Archives of Clinical Neuropsychology最新文献

Objective: Understanding how well older individuals with suspected cognitive impairment are functioning within the real-world environment can have important implications for diagnosis and treatment. To evaluate whether an individual is experiencing functional limitations suggesting the presence of mild cognitive impairment (MCI) or dementia, we establish diagnostic cutoff scores for the informant version of the Instrumental Activities of Daily Living-Compensation (IADL-C) scale.

Method: Informants of research (n = 488) and clinical (n = 119) samples of participants designated as healthy older controls, MCI, or dementia completed the IADL-C. Receiver operating characteristic curve analyses and diagnostic statistics were used to determine optimal cutoffs on the IADL-C for both the 27-item IADL-C and an 11-item short form created using item-level analysis.

Results: The optimal cutoff scores that maximized the Youden Index for the research sample long-form were 1.41 in distinguishing cognitively healthy versus MCI participants, and 3.60 in distinguishing dementia from MCI participants, favoring specificity for the clinical sample, the optimal cutoffs were 1.32 and 3.06, yielding higher sensitivity.

Conclusions: These cutoff scores, when used as a screening measure or combined with other clinical and cognitive measures, may be useful for understanding whether an individual may be experiencing functional difficulties in everyday life consistent with a diagnosis of MCI or dementia.

Objective: The current study sought to gain a clearer understanding of the impact of child and parent linguistic factors, ethnic identity salience, and acculturation to both mainstream United States of America (USA) culture and their heritage culture on executive functioning task performance among Latin American youth living in the USA.

Method: Nine hundred eleven youth (Mage = 9.5, 51% female, 93% born in the USA) from the Adolescent Brain Cognitive Development repository completed the Flanker Inhibitory Control and Attention Test and the Dimensional Change Card Sort Test (DCCS). Youth and parent completed demographic questionnaires and ethnic identity salience and acculturation measures.

Results: Hierarchical linear regression analyses revealed that greater parent acculturation to heritage culture and lower youth acculturation to USA culture predicted better performance on the Flanker task, and greater parent ethnic identity salience predicted better performance on the DCCS test after controlling for demographic variables (parent educational attainment and full-time employment, immigration status household) and linguistic variables (parent's preferred language, primary language spoken at home).

Conclusions: This is the first study to comprehensively examine the effects of linguistic factors, acculturation, and ethnic identity salience on executive functioning performance among Latin American youth living in the USA. Results show that parental acculturation can have a meaningful impact on their children's executive functioning, which has implications for those who work with this demographic in clinical or research settings. Culturally informed suggestions for qualitative and quantitative information gathering are provided to account for this variable when conducting neuropsychological evaluations in this population.

Objective: We report normative data with non-athlete college students for three brief, public-domain performance validity tests (PVT) representing multiple performance domains: Rey's Word Recognition Test (WRT), Rey's Dot Counting Test (DCT), and A Random Letter Test of Auditory Vigilance (A-Test).

Method: One hundred fifty-four non-athlete college students (45% female; representing four college years) were recruited and assigned randomly to Honest-Effort, Fake-Bad, or Instructed Fake-Bad groups. Fifty student-athletes were selected randomly for comparison. Differences for multiple measures of each test among the three effort groups were obtained, and receiver operating curve (ROC) cut scores representing suboptimal performance were reported.

Results: Only the WRT measures met normality and homogeneity of variance assumptions. Multivariate analysis of variance with post-hoc Tukey tests showed significant differences between groups for WRT Total Correct and Combination scores. For DCT Combination Score and Total Errors and A-Test Omission Errors and Total Errors, non-parametric Kruskal-Wallis comparisons were conducted, each resulting in significant differences between Honest-Effort and sub-optimal performance (SOP) groups. Athletes also differed significantly from both SOP groups. ROC cut scores that suggested suboptimal effort were DCT Combination Score ≥ 15; WRT Combination Score ≤ 12; and A-Test Omission Errors ≥1. Measures were considered poor to excellent based on the area under the curve (AUC) percentages obtained through ROC analysis.

