Automated Self-Administered Scale (AMES)

Abstract

The Automated Self-Administered Scale (AMES; Huang et al., 2023) is an innovative instrument designed for screening early cognitive impairment within community-based settings. This scale aims to measure various cognitive domains, including memory, language, and executive function. The AMES is structured around four distinct subtests: Guided Learning, Go no Go, Number Tabbing, and Delayed Recall, all programmed for administration on Android tablets. A key feature of the AMES’s memory tasks is their design, which integrates memory binding models with Parallel Distributed Processing (PDP) methods. This integration involves using two sets of stimuli and pairing items to be memorized with category or semantic hints, thereby optimizing learning and retrieval efficiency through deep semantic encoding. Furthermore, the application of PDP helps in differentiating familiarity from recollection in recognition responses, offering insights into how these memory aspects contribute to identifying early memory dysfunction. To ensure accessibility and ease of use, the AMES minimizes text display, providing all task instructions through slow-paced, built-in audio to mitigate challenges for individuals with low vision. User interactions are simplified, primarily involving clicking or tabbing. Data for the AMES was gathered from a diverse group of participants, including those diagnosed with mild cognitive impairment, subjective cognitive decline, objectively-defined subtle cognitive decline, and normal controls. The entire administration of the AMES is remarkably efficient, taking approximately 10 minutes on average to complete. Comprehensive results regarding the scale’s reliability, validity, and test sensitivity and specificity have been reported.

Keywords

Guided Learning; Go No Go; Number Tabbing; Delayed Recall; Cognitive Screening Tool; Cognitive Decline; Mild Cognitive Impairment; Memory; Language; Executive Function

Authors

Huang, Lin; Mei, Zihan; Ye, Jianfeng; Guo, Qihao

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Purpose

The primary purpose of the AMES is to serve as an effective instrument for screening early cognitive impairment in community-based settings.

Validity

Convergent Validity: The AMES demonstrated positive correlations with several established cognitive measures. Specifically, positive correlations were observed with the Mini-Mental State Examination (Spearman correlation coefficient [r] = 0.436, p < .001), the Montreal Cognitive Assessment Basic (MoCA-B; Julayanont et al., 2015) (r = 0.551, p < .001), delayed free recall (r = 0.542, p < .001), memory recognition (r = 0.492, p < .001), animal verbal fluency (r = 0.306, p < .001), and language (r = 0.300, p < .001). Conversely, negative correlations were found with attention (r = −0.360, p < .001) and executive function (r = −0.484, p < .001).

Test Sensitivity and Specificity: The AMES exhibited strong capabilities in discriminating between patient groups and normal controls. For distinguishing patients with Mild Cognitive Impairment (MCI) from Normal Controls (NC), the AMES achieved an area under the curve (AUC) of 0.88, with a sensitivity of 86% and a specificity of 80%. For distinguishing individuals with Objectively-Defined Subtle Cognitive Decline (obj-SCD) from NC, the AMES showed an AUC of 0.78, with a sensitivity of 89% and a specificity of 63%.

Reliability

Internal Consistency: The internal consistency of the AMES, assessed using Cronbach’s alpha, yielded relatively low values for certain domains. For language processing ability (item 1 and item 2), the alpha value was 0.17. For immediate memory (item 3 and item 4), it was 0.38. For executive function (item 5, item 6, item 7, and item 8), the alpha value was 0.52.

Factor Analysis

No data is Available.

Instrument

Test Type: Original Instrument Type: Inventory/Questionnaire

Format: The AMES is administered on Android tablets. User interactions are designed to be simple, primarily involving clicking or tabbing. For each pair of items, the sum of item scores corresponds to the maximum attempts allowed in the respective line, and coefficients are utilized in the calculation of the total score.

Language Available: No data is Available

Population Group: Human; Male; Female

Age Group: Adulthood (18 years & older); Middle Age (40-64 years)

Population Details: The study participants were located in China. The respondents included individuals diagnosed with Mild Cognitive Impairment, Subjective Cognitive Decline, Objectively-Defined Subtle Cognitive Decline, and Normal Controls.

Test Methodology: The methodology employed for the AMES involved assessing its Test Validity, specifically Convergent Validity, and Test Reliability, through Internal Consistency measures. Additionally, the study evaluated the Test Sensitivity and Test Specificity of the instrument.

Keywords

Cognitive Decline; Memory; Language; Executive Function; Cognitive Screening Tool; Mild Cognitive Impairment.

Authors

Author ocrid Identifier:
Mei, Zihan: orcid.org/0000-0002-8552-0034

Affiliation Email addresses:
No data is Available

Correspondence Address:
Guo, Qihao: Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Department of Gerontology, No. 600, Yi Shan Road, Shanghai, China, 200233, [email protected]

Permissions & Fee and Test Year

Permissions: Contact Corresponding Author

Commercial: No

Fee: No

Test Year: 2023

References

Huang, L., Mei, Z., Ye, J., & Guo, Q. (2023). AMES: An automated self-administered scale to detect incipient cognitive decline in primary care settings. Assessment, 30(7), 2247–2257. doi.org/10.1177/10731911221144774

Items of the AMES

The AMES consists of 16 items in total, distributed across four subtests. While the specific content of each item is not provided, the subtests are:

• Guided Learning

• Go no Go

• Number Tabbing

• Delayed Recall

The measure includes 16 items. The test items are not available.