, global memory and executive function explained 45% of the variability in SPPB. Gait and balance may in part depend on multifaceted higher cognitive demands, such as higher-order executive function. Nieto ML, Albert SM, Morrow LA, Saxton J. Cognitive status and physical function in older african americans. J Am Geriatr Soc. 2008;56(11):2014–2019.

• Computer Assessment of Mild Cognitive Impairment (NIH/NIA 5R44AG022792-03)

Principal Investigator: A. Eschman, MS, Psychology Software Tools, Inc.
The Computer Assessment of Mild Cognitive Impairment (CAMCI) is a self-administered, user-friendly computer test that scores automatically and can be completed independently in a quiet space, such as a doctor's examination room. The goal of this study was to compare the sensitivity and specificity of the CAMCI and the Mini Mental State Examination (MMSE) to identify mild cognitive impairment (MCI) in 524 nondemented individuals > 60 years old who completed a comprehensive neuropsychological and clinical assessment together with the CAMCI and MMSE. We hypothesized that the CAMCI would exhibit good sensitivity and specificity and would be superior compared with the MMSE in these measures. The results indicated that the MMSE was relatively insensitive to MCI. In contrast, the CAMCI was highly sensitive (86%) and specific (94%) for the identification of MCI in a population of community-dwelling nondemented elderly individuals. Saxton J, Morrow L, Eschman A, Archer G, Luther J, Zuccolotto A. Computer Assessment of Mild Cognitive Impairment. Postgrad Med. 2009 Mar; 121(2):177-85.

FAQs

*Saxton et al. Computer assessment of mild cognitive impairment. Postgraduate Medicine. 2009; 121(2):177-185.