Validation of the CogState battery for rapid neurocognitive assessment in Ugandan school age children

Background: CogState is a widely used computer-based cognitive test whose validity has not been addressed in resource poor settings. We examined the construct, concurrent and convergent validity of CogState, test-retest reliability and the effect of sociodemographic variables on CogState outcomes in school age children. Methods: Two hundred and thirty Ugandan children (54% male) with mean age 6.99 years (SD = 1.67, range 5-13 years) were assessed using CogState, the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) and the Test of Variables of Attention (TOVA) at baseline and 8 weeks later. Correlations were run between CogState and the KABC-II and TOVA to evaluate its concurrent and convergent validity. Factor analysis was used to evaluate construct validity of CogState. Correlations between baseline and 8 weeks CogState scores were used to determine the test-retest reliability while general linear models were used to assess associations with sociodemographic factors. Results: Significant correlations were observed between CogState's One Card Learning, One Back Memory and Card Detection with the TOVA and between CogState's Maze Chase and One Back Memory with KABC-II's Simultaneous Processing. CogState had a three factor structure with Processing Speed, Processing Accuracy and Maze Chase and Maze Learning. CogState had low to moderate test-retest reliability in Ugandan children with correlations ranging from 0.32 to 0.57. Age, sex and education were associated with CogState outcomes. Conclusions: CogState is a valid and reliable test battery for rapid computer-based neurocognitive assessment in Ugandan children and can thus be used in this cultural context.