Near vision assessment for adults using the NIH Toolbox

Abstract
Introduction: The National Institutes of Health (NIH) Toolbox Near Visual Acuity Test is a novel digitized measure designed to provide an assessment of near vision in a time-and cost-effective manner. This study is the first to report the psychometric properties of the NIH Toolbox Near Visual Acuity Test in a sample of community-dwelling middle-aged and older adults. Methods: Ninety-eight adults (ages 40–81) completed the tablet-based near vision test and the gold standard chart-based near vision test. Performance on the tablet-and chart-based near vision tests was expressed in logarithmic units. Chart-and tablet-based administration order was counterbalanced. To assess test–retest reliability, the NIH Toolbox Near Visual Acuity Test was administered twice within the same day. Additionally, two equivalent versions of the chart-based test were randomly assigned to participants. Results: Analyses revealed that test–retest reliability of the NIH Toolbox Near Visual Acuity Test was good (intraclass correlation = 0.87, p < 0.001). Concurrence between the NIH Toolbox Near Visual Acuity Test and gold standard chart-based test was also good (r = 0.79, p < 0.001). Discussion: Findings provide support for the reliability and validity of the NIH Toolbox Near Visual Acuity Test as a near vision assessment for middle-aged to older adult populations. With further research, the integration of this test within the widely used NIH Toolbox may provide a more efficient means to understanding how near visual acuity influences neurocognitive test performance and brain function in middle-aged to older adult populations.
Description
This article was originally published in Frontiers in Neurology by Frontiers Media. The version of record is available at: https://doi.org/10.3389/fneur.2025.1533382. © 2025 Finley, Slotkin, Nowinski, Bedjeti, Volpe, Weintraub and Gershon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords
near vision, visual acuity, NIH Toolbox, cognitive, neurology, neuropsychology
Citation
Finley J-CA, Slotkin J, Nowinski CJ, Bedjeti K, Volpe N, Weintraub S and Gershon R (2025) Near vision assessment for adults using the NIH Toolbox. Front. Neurol. 16:1533382. doi: 10.3389/fneur.2025.1533382