The utility of regression-based norms in interpreting the minimal assessment of cognitive function in multiple sclerosis (MACFIMS)

AbstractThe Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) is a consensus neuropsychological battery with established reliability and validity. One of the difficulties in implementing the MACFIMS in clinical settings is the reliance on manualized norms from disparate sources. In this study, we derived regression-based norms for the MACFIMS, using a unique data set to control for standard demographic variables (i.e., age, age2, sex, education). Multiple sclerosis (MS) patients (n = 395) and healthy volunteers (n = 100) did not differ in age, level of education, sex, or race. Multiple regression analyses were conducted on the performance of the healthy adults, and the resulting models were used to predict MS performance on the MACFIMS battery. This regression-based approach identified higher rates of impairment than manualized norms for many of the MACFIMS measures. These findings suggest that there are advantages to developing new norms from a single sample using the regression-based approach. We conclude that the regression-based norms presented here provide a valid alternative to identifying cognitive impairment as measured by the MACFIMS. (JINS, 2010, 16, 6–16.)

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The cognitive reserve theory in the setting of pediatric-onset multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458516629559 ◽

2016 ◽

Vol 22 (13) ◽

pp. 1741-1749 ◽

Cited By ~ 18

Author(s):

Luisa Pastò ◽

Emilio Portaccio ◽

Benedetta Goretti ◽

Angelo Ghezzi ◽

Silvia Lori ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Reserve ◽

Reliable Change Index ◽

Neuropsychological Performance ◽

Regression Analyses ◽

Neuropsychological Battery ◽

Healthy Control ◽

Multivariable Regression ◽

Potential Impact ◽

Pediatric Onset

Background: The study of cognitive reserve (CR) in relationship with cognitive impairment (CI) in pediatric-onset multiple sclerosis (POMS) may provide cues to identifying subjects at higher risk of impairment and scope for therapeutic strategies. Objectives: To assess the potential impact of CR on cognition in a cohort of POMS patients. Methods: In all, 48 POMS patients were followed up for 4.7 ± 0.4 years. CI was defined as the failure of ⩾3 tests on an extensive neuropsychological battery. Change of neuropsychological performance was assessed through the Reliable Change Index (RCI) method. At baseline, CR was estimated by measuring the intelligence quotient (IQ). The relationships were assessed through multivariable regression analyses. Results: At baseline, CI was detected in 14/48 (29.2%) patients. Two out of 57 healthy control (HC; 3.5%) met the same criteria of CI ( p < 0.001). A deteriorating cognitive performance using the RCI method was observed in 18/48 patients (37.6%). Among the 34 cases who were cognitively preserved at baseline, a higher reserve predicted stable/improving performance (odds ratio (OR) = 1.11; 95% confidence interval (CI): 1.03–1.20; p = 0.006). Conclusion: Our results suggest that higher CR in POMS patients may protect from CI, particularly in subjects with initial cognitive preservation, providing relevant implications for counseling and rehabilitation strategies.

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Positive, but Not Negative, Self-Perceptions of Aging Predict Cognitive Function Among Older Adults

The International Journal of Aging and Human Development ◽

10.1177/0091415020917681 ◽

2020 ◽

pp. 009141502091768 ◽

Cited By ~ 1

Author(s):

Kellie E. Brown ◽

Jeehoon Kim ◽

Tara Stewart ◽

Erika Fulton ◽

Anna C. McCarrey

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Processing Speed ◽

Regression Analyses ◽

Neuropsychological Battery ◽

Short Delay ◽

Older Adulthood ◽

Self Perceptions ◽

Two Measures ◽

Perceptions Of Aging

Self-perceptions of aging (SPA) refer to attitudes about one’s aging process and are linked to physical health and longevity. How SPA correlates with cognitive function in older adulthood is less well known. 136 older adults were administered a multifaceted SPA measure, The Brief Ageing Perceptions Questionnaire (B-APQ), in addition to a demographic form and a comprehensive neuropsychological battery. Positive and negative subscales of the B-APQ were correlated with aspects of cognitive function. Regression analyses revealed that only the positive B-APQ subscales predicted mental status ( β = .19, p < .05), short-delay memory ( β = .16, p < .05), processing speed ( β = −.21, p < .05), and two measures of executive function ( β = −.21, p < .01; β = .18, p < .05). This is the first study to demonstrate that positive dimensions of SPA relate to cognitive function in older adulthood.

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Who Plays Games Online?

International Journal of E-Business Research ◽

10.4018/jebr.2012100101 ◽

2012 ◽

Vol 8 (4) ◽

pp. 1-14 ◽

Cited By ~ 2

Author(s):

Ching-I Teng ◽

Shih-Ping Jeng ◽

Henry Ker-Chang Chang ◽

Soushan Wu

Keyword(s):

Factor Analysis ◽

Reliability And Validity ◽

Online Games ◽

Demographic Variables ◽

Computer Applications ◽

Measurement Reliability ◽

Regression Analyses ◽

Online Game ◽

Confirmatory Factor ◽

The Relationship

Online games have become increasingly popular computer applications, raising the question of who plays them. Thus, the present study investigates the relationship between gamer personality and online game use as well as the potential links between online game use and gamer demographic variables. The sample consisted of 1633 Taiwanese online gamers. This study used confirmatory factor analysis to assess measurement reliability and validity. The hypotheses were tested using regression analyses. Analytical results indicated that online game use is positively related to gamer openness and agreeableness but negatively related to gamer conscientiousness and emotional stability. Moreover, being male and having a high income were associated with higher levels of online game use. The results increase the knowledge on the link between personality and online gaming behaviour.

