Objective: We describe the content development of the VISually Independent test battery Of NeuroCOGnition (VISION-Cog)–a new diagnostic tool to evaluate cognitive impairment (CI) in visually impaired older Asian adults.
Method: The qualitative content development phase consisted of 2 iterative stages: a neuropsychological consultation and literature review (Stage 1) and an expert-panel discussion (Stage 2). In Stage 1, we investigated currently available test batteries for CI in visually impaired and their limitations, and construct our preliminary test battery. We then deliberated this battery during an expert-panel discussion (Stage 2) to decide, via agreement of the experts, the content of a pilot neuropsychological battery.
Result: The two-stage process resulted in a pilot VISION-Cog consisting of 9 vision-independent neuropsychological tests, including the Modified Spatial Memory Test, List Learning, List Recall & 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 5 cognitive domains–memory and learning, language, executive function, complex attention, and perceptual-motor. The expert panel made suggestions to improve the clarity of test instructions and ensure culturally relevant test content. These suggestions were incorporated and iteratively pilot-tested by the study team until no further issues emerged.
Conclusion: We have developed a 5-domain and 9-test VISION-Cog pilot instrument capable of replacing vision-dependent diagnostic batteries and 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.

Authors:
Tai Anh Vu, Duke-NUS Medical School, Singapore
Eva Fenwick, Duke-NUS Medical School, Singapore
Kinjal Doshi, National University Hospital, Singapore
Preeti Gupta, Singapore Eye Research Institute, Singapore
Ecosse Lamoureux, Duke-NUS Medical School, Singapore

About the Presenter(s)
Mr Tai Anh Vu is a University Doctoral Student at Duke-NUS Medical School in Singapore

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