Archives of Clinical Neuropsychology最新文献

Objective: To establish convergent and discriminant validity for a combined measure of print exposure (i.e., Author Recognition Test and Magazine Recognition Test [ART/MRT]) and assess its potential utility for estimating premorbid cognitive functioning.

Method: Community-dwelling older adults (N = 84; 95% non-Hispanic White) completed the ART/MRT, Test of Premorbid Functioning (ToPF), Dementia Rating Scale - 2nd Edition (DRS-2), Hopkins Verbal Learning Test - Revised (HVLT-R-DR), and select subtests from the Delis-Kaplan Executive Functioning System (D-KEFS) as measures of executive functioning (i.e., D-KEFS-EF) and processing speed (i.e., D-KEFS-PS). Pearson correlations and linear regressions were used to examine the relationships between the ART/MRT, cognition, and demographics.

Results: Cognitive scores, with the exception of HVLT-R-DR, were positively correlated with ART/MRT score such that better cognitive performance was associated with greater print exposure (range r = 0.39-0.49). ART/MRT score was positively correlated with years of education and negatively correlated with age. ToPF and DRS-2 differentially and uniquely predicted ART/MRT score beyond the other cognitive and demographic variables and beyond each other.

Conclusions: Findings indicate that measures of print exposure reflect crystallized knowledge but may also capture fluid abilities that may be more vulnerable to age-related decline or neurodegeneration. Assessment of print exposure may offer an alternative to word reading measures that may be inappropriate for translation into other languages and for use with individuals with certain language difficulties.

Objective: The goal of the present study was to examine teachers' perceptions of neuropsychological reports broadly and their preparedness to support the educational needs of students with chronic health conditions.

Method: Teachers were selected from across the United States using stratified random sampling. 280 teachers (76.2% female; 58.4% public school; 53.9% rural setting) completed an anonymous electronic survey via Qualtrics.

Results: Half of the teachers were familiar with neuropsychology and previously read a neuropsychological report, which the majority found useful with a preference toward shorter reports. Most found listed recommendations to be appropriate, but half of teachers identified limited resources as a barrier to implementation. Teachers reported limited education, training, and comfort for providing accommodations to children with chronic health conditions, which was significantly lower for cancer, congenital heart disease, and sickle cell disease. Older teachers, more years of experience, and special education teachers demonstrated significantly higher levels of education, training, and comfort. Frequency of implementing accommodations was significantly negatively correlated with perceived burden and positively correlated with perceived benefit across most accommodations. Teachers reported a preference for single-page handouts and speaking directly to neuropsychologists about the specific learning needs of students with chronic health conditions.

Conclusions: Results highlight areas for future research and intervention regarding teacher's preparedness for working with children with chronic health groups and opportunities to improve communication between neuropsychologists and teachers to ultimately improve access to educational supports and overall quality of life of students with chronic health conditions.

Objective: Compensatory strategies can be used to help mid-life and older adults successfully manage instrumental activities of daily living that rely upon prospective memory. This study compared the quality of digital and non-digital compensatory strategies in supporting accurate completion of naturalistic, real-world prospective memory tasks.

Method: Participants included 70 community-dwelling mid-life and older adults. In this cross-sectional study, participants were tested remotely via Zoom in their homes. They were tasked with completing four real-world prospective memory tasks and encouraged to use their typical compensatory strategies. Utilized strategies were categorized, counted, and assigned quality scores (rating of thoroughness and utility), and prospective memory performance was coded.

Results: Participants who used any digital strategies utilized significantly more (ηp2 = .17) and better quality (ηp2 = .12) strategies than participants who did not use any digital strategies. However, the groups demonstrated equivalent prospective memory performance (ηp2 = .006). Within the digital group, participants' digital and non-digital strategies were of similar quality (d = .14) and resulted in similar prospective memory task accuracy (d = .01).

Conclusions: Digital and non-digital strategies led to similar performance on naturalistic prospective memory tasks. Findings suggest that many different types of strategies can provide adequate prospective memory support to healthy mid-life and older adults. To inform development of compensatory strategy interventions, future studies should explore other factors that lead to successful prospective memory, such as the specific strategy type and task type match, across the continuum of cognitive impairment.

Introduction: The use of performance validity tests (PVTs) in a neuropsychological assessment to determine indications of invalid performance has been a common practice for over a decade. Most PVTs are memory-based; therefore, the Groningen Effort Test (GET), a non-memory-based PVT, has been developed.

Objectives: This study aimed to validate the GET in patients with suspected chronic solvent-induced encephalopathy (CSE) using the criterion standard of 2PVTs. A second goal was to determine diagnostic accuracy for GET.

Method: Sixty patients with suspected CSE referred for NPA were included. The GET was compared to the criterion standard of 2PVTs based on the Test of Memory Malingering and the Amsterdam Short Term Memory Test.

Results: The frequency of invalid performance using the GET was significantly higher compared to the criterion of 2PVTs (51.7% vs. 20.0% respectively; p < 0.001). For the GET index, the sensitivity was 75% and the specificity was 54%, with a Youden's Index of 27.

