Cognitive profiles and deviation patterns of dyslexic children.

Cognitive profiles of 20 dyslexic children were examined using a battery of neuropsychological tests. Their ages ranged from 90 to 114 mo. (M = 106.6 mo.). Intelligence and reading comprehension were normal, but the subjects had specific problems in decoding written material. These subjects were matched with a control group of same age, sex, and sociocultural status. The dyslexic children presented specific patterns of response on WISC-R subtests and failed a battery of cognitive tests examining subcomponents of reading. For each child, a deviation score was computed which represented the imbalance among the different cognitive functions. Greater imbalance was observed among the dyslexic children in development of cognitive functions than among the normal children.     

Influence of cognitive style on an incidental memory task.

The present study investigated the interaction between cognitive style, imagery, and memory. The Tactual Performance Test Location Score from the Halstead-Reitan battery was used as a measure of incidental tactual memory and mental imagery. The Group Embedded Figures Test was used to assess cognitive style. Results for 38 Caucasian males of mean age 49.9 yr. suggest that cognitive style is related to an individual's ability to perform a non-verbal, non-visual memory task. Further, cognitive style may be an important mediating variable influencing intrapersonal behaviors such as non-verbal memory and mental imagery.     

Statistical significance and reliability of single-subtest and cluster deviation scores

Suppose one has a battery of K subtests and a composite for the battery is defined as the mean of the K standardized subtest scores. An individual's single-subtest deviation score is the difference between the individual's score on any single subtest and his composite score. A cluster deviation score is the difference between an examinee's average for a small set (cluster) of subtests and his composite. Formulas are given for the test of statistical significance of the individual's subtest or cluster deviation score and the internal consistency reliability of such deviation scores.     

Concurrent validity of the Wechsler abbreviated scale of intelligence and the Kaufman brief intelligence test among psychiatric inpatients

This study examined the convergent and discriminant validity of the Wechsler Abbreviated Scale of Intelligence and the Kaufman Brief Intelligence Test for 85 psychiatric inpatients. The correlation between the WASI Full Scale and K-BIT Composite IQ scores was significant (r = .89, p < .001). Multitrait-multimethod analysis of the subtest scores showed that the K-BIT had higher internal consistency for its two subtests but, therefore, less differentiation of cognitive functioning than the brief Wechsler scale, as would be expected due to the larger number and diversity of the latter subtests. Correlations among the Wechsler scale subtests were lower than among those for the K-BIT, so the former may tap different cognitive functions and yield more clinically useful information than the latter. This brief Wechsler scale appears to be a valid screening measure of verbal, performance. and general intellectual ability for use with an inpatient psychiatric population when considerations of the setting or patient preclude administration of a longer measure of intellectual ability.     

Examining the reliability of ADAS-Cog change scores

The purpose of this study was to estimate and examine ways to improve the reliability of change scores on the Alzheimer’s Disease Assessment Scale, Cognitive Subtest (ADAS-Cog). The sample, provided by the Alzheimer’s Disease Neuroimaging Initiative, included individuals with Alzheimer’s disease (AD) (n = 153) and individuals with mild cognitive impairment (MCI) (n = 352). All participants were administered the ADAS-Cog at baseline and 1 year, and change scores were calculated as the difference in scores over the 1-year period. Three types of change score reliabilities were estimated using multivariate generalizability. Two methods to increase change score reliability were evaluated: reweighting the subtests of the scale and adding more subtests. Reliability of ADAS-Cog change scores over 1 year was low for both the AD sample (ranging from .53 to .64) and the MCI sample (.39 to .61). Reweighting the change scores from the AD sample improved reliability (.68 to .76), but lengthening provided no useful improvement for either sample. The MCI change scores had low reliability, even with reweighting and adding additional subtests. The ADAS-Cog scores had low reliability for measuring change. Researchers using the ADAS-Cog should estimate and report reliability for their use of the change scores. The ADAS-Cog change scores are not recommended for assessment of meaningful clinical change.     

