Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore
Objectives Current cognitive screening and diagnostic instruments rely on visually dependent tasks and are, therefore, not suitable to assess cognitive impairment (CI) in visually impaired older adults. We describe the content development of the VISually Independent test battery Of NeuroCOGnition (V...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/10/e070850.full |
| _version_ | 1797641123148070912 |
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| author | Preeti Gupta Ecosse Luc Lamoureux Christopher Chen Philip Yap Dan Milea Adeline S L Ng Eva Fenwick Kinjal Doshi Tai Anh Vu Shin Yi Quek Simon Ting Donald Yeo |
| author_facet | Preeti Gupta Ecosse Luc Lamoureux Christopher Chen Philip Yap Dan Milea Adeline S L Ng Eva Fenwick Kinjal Doshi Tai Anh Vu Shin Yi Quek Simon Ting Donald Yeo |
| author_sort | Preeti Gupta |
| collection | DOAJ |
| description | Objectives Current cognitive screening and diagnostic instruments rely on visually dependent tasks and are, therefore, not suitable to assess cognitive impairment (CI) in visually impaired older adults. We describe the content development of the VISually Independent test battery Of NeuroCOGnition (VISION-Cog)–a new diagnostic tool to evaluate CI in visually impaired older Singaporean adults.Design The content development phase consisted of two iterative stages: a neuropsychological consultation and literature review (stage 1) and an expert-panel discussion (stage 2). In stage 1, we investigated currently available neuropsychological test batteries for CI to inform constructions of our preliminary test battery. We then deliberated this battery during a consensus meeting using the Modified Nominal Group technique (stage 2) to decide, via agreement of five experts, the content of a pilot neuropsychological battery for the visually impaired.Setting Singapore Eye Research Institute.Participants Stakeholders included researchers, psychologists, neurologists, neuro-ophthalmologists, geriatricians and psychiatrists.Outcome measure pilot VISION-Cog.Results The two-stage process resulted in a pilot VISION-Cog consisting of nine vision-independent neuropsychological tests, including the modified spatial memory test, list learning, list recall and list recognition, adapted token test, semantic fluency, modified spatial analysis, verbal subtests of the frontal battery assessment, digit symbol, digit span forwards, and digit span backwards. These tests encompassed five cognitive domains–memory and learning, language, executive function, complex attention, and perceptual-motor abilities. The expert panel suggested improvements to the clarity of test instructions and culturally relevant test content. These suggestions were incorporated and iteratively pilot-tested by the study team until no further issues emerged.Conclusions We have developed a five-domain and nine-test VISION-Cog pilot instrument capable of replacing vision-dependent diagnostic batteries in aiding the clinician-based diagnosis of CI in visually impaired older adults. Subsequent phases will examine the VISION-Cog’s feasibility, comprehensibility and acceptability; and evaluate its diagnostic performance. |
| first_indexed | 2024-03-11T13:41:02Z |
| format | Article |
| id | doaj.art-15e425dedb67422abf9315502d7bfaad |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T13:41:02Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-15e425dedb67422abf9315502d7bfaad2023-11-02T12:40:07ZengBMJ Publishing GroupBMJ Open2044-60552023-10-01131010.1136/bmjopen-2022-070850Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in SingaporePreeti Gupta0Ecosse Luc Lamoureux1Christopher Chen2Philip Yap3Dan Milea4Adeline S L Ng5Eva Fenwick6Kinjal Doshi7Tai Anh Vu8Shin Yi Quek9Simon Ting10Donald Yeo11Population Health Research, Singapore Eye Research Institute, Singapore1 Ocular Epidemiology Research Group, Singapore Eye Research Institute, SingaporeDeaprtment of Pharmacology and Psychological Medicine, National University of Singapore, SingaporeDepartment of Geriatric Medicine, Khoo Teck Puat Hospital, SingaporeRothschild Foundation Hospital, Paris, FranceDepartment of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore1 Ocular Epidemiology Research Group, Singapore Eye Research Institute, SingaporeDepartment of Psychology, National University of Singapore, SingaporeHealth Services and Systems Research, Duke-NUS Medical School, SingaporeDepartment of Psychology, Ng Teng Fong General Hospital, SingaporeDepartment of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, SingaporeKALL Psychological & Counselling Services Pte Ltd, SingaporeObjectives Current cognitive screening and diagnostic instruments rely on visually dependent tasks and are, therefore, not suitable to assess cognitive impairment (CI) in visually impaired older adults. We describe the content development of the VISually Independent test battery Of NeuroCOGnition (VISION-Cog)–a new diagnostic tool to evaluate CI in visually impaired older Singaporean adults.Design The content development phase consisted of two iterative stages: a neuropsychological consultation and literature review (stage 1) and an expert-panel discussion (stage 2). In stage 1, we investigated currently available neuropsychological test batteries for CI to inform constructions of our preliminary test battery. We then deliberated this battery during a consensus meeting using the Modified Nominal Group technique (stage 2) to decide, via agreement of five experts, the content of a pilot neuropsychological battery for the visually impaired.Setting Singapore Eye Research Institute.Participants Stakeholders included researchers, psychologists, neurologists, neuro-ophthalmologists, geriatricians and psychiatrists.Outcome measure pilot VISION-Cog.Results The two-stage process resulted in a pilot VISION-Cog consisting of nine vision-independent neuropsychological tests, including the modified spatial memory test, list learning, list recall and list recognition, adapted token test, semantic fluency, modified spatial analysis, verbal subtests of the frontal battery assessment, digit symbol, digit span forwards, and digit span backwards. These tests encompassed five cognitive domains–memory and learning, language, executive function, complex attention, and perceptual-motor abilities. The expert panel suggested improvements to the clarity of test instructions and culturally relevant test content. These suggestions were incorporated and iteratively pilot-tested by the study team until no further issues emerged.Conclusions We have developed a five-domain and nine-test VISION-Cog pilot instrument capable of replacing vision-dependent diagnostic batteries in aiding the clinician-based diagnosis of CI in visually impaired older adults. Subsequent phases will examine the VISION-Cog’s feasibility, comprehensibility and acceptability; and evaluate its diagnostic performance.https://bmjopen.bmj.com/content/13/10/e070850.full |
| spellingShingle | Preeti Gupta Ecosse Luc Lamoureux Christopher Chen Philip Yap Dan Milea Adeline S L Ng Eva Fenwick Kinjal Doshi Tai Anh Vu Shin Yi Quek Simon Ting Donald Yeo Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore BMJ Open |
| title | Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore |
| title_full | Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore |
| title_fullStr | Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore |
| title_full_unstemmed | Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore |
| title_short | Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore |
| title_sort | content development of the vision cog a novel tool to assess cognitive impairment in visually impaired older adults in singapore |
| url | https://bmjopen.bmj.com/content/13/10/e070850.full |
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