Conclusion: The DCT Combination and A-Test Omission Errors were valid indicators of suboptimal performance. The WRT measures fell short of adequate prediction based on the AUC. Combining multiple PVT "failures" maximized identification of suspect performers and minimized inclusion of Honest-Effort participants.

Objective: This study aims to analyze the treatment intensity applied in neurorehabilitation centers in Spain and its relationship with sociodemographic, biomedical, and cognitive variables in post-stroke patients. Current guidelines recommend rehabilitation sessions lasting at least 45 min per day, 2-5 days/week, but there is no consensus on neuropsychology intensity.

Method: This Spanish multicenter, observational, descriptive cross-sectional study included 163 adult participants diagnosed with stroke, collecting 48 biopsychosocial variables. Statistical analyses, including non-parametric tests and linear regressions, were conducted to assess the relationship between intervention intensity and the studied variables.

Results: Our findings reveal an average neuropsychology of 59 min/week, significantly below international recommendations for intensive therapies. Patients in subacute phases (<6 months) and those with severe cognitive impairment (Montreal Cognitive Assessment <21) receive higher-intensity interventions, though still far from optimal standards. Significant differences were also identified between center types, reflecting variations in the resources available.

Conclusion: This study not only highlights the need to establish clear intensity criteria in neuropsychology but also provides a foundation for future experimental studies to evaluate the impact of increased intensity on cognitive outcomes. Additionally, future research should analyze whether the observed differences between center types could lead to inequalities in access to therapies. These unique data in the Spanish context can serve as a starting point for designing more equitable and effective clinical guidelines.

Background: Single-item depression screening has shown utility in young adult samples with limited work focused on individuals 50 and older. We examined single-item depression screening in adults 50 and older with a history of TBI one year post-injury.

Method: This project involved secondary analysis of deidentified TRACK-TBI data. The sample (N = 508) included 61 control participants and 447 cases grouped by TBI severity. Outcome measures included the Brief Symptom Inventory-18 depression scale (BSI-D) and Patient Health Questionnaire-9 (PHQ-9). Depression was determined psychometrically by BSI-D (≥63 T) and PHQ-9 (≥10) if either score was above the cutoff. The Rivermead Postconcussion Symptoms Questionnaire depression item (RPQ-D) was used in logistic regression (LR) and receiver operating characteristic (ROC) analyses to predict depression.

Results: Depression was observed in 16.1% of cases and 6.6% of control participants (p = .05) with non-significant variability across TBI severity (12.9-18.3%; p = .17). The LR model with age, education, TBI severity, and RPQ-D as predictors was significant with age and RPQ-D as significant predictors. The model classified 87.9% of participants correctly. The area under the ROC curve was 0.86. The optimal cutoff was RPQ-D ≥ 2.

Conclusion: Single-item screening for depression is a suitable approach in adults 50 and older with a history of TBI.

Objective: An increasing focus in Alzheimer's disease and aging research is to identify transitional cognitive decline. One means of indexing change over time in serial cognitive evaluations is to calculate standardized regression-based (SRB) change indices. This paper includes development and preliminary validation of SRB indices for the Uniform Data Set 3.0 Neuropsychological Battery, as well as base rate data to aid in their interpretation.

Method: The sample included 1341 cognitively intact older adults with serial assessments over 0.5-2 years in the National Alzheimer's Coordinating Center Database. SRB change scores were calculated in half of the sample, then validated in the other half of the sample. Base rates of SRB decline were evaluated at z-score cut-points, corresponding to two-tailed p-values of .20 (z = -1.282), 0.10 (z = -1.645) and .05 (z = -1.96). We examined convergent associations of SRB indices for each cognitive measure with each other, as well as concurrent associations of SRB indices with Clinical Dementia Rating sum of box scores (CDR-SB).

Results: SRB equations were able to significantly predict the selected cognitive variables. The base rate of at least one significant SRB decline across the entire battery ranged from 28.91% to 64.90%. SRB indices for cognitive measures demonstrated theoretically expected significant positive associations with each other. Additionally, CDR-SB impairment was associated with decline on three different SRB indices.

Conclusions: This paper provides preliminary validation of SRB indices in a large sample, and we present a user-friendly tool for calculating SRB values.

