The utility of the Oral Trail Making Test in telehealth assessments with cognitively impaired older adults
Bibliographic record
Abstract
Abstract Background Due to the recent COVID‐19 pandemic, many clinicians have transitioned to telehealth‐based cognitive assessments as a practical alternative to in‐person evaluations. Meta‐analysis has shown that verbally‐mediated measures of cognition are the most easily adapted to telehealth administration, while measures that include visual or motor components are more variably impacted. The Oral Trail Making Test (O‐TMT) is one verbal measure of executive function that removes motor and visual demands. However, there is a dearth of research related to the use of the O‐TMT in cognitively impaired older adults to evaluate executive function. Therefore, this project aimed to examine the relationship between O‐TMT scores with other neuropsychological measures in individuals with cognitive impairment. Method Forty‐one participants enrolled in the Emory Cognitive Empowerment Program underwent telehealth‐based neuropsychological assessment that included the O‐TMT. The O‐TMT is comprised of two parts. Part A requires individuals to count out loud from 1 to 25 and is primarily a measure of processing speed and simple attention. Part B requires individuals to alternate saying numbers and letters (1‐A, 2‐B, etc.) and is a measure of mental flexibility. Time to completion as well as total errors are captured during administration. Participants also completed the Montreal Cognitive Assessment (MoCA) as a measure of global cognitive function, a measure of practical reasoning (Test of Practical Judgement), and a self‐report measure of cognitive change (Everyday Cognition). Correlational analyses were completed to examine the relationship between O‐TMT scores and global cognitive function, practical judgment, and subjective cognitive status. Results The sample consisted of older adults (Mage = 72.84, SDage = 8.20) who were well‐educated (Myears = 16.07, SDyears = 2.22). O‐TMT Part B Time to Completion was moderately correlated with total MoCA score (r = ‐0.36, p = 0.03), such that slower performance was associated with poorer overall cognitive function. The O‐TMT was not significantly correlated with practical judgment or subjective cognitive status. Conclusion Results of the current study indicate poorer performance on the O‐TMT part B is associated with poorer overall cognitive function on the MoCA. Future research should examine the sensitivity and specificity of the O‐TMT part B for individuals who are cognitively impaired.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".