Computerized assessment of executive functioning: Validation of the CNS Vital Signs executive functioning scores in a sample of community-dwelling older adults

• Published in: Clinical neuropsychologist 2025-01, Vol.39 (1), p.159-181
• Main Authors: DesRuisseaux, Libby A., Gereau Mora, Michelle, Suchy, Yana
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; computerized assessment; Diagnosis, Computer-Assisted - standards; Executive function; Executive Function - physiology; Female; Humans; Independent Living; Inhibition, Psychological; Male; Memory, Short-Term - physiology; Middle Aged; Neuropsychological Tests - standards; older adults; Reproducibility of Results; technology; teleneuropsychology
• ISSN: 1385-4046; 1744-4144; 1744-4144
• DOI: 10.1080/13854046.2024.2354953

Objective: Computerized assessment of cognitive functioning has gained significant popularity over recent years, yet options for clinical assessment of executive functioning (EF) are lacking. One computerized testing platform, CNS Vital Signs (CNS-VS), offers tests designed to measure EF but requires further validation. The goal of the present study was to validate CNS-VS executive scores against standard clinical measures of EF. We also sought to determine whether a modified CNS-VS composite score that included variables purported to measure inhibition, switching, and working memory would outperform the currently available CNS-VS Executive Function Index. Method: A sample of 73 cognitively healthy older adults completed four tests from the Delis-Kaplan Executive Function System, the Digit Span subtest from the Wechsler Adult Intelligence Scale-fourth edition, and three CNS-VS tasks purported to measure inhibition, switching, and working memory. Results: Performances on the CNS-VS tests were predicted by performances on standard paper-and-pencil measures. Although the currently available CNS-VS Executive Function Index predicted unique variance in a well-validated paper-and-pencil EF composite score, our Modified CNS-VS EF composite accounted for unique variance above and beyond the original CNS-VS Executive Function Index, while the reverse was not true. Conclusions: The present results support the construct validity of CNS-VS EF tests but also suggest that modifications to their current composite scores would improve the prediction of EF performance.