Conclusion: The GET showed significantly more invalid performance compared to the 2PVTs criterion suggesting a high number of false positives. The general accepted minimum norm of specificity for PVTs of >90% was not met. Therefore, the GET is of limited use in clinical practice with suspected CSE patients.

Objective: In dementia research, the Driving Scenes test from the Neuropsychological Assessment Battery has been shown to relate to memory, dementia diagnosis, and functional impairment. The aim of the current study was to examine Driving Scenes and its component scores, and their relationships with cognition and daily functioning, in a mixed dementia clinic sample.

Method: One hundred U.S. military veterans between the ages of 55 and 88 were administered a full neuropsychological protocol that included Driving Scenes.

Results: The Driving Scenes score and its subscores were strongly related to memory skills, and there were additional subscore associations with language and visuospatial functions. Driving Scenes uniquely predicted reported bill payment difficulties and tendency to get lost while driving, which were not predicted by other performances across cognitive domains.

Conclusion: Driving Scenes is a clinically and functionally relevant measure of memory. Although the Driving Scenes total score remains useful in dementia evaluations, component scores and error scores contribute additional practical information.

Objective: To determine if the co-occurrence of apathy and impulse control disorders (ICDs) in Parkinson disease is dependent on instrument selection and assess the concurrent validity of three motivation measures by examining interrelationships between them.

Method: Ninety-seven cognitively normal individuals with idiopathic Parkinson disease (PD) completed the Questionnaire for Impulsive-Compulsive Disorders in Parkinson Disease-Rating Scale (QUIP-RS) and three apathy measures: the Apathy Scale, Lille Apathy Rating Scale, and Item 4 of the Movement Disorder Society-Unified Parkinson Disease Rating Scale.

Results: Fifty (51.5%) participants were classified as apathetic on at least one measure, and only four individuals (4.3%) obtained clinically elevated scores on all three measures. The co-occurrence of apathy and ICD varied across measures.

Conclusions: We observed a co-occurrence of apathy and ICDs in PD patients with each apathy instrument; however, limited concurrent validity exists across measures. This is important for future investigations into shared pathophysiology and the design of future clinical trials aimed at improving the early detection and treatment of these debilitating syndromes.

Objective: The purpose of this retrospective archival study was to explore the clinical utility of the Judgment subtest of the Neuropsychological Assessment Battery (NAB) in older adults who were referred because of cognitive concerns. Specifically, we were interested in how NAB Judgment covaried with other measures of executive functioning.

Method: 226 adults, aged 61-89 years (48% dementia, 35% mild cognitive impairment, 18% cognitively intact) completed NAB Judgment. They also completed Trail Making Test (TMT) A and B. In addition, Behavior Rating Inventory of Executive Function (BRIEF-A) informant and self-reports were obtained to measure executive functioning in daily life.

Results: Scores on NAB Judgment did not correlate significantly with BRIEF-A informant ratings. However, there was a statistically significant correlation between BRIEF-A informant ratings and TMT B. Better performance on TMT B was associated with fewer informant concerns. Furthermore, subgroups with versus without informant BRIEF-A Metacognition indices in the range of impairment demonstrated a statistically significant difference on TMT B but not on Judgment.

Conclusions: Executive functioning in older adults should not be assessed using NAB Judgment alone. Such an evaluation should be supplemented with other in-person tests as well as informant ratings of daily functioning.

Objective: This study aims to evaluate the efficacy of the Uniform Data Set (UDS) 2 battery in distinguishing between individuals with mild cognitive impairment (MCI) attributable to Alzheimer's disease (MCI-AD) and those with MCI due to other causes (MCI-nonAD), based on contemporary AT(N) biomarker criteria. Despite the implementation of the novel UDS 3 battery, the UDS 2 battery is still used in several non-English-speaking countries.

Methods: We employed a cross-sectional design. A total of 113 Czech participants with MCI underwent a comprehensive diagnostic assessment, including cerebrospinal fluid biomarker evaluation, resulting in two groups: 45 individuals with prodromal AD (A+T+) and 68 participants with non-Alzheimer's pathological changes or normal AD biomarkers (A-). Multivariable logistic regression analyses were employed with neuropsychological test scores and demographic variables as predictors and AD status as an outcome. Model 1 included UDS 2 scores that differed between AD and non-AD groups (Logical Memory delayed recall), Model 2 employed also Letter Fluency and Rey's Auditory Verbal Learning Test (RAVLT). The two models were compared using area under the receiver operating characteristic curves. We also created separate logistic regression models for each of the UDS 2 scores.

Results: Worse performance in delayed recall of Logical Memory significantly predicted the presence of positive AD biomarkers. In addition, the inclusion of Letter Fluency RAVLT into the model significantly enhanced its discriminative capacity.

Conclusion: Our findings demonstrate that using Letter Fluency and RAVLT alongside the UDS 2 battery can enhance its potential for differential diagnostics.