The Language and Memory Test: Multinational Feasibility Study of a Digital Test to Measure Cognitive Change

Cognitive measures that are brief, tolerable, accurate, and inexpensive permit mechanistic insights, support clinical trials, and facilitate clinical care. The Language and Memory Test (LMT) is a novel digital test measuring rapid naming (Language 1 and 2), visuospatial memory (Memory 1 and 2), and fine motor dexterity (Finger tapping). The LMT takes approximately 4 min to complete and was designed to be cross-culturally acceptable. This feasibility study of the LMT in English and non-English speaking adults in three countries employed in-person and remote, supervised and unsupervised administration modalities. We investigated test-retest reliability, internal consistency, tolerability, equivalence across centers, administration modalities, language spoken, and age groups. A total of 440 adults ages 18-84 years in Canada, Iran, and the United States, a control sample (n = 115) and neurologic populations (n = 325), completed the LMT. Tolerability was good: 99% who began the test completed all subtests; 115 participants from the United States and Canada samples completed the LMT twice. Test-retest reliability ranged from medium to large: finger tapping (r = 0.892), Language 1 (r = 0.697), Language 2 (r = 0.687), Memory 1 (r = 0.433), and Memory 2 (r = 0.265). Equivalence varied across centers, administration modalities, and language status. Age-related performance decrements were shown for all subtests. Results support the feasibility of the LMT as a brief, multidomain tool for use in healthy adults and neurologic populations and in both in-person and remote settings. Its use across cultures remains to be validated in rigorous studies using culturally adapted versions of the LMT. Sensitivity to change over time remains to be established by future research.