Test-retest reliability and minimal detectable change of the Contextual Memory Test in older adults with and without mild cognitive impairment

PLoS One. 2020 Jul 31;15(7):e0236654. doi: 10.1371/journal.pone.0236654. eCollection 2020.

Abstract

Background: The ability to detect one's own memory capacity and develop strategies based on daily contexts is important for daily activities. The Contextual Memory Test (CMT) assesses self-awareness, self-efficacy, self-perception/evaluation of performance, recall, and strategy use that are associated with daily contexts, and could be a potentially suitable measurement for assessing memory and meta-memory in older adults with and without cognitive impairment. Nevertheless, the test-retest reliability and minimal detectable change (MDC) remain unknown in these individuals.

Objective: The purpose of this study was to examine test-retest reliability and calculate MDC of the CMT in healthy older adults and those with mild cognitive impairment (MCI).

Methods: Eighty-three participants completed the CMT twice with a one-month interval. Test-retest reliability was examined using intraclass correlation coefficient (ICC) in all seven domains of the CMT and the recognition subtest. The standard error of measurement (SEM) and MDC were calculated. The Bland-Altman analysis was performed to evaluate the degree of agreement between measurements.

Results: The ICC of five domains (self-awareness, self-perception/evaluation of performance, immediate/delayed/total recall) and the recognition subtest were good to excellent (ICC = 0.63-0.94) in healthy and MCI participants and the MDC% were less than 30% The ICC of the other two domains (self-efficacy and total strategy use, TSS) were low (ICC = 0.07-0.59) and the MDC% exceeded 30%. The Bland-Altman analysis showed generally better performance in the 2nd than the 1st measurement in most CMT domains.

Conclusions: Our results revealed sufficient test-retest reliability and acceptable MDC in most CMT domains in healthy and MCI participants. Only the self-efficacy and TSS domains demonstrated low ICC and large MDC. Possible practice effects were found between repeated measurements. Clinicians should be cautious when evaluating self-efficacy and strategy use using the CMT in older adults. Further improvements are needed for these two domains.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Case-Control Studies
  • Cognitive Dysfunction / physiopathology*
  • Female
  • Humans
  • Male
  • Memory and Learning Tests*
  • Middle Aged
  • Reproducibility of Results

Grants and funding

This work was supported by Chang Gung Memorial Hospital (CMRPD1F0411-413, CORPD1J0011, BMRP553; Recipient: CYW), Healthy Aging Research Center, Chang Gung University from the Featured Areas Research Center Program within the Framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan (EMRPD1I0451;Recipient: CYW), and the Ministry of Science and Technology (MOST 108-2314-B-182-040-MY3; Recipient: CYW) in Taiwan. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.