Objectives: Socioeconomic (SES) and health status (HS) are rarely considered when normative data are calculated. In the present study, normative data for the Trail Making Test (TMT) were developed from a large cohort and the association of sex, age and education, as well as HS and SES, with direct and derived TMT scores was explored.

Methods: Two thousand three hundred sixteen participants [1412 (61%) women; mean age: 47.11 (SD = 11.67) years; mean education: 14.82 (SD = 3.39) years] were drawn from the population-based Epirus Health Study. HS was rated on a self-reported scale and participants' medical conditions were recorded. SES was estimated from participants' after-tax income per month. The association of sex, age and education with TMT-A, TMT-B, TMT B-A and TMT B/A was explored with linear regression analyses. Hierarchical regression analyses were applied to control for HS and SES.

Results: Direct TMT scores were associated with sex, age and education (TMT-A: Bsex = 0.060, Bage = 0.322 and Beducation = -0.191; ΤΜΤ-Β: Bsex = 0.042, Bage = 0.330 and Beducation = -0.208). TMT B-A was associated with age (B = 0.176) and education (B = -0.130), whereas TMT B/A was not associated with any tested variable. SES, but not HS, was associated with TMT-A and TMT-B explaining the association of sex with TMT scores when included simultaneously in the model.

Conclusions: TMT performances are associated with age, education and sex. However, sex differences in direct TMT scores are attributed to underlying socioeconomic disparities in this large well-characterized cohort.

Objective: The social cognitive abilities of emotion perception, cognitive theory of mind (ToM), affective ToM, and emotional empathy change across adulthood. Few existing studies have examined the performance of a single social cognitive domain in later life, with no known studies having examined all four abilities together. Although it is well understood how non-social cognitive performance changes with age, and this has helped inform diagnostic methods for age-related disorders, relatively little is known about typical age-related social cognitive performance in later life. The current study aimed to investigate the association between age and social cognitive performance within a sample of healthy midlife to older adults.

Method: This cross-sectional study examined emotion perception using the Mini-SEA Facial Emotion Recognition Test, cognitive and affective ToM using The Shortened Awareness of Social Inference Test-Short Form, and emotional empathy using the Interpersonal Reactivity Index in 236 healthy adults aged 43-80 years (M = 60.30, SD = 6.88, 76% female).

Results: Multiple linear regression analyses revealed that age only had a significant, medium, negative association with cognitive (B = -.08, p < .001) and affective (B = -.05, p < .001) ToM and was not significantly associated with emotion perception or emotional empathy.

Conclusions: These findings enhance our understanding of normal social cognitive aging in later life, which can inform decisions around adding social cognitive measures into existing neuropsychological diagnostic tools for psychiatric, neurological, and developmental disorders.

Objective: Stroke is the third leading cause of death and disability worldwide in 2019. In stroke patients, about one-third or more are affected by depression, which makes it a serious social and public health problem. This study aims to create and validate a nomogram for early prediction and identification of depression in stroke patients.

Methods: Cross-sectional data from 605 stroke survivors aged 60 and over in the CHARLS 2011, 2015 was used. Participants were split into training and testing groups. Predictive factors were identified using Least Absolute Shrinkage and Selection Operator (LASSO) and multivariable logistic regression, leading to the creation of a nomogram model. The model's performance was assessed with Receiver Operating Characteristic (ROC) curves, the Concordance Index (C-index), calibration plots, and Decision Curve Analysis (DCA).

Results: It identified Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), sleep hours, uric acid, and Triglyceride-Glucose-Body Mass Index (TyG-BMI) as risk factors for depression post-stroke, which were integrated into the final model. The nomogram's predictive performance was deemed acceptable, with ROC curve values of 0.7512 (95% CI: 0.705-0.798) for the training set and 0.723 (95% CI: 0.65-0.797) for the testing set. The calibration curve confirmed the model's accuracy, and the DCA showed it had clinical utility.

Conclusions: Five key factors were chosen to create a nomogram predicting depression in stroke patients. This nomogram demonstrates evaluation performance and serves as a tool for forecasting depression in this population.