Computerized tests of cognitive decline in presymptomatic Alzheimer’s disease

Abstract. Hispanic Americans are the largest and fastest growing US minority and, over coming decades, will show the largest relative increase in Alzheimer’s disease (AD) incidence of any ethnic group. However, Spanish-speaking Hispanics have been largely excluded from clinical trials and research studies for several reasons: (1) Only 5.5% of US neuropsychologists have sufficient fluency to administer cognitive tests in Spanish; (2) Existing Spanish-language cognitive tests lack adequate norms for older Hispanic Americans, and (3) many Hispanics live in rural or hard-to-reach locations that make test administration challenging. Here, we propose to create a Spanish version of the California Cognitive Assessment Battery (CCAB) and gather normative data from 256 older Spanish-speaking Hispanics, telemedically tested in their homes. CCAB-Spanish will significantly enhance access to cognitive testing for US Hispanics for several reasons: (1) Automated and computerized test delivery and scoring means examiners with limited Spanish fluency can administer CCAB-Spanish tests, with on-call interpreters as needed; (2) Nationwide telemedical administration reaches populations underserved by manual testing; and (3) A single examiner can remotely test multiple subjects concurrently making clinical assessments of cognition economically feasible in economically disadvantaged populations. The supplement will further enhance the long-term scientific and commercial impact of the CCAB, and provide older Spanish-speaking US residents with improved access to cognitive testing.