Level of performance accuracy for core Halstead-Reitan measures by pooling normal controls from published studies: comparison with existing norms in a clinical sample

The Halstead-Reitan Neuropsychological Test Battery offers a multifaceted, empirically supported interpretive framework for neuropsychological assessment founded upon raw scores referenced to a brain-damaged sample. Complementary approaches have used T scores from normal samples often composed of community volunteers or medical patients, augmented by regression. By pooling normal controls of all types from published studies, a sample large enough for stratification of core Halstead-Reitan measures by age and education was obtained (206 studies, N1 = 17,980). Comparisons based on T scores with two published normative systems in an outpatient sample produced a continuum: liberal norms for medical patients, intermediate pooled values from many types of subjects, and stringent norms for community volunteers. Features recommending clinical application of pooled norms include enhanced accuracy in clinical situations precluding a full battery, few empty cells or inversions for nonelderly subjects, and a screening application based upon a very large Trail Making Test sample (Trails B: n > 14,000).     

Feasibility of telecognitive assessment in dementia

Videoconferencing (VC) technology has been used successfully to provide psychiatric services to patients in rural and otherwise underserved settings. VC-based diagnostic interviewing has shown good agreement with conventional face-to-face diagnosis of dementia in several investigations, but extension of this technology to neurocognitive assessment has received little attention. To this end, the authors administered a brief battery of common neuropsychological tests via VC technology (telecognitive) and traditional face-to-face methods to 14 older persons with mild cognitive impairment (MCI) and 19 persons with mild to moderate Alzheimer's disease (AD). Highly similar test scores were obtained when participants were tested in-person or via VC. Telecognitive assessment appears to be a valid means to conduct neuropsychological evaluation of older adults with cognitive impairment. Furthermore, continued development of VC technology has implications for expanding neuropsychological assessment options in under-served populations.     

Test–Retest Reliability of the ECO Computerised Cognitive Battery for the Elderly

The current study presents the test–retest reliability data for the ECO (Examen Cognitif par Ordinateur) computerised cognitive battery developed by Ritchie et al. (1993). Repeat testings were conducted using a sample of 36 healthy elderly with normal cognitive functioning. Sixteen of the battery’s 23 subtests yielded significant correlation coefficients ranging from .42 to .90 (Pearson’s r). A mild practice effect was detected with two of the seven memory tests and two of the seven visuospatial tests (p &lt;.05). Comments about the sources of measurement error and recommendations for further test development are made.     

Visual associations to retrieve episodic memory across healthy elderly,mild cognitive impairment,and patients with Alzheimer’s disease

Episodic memory tests need to determine the degree to which patients with moderate to severe memory deficits can still benefit from retrieval support. Especially in the case of Alzheimer’s disease (AD), this may support health care to be more closely aligned with patients’ memory capacities. We investigated whether the different measures of episodic memory of the Visual Association Test-Extended (VAT-E) can provide a more detailed and informative assessment on memory disturbances across a broad range of cognitive decline, from normal to severe impairment as seen in AD, by examining differences in floor effects. The VAT-E consists of 24 pairs of black-and-white line drawings. In a within-group design, we compared score distributions of VAT-E subtests in healthy elderly controls, mild cognitive impairment (MCI), and AD (n = 144), as well as in relation to global cognitive impairment. Paired associate recall showed a floor effect in 41% of MCI patients and 62% of AD patients. Free recall showed a floor effect in 73% of MCI patients and 84% of AD patients. Multiple-choice cued recognition did not show a floor effect in either of the patient groups. We conclude that the VAT-E covers a broad range of episodic memory decline in patients. As expected, paired associate recall was of intermediate difficulty, free recall was most difficult, and multiple-choice cued recognition was least difficult for patients. These varying levels of difficulty enable a more accurate determination of the level of retrieval support that can still benefit patients across a broad range of cognitive decline.     

Closing-in behaviour in preschool children

Many pre-school children show closing-in behaviour (CIB) in graphic copying tasks: a tendency to place their copy abnormally close to or even on top of the model. Similar phenomena have been studied in patients with dementia, though it is unclear whether the superficial similarities between CIB in development and dementia reflect common underlying cognitive mechanisms. The aim of the present study was to investigate the cognitive functions involved in CIB in pre-school children. Forty-one children (3–5 years) were assessed for CIB, and completed a neuropsychological battery targeting visuospatial abilities, short term memory (verbal and spatial) and attention (sustained attention, selective attention and attention switching). Binary logistic regression found that performance on the attention subtests was the best unique predictor of CIB. A second analysis, in which the three attention subtests were entered as separate predictors, suggested that attention switching ability was most strongly related to CIB. These results support the view that CIB in children reflects inadequate attentional control. The convergence of these results with similar observations in patients with dementia further suggests that similar cognitive factors underlie CIB in these two populations.     

