Rationale: Cognitive impairment is prevalent in epilepsy and often present at the time of initial diagnosis. This study sought to validate a brief, self-administered, iPad-based screening tool in a sample of patients with epilepsy and to examine its utility in identifying patients with cognitive impairment. Methods: The Brief Assessment of Cognitive Health (BACH™) was administered to 145 adult patients with epilepsy along with a neuropsychological battery. Correlation analyses examined the convergent and divergent validity of the BACH, and a series of logistic regression analyses examined discriminative ability of the BACH in identifying patients with and without cognitive impairments on neuropsychological measures. Patient performance was compared to that of a healthy control group (n=223), and the relationship between the BACH and disease-related variables (i.e., antiepileptic medication burden, seizure lateralization/ localization) was examined. Results: The BACH was positively correlated with traditional paper-and-pencil neuropsychological measures of episodic memory, with generally moderate to large effect sizes (r >.40), while correlations between the BACH and non-memory measures were generally small in magnitude (r < .30). Patients with epilepsy had significantly lower scores on all BACH subtests compared to healthy controls, and BACH performance was associated with antiepileptic medication burden and seizure localization. The BACH demonstrated good predictive accuracy in identifying any cognitive impairment (concordance (c) statistic = .77), and excellent predictive accuracy (c = .85) in identifying patients with impairments on traditional memory measures. The BACH also demonstrated reasonable discrimination for impairments in non-memory domains including executive function, language, attention, processing speed, and visuospatial ability (c = .62 - .70). Importantly, the BACH Immediate score performed just as well as the Total score, suggesting a short version of this screening tool (~15 minutes) is sufficient for identifying patients with cognitive impairment. Conclusions: The BACH is a valid, computerized tool that can be used for routine screening for cognitive impairment in adults with epilepsy.
Funding: Please list any funding that was received in support of this abstract.: Cleveland Clinic Neurological Institute Innovations & Discovery Program Award