Construct Validity of the NIH Toolbox Cognitive Domains: A Comparison With Conventional Neuropsychological Assessments

Objective: Previous studies have assessed the construct validity of individual subtests in the National Institutes of Health (NIH) Toolbox Cognition Battery (NIHTB-CB), though none have examined the construct validity of the cognitive domains. Importantly, the original NIHTB-CB validation studies were administered on a desktop computer, though the NIHTB-CB is now solely administered via an iPad. We examined the construct validity of each cognitive domain assessed in the NIHTB-CB, including a motor dexterity domain using the iPad application compared to a neuropsychological battery in a sample of healthy adults. Method: Eighty-three adults aged 20-66 years (M = 44.35 ± 13.41 years) completed the NIHTB-CB and a comprehensive neuropsychological assessment. Domain scores for each of six cognitive domains (attention and executive function, episodic memory, working memory, processing speed, language, and motor dexterity) and the fluid composite were computed for both batteries. We then assessed the construct validity using Pearson correlations and intraclass correlation coefficients (ICCs) for both demographically corrected and uncorrected domains. Results: We found the attention and executive function, episodic memory, and processing speed domains had poor-to-adequate construct validity (ICCConsistency = −0.029 to 0.517), the working memory and motor dexterity domains and the fluid composite had poor-to-good construct validity (ICCConsistency = 0.215-0.801), and the language domain had adequate-to-good construct validity (ICCConsistency = 0.408-0.829). Conclusion: The NIHTB-CB cognitive domains have poor-to-good construct validity, thus researchers should be aware that some tests representing cognitive constructs may not fully reflect the cognitive domain of interest. Future investigation of the construct validity and reliability of the NIHTB-CB administered using the iPad is recommended. Key Points Question: Do the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) cognitive domains administered via iPad have adequate construct validity when compared to a comprehensive neuropsychological assessment? Findings: The NIHTB-CB cognitive domains have poor-to-good construct validity when administered via iPad. Importance: The NIHTB-CB is widely utilized in research, but the construct validity of the battery has not been tested since the change to iPad-based administration. Next Steps: More rigorous testing of the validity and reliability of the indivi