Common variance among three measures of nonverbal cognitive ability: WISC-R performance scale,WJPB-TCA reasoning cluster,and Halstead category test

The relationships among two psychometric measures of nonverbal cognitive ability (1) the Wechsler Intelligence Scale for Children-Revised (WISC-R) Performance IQ and (2) the Reasoning Cluster score and two subtests, Analysis-Synthesis and Concept Formation, from the Woodcock-Johnson Psychoeducational Battery-Tests of Cognitive Ability (WJPB-TCA)- and a neuropsychological test of abstract reasoning and concept formation (Halstead Category Test) were examined for a population of 25 children referred for psychoeducational evaluation as a result of learning difficulty. The findings demonstrated that the WISC-R Performance IQ and the Halstead Category Test have a common variance and appear to be sensitive to nonverbal cognitive ability, particularly of a perceptual organization nature. In contrast, the Reasoning Cluster score and the individual subtests from the WJPB-TCA appear to have a substantial g loading, as well as significant language correlates.     

Oxford cognitive screen: A critical review and independent psychometric evaluation

The Oxford cognitive screen (OCS) is a stroke-specific cognitive screening assessment. Although the test developers have provided psychometric information for the assessment, the OCS has received minimal external scrutiny, with which to triangulate the underpinning psychometrics. The purpose of this study is to provide a critical review and independent validation of the OCS. This study analysed data from an anonymised clinical database, which consisted of 316 patients who were assessed using the OCS on an Acute Stroke Unit. The rates of impairment on tests of memory and receptive communication were lower than expectation, suggesting that these subtests may be relatively insensitive. Patients with aphasia were more likely to be unable to categorised as impaired on non-language tests, suggesting that they remain sensitive to language processing or non-dominant hand usage. Some of the subtests of the OCS achieve high retest reliability, which makes them good candidates for measuring cognitive change over time. Although the OCS has many advantages, it is also important to adequately consider its limitations, that is insensitivity to memory problems, the potential confounding impact of non-dominant hand usage, and the potential that some tests may sample overall cognitive ability instead of domain-specific functioning.     

Comparing neurocognitive impairment in schizophrenia and bipolar I disorder using the Screen for Cognitive Impairment in Psychiatry Scale

The purpose of this study was to compare the psychometric properties of the Screen for Cognitive Impairment in Psychiatry (SCIP) when applied to patients diagnosed with schizophrenia (n = 126) or bipolar I disorder (n = 76), and also to compare the cognitive impairment in both samples of patients and a control group (n = 83) using the SCIP and a complete neuropsychological battery. The SCIP is a scale intended to quickly and easily assess cognitive impairment in patients with severe psychiatric disorders. The results showed firstly that, in terms of internal consistency, temporal stability, dimensional structure, and criterion-referenced validity, the SCIP provides reliable and valid scores at an equivalent level in both schizophrenia and bipolar I disorder samples. Secondly, it showed that differential cognitive impairment between the two patient groups occurs only in verbal memory, although the effect size of the difference is small. Finally, compared with the control group, cognitive impairment was present at all levels in both groups of patients using both the SCIP and the neuropsychological battery, which indicates that the SCIP is a good screening tool for cognitive deficits in schizophrenia and bipolar and useful in clinical practice for healthcare professionals.     

Development of a Brief Cognitive Screen for Mild Cognitive Impairment and Neurocognitive Disorder

Abstract

The purpose of this study was to develop and evaluate a brief cognitive screen for possible Mild Cognitive Impairment (MCI) and other neurocognitive impairment in a sample of general medical patients. Two hundred community-dwelling general medical patients aged 65 or older participated in this study. Age and education corrected scores from the Rey Auditory Verbal Learning Test and Mattis Dementia Rating Scale were used to classify participants into three groups: MCI, neurocognitive disorder, cognitively intact. Groups were then compared on an independent set of measures: the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery, Mini-Mental State Examination, and Clock Drawing Test. The MCI group constituted 9% of the sample, while 10.5% of the sample was classified into the neurocognitive disorder group. The CERAD Verbal Category Fluency and CERAD Word List Memory Test Delayed Recall measures were individually and collectively the most effective in differentiating cognitively intact elders from persons in both the MCI and neurocognitive disorder groups. We conclude that these two brief measures appear to be effective for detecting possible MCI or neurocognitive disorder, thereby facilitating identification of candidates who would benefit from more detailed neuropsychological assessment.     

