EXPANDING THE BRIEF ASSESSMENT OF COGNITION (BAC-APP) FOR ASSESSMENT OF COGNITION IN AGING: INITIAL FINDINGS FROM AN ONGOING NORMATIVE STUDY

The Brief Assessment of Cognition in Schizophrenia (BACS) is a pen-and-paper cognitive assessment used in hundreds of research studies and clinical trials. A tablet-based version of the BACS, the BAC App, has been developed to allow standardized presentation of task instructions and stimuli, audio-recording of responses, and automatized scoring and data management. To extend use of the BAC App for assessment of cognition in aging and early detection of Mild Cognitive Impairment due to Alzheimer's disease (MCI-AD), additional tests of episodic verbal memory and visuospatial working memory were developed and incorporated. Collection of census-matched normative data in 750 healthy individuals is currently underway. We describe preliminary findings comparing performance of young (<55) and older (≥55) healthy adults, as well as performance of individuals with subjective cognitive complaints. Tasks were designed in compliance with guidance for objective psychometric tests (Ferris et al., 1997) and to enable tablet-assisted administration, automatic scoring, and data management in compliance with 21 CRF Part 11 requirements. Data currently includes 143 participants, including 63 healthy young adults (YA, <55 years), 76 healthy older adults (OA, ≥55 years), and 4 individuals with cognitive complaints. Participants with cognitive complaints were classified as such based on total scores of ≥ 4 on the Mail-In Function Cognitive Screening Instrument (MCSFI). Means and standard deviations are presented for YAs, OAs and cognitive complainers. OAs underperformed YAs on BAC App endpoints including verbal learning, verbal fluency, symbol coding, and token motor test (p<.01 for all). Although delayed recall did not reliably differ between healthy YAs (mean=9.01, SD=3.02) and OAs (mean=8.38, SD=3.26), cognitive complainers performed well below their normative counterparts (mean=4.25, SD=2.99). Visuospatial working memory performance showed significant decline in OAs as compared to YAs (p<.01), and preliminary data suggest increased decline in cognitive complainers. Preliminary findings suggest the BAC App is sensitive to age-related changes in cognition, and show potential sensitivity to differences between healthy OAs and those with subjective cognitive complaints. Enhancement of the BAC App with additional measures of episodic memory and visuospatial working memory shows potential for increasing the utility of the measure in early MCI-AD.