Validation of the NIH Toolbox-Cognition Battery against legacy neurocognitive measures in adults with cognitive impairments: An exploratory analysis.

OBJECTIVE: The purpose of this exploratory study was to describe associations between NIH Toolbox-Cognition Battery subtests and legacy measures of neurocognitive function in two samples with neurological conditions (stroke and sickle cell disease (SCD)).

METHOD: This exploratory secondary analysis uses data from two studies that assessed cognition at one time point using the NIH Toolbox-Cognition Battery, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and subtests from the Delis-Kaplan Executive Functions System (DKEFS). People with stroke ( n = 26) and SCD ( n = 64) were included. Associations between the NIH Toolbox-Cognition Battery subtests and corresponding legacy measures were examined using linear correlations, Bland-Altman analysis, and Lin's Concordance Correlation Coefficient.

RESULTS: Linear correlations and Lin's Concordance Correlation Coefficient were poor to strong in both samples on NIH Toolbox-CB subtests: Flanker Inhibitory Control and Attention ( r = .35 to .48, Lin CCC = .27 to .37), Pattern Comparison Processing Speed ( r = .40 to .65, Lin CCC = .37 to .62), Picture Sequence Memory ( r = .19 to .55, Lin CCC = .18 to .48), Dimensional Change Card Sort ( r = .39 to .77, Lin CCC = .38 to .63), Fluid Cognition Composite ( r = .88 to .90, Lin CCC = .60 to .79), and Total Cognition Composite ( r = .64 to .83, Lin CCC = .60 to .78). Bland-Altman analyses demonstrated wide limits of agreement across all subtests (-3.17 to 3.78).

CONCLUSIONS: The NIH Toolbox-Cognition Battery subtests may behave similarly to legacy measures as an overall assessment of cognition across samples at risk for neurological impairment. Findings should be replicated across additional clinical samples.