Brief Cognitive Behavioral Therapy for Insomnia in Parkinson's Disease: A Case Series Study1

Parkinson's disease (PD) patients frequently suffer from insomnia and insomnia can result in reduction of quality of life in PD. Although pharmacotherapy is most applicable for insomnia, it may cause side-effects in PD. The purpose of the study was to investigate the efficacy of brief cognitive behavioral therapy for insomnia (CBTI) in PD. A total of 11 PD patients aged 43–84 years with chronic insomnia received two sessions of CBTI. Patients reported a significant decrease in total score for the Insomnia Severity Index (ISI). The total score for the Parkinson's Disease Sleep Scale (PDSS) improved. Although objective sleep measured by actigraph did not improve, subjective sleep measured by sleep diary improved. Functional impairment measured by the Sheehan Disability Scale (SDS) significantly decreased. These results revealed that brief CBTI was effective in improving insomnia in PD, with improvements extending to functional impairments that had been affected by insomnia. Additionally, this non-pharmacotherapy treatment could be easily applied to PD patients who may have difficulty coming to the clinic frequently due to physical symptoms.     

The relationship between menopausal status, phase of menstrual cycle, and replacement estrogen on cognition in healthy women without dementia

The authors examined the effect of menopausal status on several aspects of cognition in 4 groups of women (young premenopausal women, middle-aged premenopausal women, naturally postmenopausal women not using hormone therapy, and postmenopausal women using hormone replacement therapy). Participants (N = 48) completed questionnaires designed to assess psychological and physical health. The authors administered a test battery consisting of 10 neuropsychological tests to assess cognitive functioning. Using multivariate analyses of covariance with age as the covariate, the authors found a significant main effect of menopausal status on attention and complex processing abilities. Postmenopausal women using hormone replacement therapy significantly outperformed postmenopausal women not using hormone therapy on the Trail Making Test, Part B of the Halstead-Reitan (R. M. Reitan, 1958). This effect was significant even when the authors controlled for the effects of age, vocabulary levels, and education. Results are consistent with previous findings and may provide further evidence for an ameliorative effect of estrogen replacement therapy on specific cognitive functions.     

Reaction times and speed-of-processing: Their relationship to timed and untimed measures of intelligence

Eighty-one university students were given a battery of reaction time tests, measuring the speed with which they performed various elementary cognitive processes, and a group test of intelligence which yielded timed and untimed scores. Multiple regression analyses indicated that speed of information-processing was an equally good predictor of timed and untimed intelligence test performance, and that various combinations of speed-of-processing variables accounted for as much as 48% of the variance in intelligence test scores. Different speed-of-processing variables varied relatively systematically in the extent to which they correlated with the individual subtests and scales of the intelligence test.     

Cognitive Testing Battery: differences among groups with dementia, Huntington's disease, and controls

This study evaluated a new test for dementia, the Cognitive Testing Battery, used for over six years in outpatient clinics for aging-related disorders. This battery was developed to be brief, easy to administer, and to provide useful feedback as a cognitive profile for clinicians, patients, and caregivers. 489 participants were tested during a 5-yr. period. Multidisicplinary teams diagnosed these patients with dementia, depression, or Huntington's Disease. A control group was also included. Groups were then compared on the 10 key subscales that subserve dementia populations. Analysis showed there were significant differences among the groups on all measures and that selected scales differentiated the groups. The total score maximally differentiated the groups, and the dementia group was most different from the other groups.     

RBANS Validity Indices: a Systematic Review and Meta-Analysis

Neuropsychology practice organizations have highlighted the need for thorough evaluation of performance validity as part of the neuropsychological assessment process. Embedded validity indices are derived from existing measures and expand the scope of validity assessment. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief instrument that quickly allows a clinician to assess a variety of cognitive domains. The RBANS also contains multiple embedded validity indicators. The purpose of this study was to synthesize the utility of those indicators to assess performance validity. A systematic search was completed, resulting in 11 studies for synthesis and 10 for meta-analysis. Data were synthesized on four indices and three subtests across samples of civilians, service members, and veterans. Sufficient data for meta-analysis were only available for the Effort Index, and related analyses indicated optimal cutoff scores of ≥1 (AUC?=?.86) and?≥?3 (AUC?=?.85). However, outliers and heterogeneity were present indicating the importance of age and evaluation context. Overall, embedded validity indicators have shown adequate diagnostic accuracy across a variety of populations. Recommendations for interpreting these measures and future studies are provided.