Abstract for Clinical Trials on Alzheimer’s Disease San Francisco, CA, USA
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Consider: 6. Cognitive assessment and clinical trials
Presenter: Curtis Burkett Ashford,
CogniFit, Inc., MemTrax, LLC
Curtis B. Ashford, Chief Marketing Officer, CogniFit; MemTrax, LLC, Principle Member
Bio (200 words)
Curtis B. Ashford is a Cognitive Scientist (BA, Psychology, San Jose State University, 2011) dedicated to understanding and improving human brain function. His focus since 2011 is cognitive testing. He is addressing the urgent need in the healthcare industry for improvements, replacements, and remote tools for cognitive tests. He developed an on-line cognitive assessment, MemTrax (www.memtrax.com ), to replace in-person, paper & pencil tests for patients who have cognitive difficulty. He has worked with clinicians and researchers nationally (e.g., Stanford, Harvard, University of Kentucky, University of California San Francisco – The Brain Health Registry) and internationally (France -HAPPYneuron, the Netherlands -University of Wagingen, and China -SJN Biomed Pharmaceuticals), including specific projects which have led to 9 peer-reviewed publications on MemTrax (9/26/2022 listed on PubMed). He has also worked with the Alzheimer’s Foundation of America to provide an on-line memory screening test based on MemTrax (www.afamemorytest.com ).
With an emphasis on early detection and providing fun, repeatable, online cognitive testing, Mr. Ashford is now working as Chief Marketing Officer for CogniFit, Inc. (www.cognifit.com ), developing approaches to measure multiple brain regions over time and collect longitudinal data to help clinicians and researchers evaluate indicators and progression of cognitive abnormalities.
Jon Andoni Duñabeitia, PhD, Chief Scientific Officer, CogniFit; Nebrija University; The Arctic University of Norway
Prof. Jon Andoni Duñabeitia is a cognitive neuroscientist whose main research interests are the neurobiological structures and cognitive processes that underlie multilingualism and reading, how these develop over the lifespan, and how cognitive functioning could be improved using computerized cognitive intervention programs to facilitate learning and to ameliorate the impact of normal and pathological neurodegeneration. He is Full Professor at Nebrija University (Madrid), where he directs the Nebrija Research Center on Cognition (CINC), and he has a secondary appointment as an invited Full Professor in the Department of Language and Culture at the Arctic University of Norway. He has published over 130 articles on multilingual literacy and cognitive science, and he also appears on Spanish radio and television and in print media to talk about cognition, language, and learning. Prof. Duñabeitia is now working as Chief Scientific Officer for CogniFit, Inc., being responsible for the scientific development of the company and the liaison with research partners.
MemTrax Personnel:
J. Wesson Ashford, M.D., Ph.D.
Clinical Professor (affiliated), Department of Psychiatry and Behavioral Sciences, Stanford University
Director, War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System
James O. Clifford, Ph.D.
Professor, Department of Psychology & Behavioral Sciences, College of San Mateo
e-mail: clifford@smccd.edu
Michael Bergeron, Ph.D.
Visiting Scholar, Department of Health Sciences, at the University of Hartford
CogniFit Personnel:
Jon Andoni Duñabeitia, Ph.D.
Professor, Nebrija University and The Arctic University of Norway
Director, Nebrija Research Center on Cognition (CINC)
e-mail: j.dunabeitia@cognifit.com
Stepped-Assessment for Cognitive Screening and Evaluation: MemTrax-CogniFit
Background:
Cognitive and functional impairment are stigmata of dementia, traumatic brain injury, and many other conditions affecting mental processing. Neuropsychologists use paper and pencil tools and questionnaires for estimating cognitive function. However, this methodology is time-consuming, expensive, subject to rater variations and biases, and is not amenable to monitoring change over time. New directions are needed for neuro-cognitive assessment.
