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Development and validation of the TabCAT-EXAMINER: A tablet-based executive functioning battery for research and clinical trials

Published online by Cambridge University Press:  30 October 2025

Mark Sanderson-Cimino Open the ORCID record for Mark Sanderson-Cimino [Opens in a new window] ,
Katherine L. Possin ,
Dan M. Mungas Open the ORCID record for Dan M. Mungas [Opens in a new window] ,
Emily W. Paolillo ,
Breton M. Asken ,
Elena Tsoy ,
Sabrina Jarrott ,
Yann Cobigo ,
Rowan Saloner  and
Kaitlin B. Casaletto
...Show all authors
Mark Sanderson-Cimino*
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Katherine L. Possin
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
Dan M. Mungas
Affiliation:
Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA Alzheimer’s Disease Research Center, Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA
Emily W. Paolillo
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Breton M. Asken
Affiliation:
Florida Alzheimer’s Disease Research Center, Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
Elena Tsoy
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Sabrina Jarrott
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Yann Cobigo
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Rowan Saloner
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Kaitlin B. Casaletto
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Ciaran Considine
Affiliation:
Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
Julie A. Fields
Affiliation:
Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
Joie Molden
Affiliation:
Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA
Katya Rascovsky
Affiliation:
Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
Sandra Weintraub
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, Chicago, IL, USA
Bonnie Wong
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Hilary W. Heuer
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Leah K. Forsberg
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, MN, USA
Julio C. Rojas
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Lawren VandeVrede
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Peter Ljubenkov
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Gil D. Rabinovici
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Maria Luisa Gorno-Tempini
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
William W. Seeley
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Bruce L. Miller
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
Bradley F. Boeve
Affiliation:
Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Department of Neurology, Northwestern University, Chicago, IL, USA
Howard J. Rosen
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
Adam L. Boxer
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Katherine P. Rankin
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Joel H. Kramer
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
Adam M. Staffaroni*
Affiliation:
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
*
Corresponding authors: Mark Sanderson-Cimino; Email: mark.sandersoncimino@ucsf.edu, Adam M. Staffaroni, email: adam.staffaroni@ucsf.edu
Corresponding authors: Mark Sanderson-Cimino; Email: mark.sandersoncimino@ucsf.edu, Adam M. Staffaroni, email: adam.staffaroni@ucsf.edu
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Abstract

Objective:

The National Institutes of Health (NIH) Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER) is a validated laptop-based battery of executive functioning tests. A modified tablet version of the EXAMINER was developed on the UCSF Tablet-based Cognitive Assessment Tool (TabCAT-EXAMINER). Here we describe the battery and investigate the reliability and validity of a composite score.

Methods:

A diagnostically heterogeneous sample of 2135 individuals (mean age = 65.58, SD = 16.07), including controls and participants with a variety of neurodegenerative syndromes, completed the TabCAT-EXAMINER. A composite score was developed using confirmatory factor analysis and item response theory. Validity was evaluated via linear regressions that tested associations with neuropsychological tests, demographics, clinical diagnosis, and disease severity. Replicability of cross-sectional results was tested in a separate sample of participants (n = 342) recruited from a frontotemporal dementia study. As this separate sample also collected longitudinal TabCAT-EXAMINER measures, we additionally assessed test-retest reliability and associations between baseline disease severity and changes in TabCAT-EXAMINER scores.

Results:

The TabCAT-EXAMINER score was normally distributed, demonstrated high test-retest reliability, and was associated in the expected directions with independent tests of executive functioning, demographics, disease severity, and diagnosis. Greater baseline disease severity was associated with more rapid longitudinal TabCAT-EXAMINER decline.

Conclusions:

The TabCAT-EXAMINER is a tablet-based executive functioning battery developed for observational research and clinical trials. Performance can be summarized as a single composite score, and results of this study support its reliability and validity in cognitive aging and neurodegenerative disease cohorts.

Keywords

NeuropsychologyAlzheimer’s diseasefrontotemporal dementiadigitalcomputerized cognitive assessment

Information

Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 31 , Issue 3 , March 2025 , pp. 242 - 253
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of International Neuropsychological Society

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Footnotes

Joel Kramer and Adam Staffaroni are co-senior authors.

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