Validation of the CogState battery for rapid neurocognitive assessment in Ugandan school age children

Paul Bangirana, Alla Sikorskii, Bruno Giordani, Noeline Nakasujja, Michael J Boivin

CogState is a widely used computer-based cognitive test whose validity has not been addressed in resource poor settings. We examined the construct, concurrent and convergent validity of CogState, test-retest reliability and the effect of sociodemographic variables on CogState outcomes in school age children. Two hundred and thirty Ugandan children (54% male) with mean age 6.99 years (SD = 1.67, range 5-13 years) were assessed using CogState, the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) and the Test of Variables of Attention (TOVA) at baseline and 8 weeks later. Correlations were run between CogState and the KABC-II and TOVA to evaluate its concurrent and convergent validity. Factor analysis was used to evaluate construct validity of CogState. Correlations between baseline and 8 weeks CogState scores were used to determine the test-retest reliability while general linear models were used to assess associations with sociodemographic factors. Significant correlations were observed between CogState's One Card Learning, One Back Memory and Card Detection with the TOVA and between CogState's Maze Chase and One Back Memory with KABC-II's Simultaneous Processing. CogState had a three factor structure with Processing Speed, Processing Accuracy and Maze Chase and Maze Learning. CogState had low to moderate test-retest reliability in Ugandan children with correlations ranging from 0.32 to 0.57. Age, sex and education were associated with CogState outcomes. CogState is a valid and reliable test battery for rapid computer-based neurocognitive assessment in Ugandan children and can thus be used in this cultural context.