With the advent of computerized cognitive testing, cognitive tests can be quickly implemented, providing robust information and rapid reporting of brain function, and allowing frequent repetition within minutes. Brief computerized tests can provide rapid (< 2 minutes), accurate, reliable measures of memory and executive function, with processing speed in these domains precisely quantified. For example, MemTrax can be repeated frequently and indefinitely to screen for cognitive impairment and assess treatment and clinical trial outcomes. Other tests are computerized cognitive batteries that can assess performance of numerous cognitive domains, supplemented by questionnaires to assess daily activity. CogniFit, can provide such information in a wide variety of domains, that the underlying pathology can be precisely characterized.
Objective: Describe on-line computerized tools for screening and assessment of cognitive impairment.
Methods:
MemTrax is a rapid on-line test using a continuous recognition paradigm, assessing visual information processing, episodic memory, and recognition accuracy and speed:
https://pubmed.ncbi.nlm.nih.gov/?term=memtrax&sort=date
CogniFit Cognitive Assessment Battery (CAB)® PRO (FDA Registration Number: 3017544020) is an extended computerized battery providing physical, psychological, and social function estimates. CogniFit PRO is a comprehensive online neuropsychological battery of 17 non-invasive tests that provide a broad, objective, and precise assessment of 22 well-documented cognitive skills. CogniFit is broadly used and implements state-of-the-art cognitive science, psychometrics and technology:
Results:
MemTrax can be repeated frequently to provide indices of change over time. This 50 picture-based MemTrax has a variable N-back design developed to measure episodic memory and processing speed impairments associated with early AD; but it is useful for related conditions. MemTrax has been implemented and utilized online in different countries and on various platforms, including an online in 120 languages:
Administered to a senior cohort in an independent-living elderly population in the Netherlands and another group in China, MemTrax was more efficient than the Montreal Cognitive Assessment (MoCA) with similar clinical efficacy much better efficiency.
MemTrax and the Brain Health Registry:
https://www.brainhealthregistry.org
and the Alzheimer’s Foundation of America:
MemTrax has been performed by over one million individuals on-line, and performance data in different settings has generated several reference norms. The performance measures, percent correct, percent hits, percent correct rejections, and response time, can be translated into the summary score and 4 of the component scores of the Montreal Cognitive Assessment (MoCA), with equal or better ROC measures for distinguishing normal cognitive function and mild cognitive impairment in less time, in any locale.
CogniFit has 24/7 online availability, unlimited locations, and cost-efficiency, making it an ideal tool for clinical practice and research. Backed by highly accurate psychometrics, intelligent data science and advanced automation systems, CogniFit makes cognitive measurement and delivery of individual and group data effortless, instantaneous, and accessible. The reference normative dataset behind (CAB)® PRO matrix used 1,282,242 unique subjects (711,262 females, 570,980 males) ages 7-85 years. The Cognitive Assessment Battery (CAB)™ has been validated using construct and convergent validity. For details:
The CogniFit Cognitive Assessment Battery (CAB)® assessment has a Validity Index of its measurements. The system detects absent-minded performance and asks the users to pay more attention. With corrected behavior, the variables measured during the task are considered valid. Otherwise, the variables measured are considered invalid, and reported. CAB accurately captures human cognitive development across lifespan, using normative data to depict cognitive growth during childhood, peak of cognitive abilities in young adulthood, and the progressive cognitive decline associated with ageing.
For both tests, deeper analysis can be provided by artificial intelligence/machine learning, and with the capacity to assemble very large data sets of information, progressively more salient interpretations will become available. However, clinician oversight of the assessment continuum remains essential to confirm results and provide safety assurances. Moreover, stepped assessment combines an initial brief test (e.g., MemTrax) for initial broad cognitive screening, potentially providing an indication of the need for more comprehensive evaluation (e.g., CogniFit), including an in-depth series of measurements.
This presentation outlines an initial screening test which can lead to a broad evaluation of brain function with biological, psychological, and social components.
Conclusion: MemTrax and CogniFit are effective for screening and longitudinal assessment of cognitive function.