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Cognitive impairment in multiple sclerosis does not affect reliability and validity of self-report health measures

Multiple Sclerosis Journal ◽

10.1191/1352458503ms927oa ◽

2003 ◽

Vol 9 (4) ◽

pp. 404-410 ◽

Cited By ~ 83

Author(s):

Stefan M Gold ◽

Holger Schulz ◽

Andrea Mönch ◽

Karl-Heinz Schulz ◽

Christoph Heesen

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Dysfunction ◽

Depression Scale ◽

Reliability And Validity ◽

Self Report ◽

Poor Correlation ◽

Health Measures ◽

Health Status Measures

Patient self-report health measures have received increasing recognition as supplementar y outcome parameters in multiple sclerosis (MS). G iven the high prevalence of cognitive problems in this population, reliability and validity of self-report instruments in patient groups with cognitive impairment is essential, especially when using such scales longitudinally. A sample of 80 MS patients with cognitive dysfunction according to Symbol Digit Modalities Test (SDMT) score and 107 unimpaired patients were included in the analyses. Data was available from the Hamburg Q uality of Life Q uestionnaire in Multiple Sclerosis (HAQ UA MS), the Hospital A nxiety and Depression Scale (HA DS), clinical rating scores [Expanded Disability Status Scale (EDSS) and FS (Functio nal Status) scales, C A MBS (Cambridge MS Basic Score)] and objective tests of upper and lower limb function [Timed 8 Meter Walk (T8) and Nine Hole Peg Test (9HPT)). Both self-report questionnaires showed satisfactory internal consistencies and retest reliability. Pattern and magnitude of correlations with other health status measures supported the validity of both instruments. However, there was a marked discrepancy between subjective and objective measures of cognitive function. C ognitively impaired patients furthermore showed significantly higher depression and anxiety as well as lower quality of life (Q oL). The report provides evidence that Q oL and affective symptomatology can be reliably assessed in MS patients with cognitive dysfunction. The common pattern of poor correlation between self-rated and objective cognitive function thus appears to be a result of the patients’ (adaptive or maladaptive) coping mechanisms rather than being due to inaccurate measurement.

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Screening for cognitive impairment in multiple sclerosis using the Symbol Digit Modalities Test

Multiple Sclerosis Journal ◽

10.1177/1352458506070750 ◽

2007 ◽

Vol 13 (1) ◽

pp. 52-57 ◽

Cited By ~ 196

Author(s):

B A Parmenter ◽

B Weinstock-Guttman ◽

N Garg ◽

F Munschauer ◽

R HB Benedict

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Positive Predictive Value ◽

Bayesian Statistics ◽

Negative Predictive Value ◽

Predictive Value ◽

Demographic Variables ◽

Healthy Controls ◽

Neurologic Examination

Cognitive impairment is common in multiple sclerosis (MS), yet difficult to detect duringroutine neurologic examination. Therefore, briefscreening tests that identify patients who may benefit from a more thorough assessment or treatment are needed. We investigated the utility of the Symbol Digit Modalities Test (SDMT) as a screen for cognitive dysfunction because it can be administered and scored in about 5 minutes. One hundred MS patients and 50 healthy controls, matched on demographic variables, participated in the study. Examination procedures included the neuropsychological (NP) tests included in the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery. Patients were considered impaired if they performed one and a half standard deviations below controls on two or more MACFIMS variables, excluding theSDMT. Bayesian statistics showed that a total score of 55 or lower onthe SDMT accurately categorized 72% of patients, yielding sensitivityof 0.82, specificity of 0.60, positive predictive value (PPV) of 0.71, and negative predictive value (NPV) of 0.73. These results suggest that the effectiveness of the SDMT as a screen for cognitive impairment in MS is roughly equal to that of other psychometric and questionnaire methods.

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Canadian Normative Data for Minimal Assessment of Cognitive Function in Multiple Sclerosis

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2017.199 ◽

2017 ◽

Vol 44 (5) ◽

pp. 547-555 ◽

Cited By ~ 6

Author(s):

Lisa A.S. Walker ◽

David Marino ◽

Jason A. Berard ◽

Anthony Feinstein ◽

Sarah A. Morrow ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Function ◽

Normative Data ◽

Clinical Decision Making ◽

Clinical Decision ◽

Demographic Variables ◽

Data Sets ◽

Demographic Differences ◽

Canadian Population ◽

Healthy Control

AbstractObjective: The Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) is a consensus-based collection of neuropsychological tests that evaluate cognitive functioning in individuals with multiple sclerosis (MS). The tests are typically scored using each respective published test manual, leaving the examiner to make interpretations from norms derived from different American populations. Given demographic differences, this may lead to misinterpretation of findings in Canadians. Our goal was to establish both discrete and regression-based normative data for the MACFIMS based on a largely co-normed Canadian population to allow for improved psychometric interpretation. Methods: MACFIMS data sets were aggregated from across three different Canadian cities (Ottawa, Toronto, and London), yielding a total of 330 healthy control participants from four different studies evaluating cognition in individuals with MS. Given the variety of contributing studies, there was variability in terms of the number of participants completing each measure. Results: Both age-based discrete normative data and demographically adjusted (sex, age, and education) regression-based formulae were established. The demographic variables varied in their contribution to each MACFIMS test in the regression models, predicting 0 to 18% of the variance. Conclusions: Provision of these regression-based formulae will allow for more accurate interpretation of Canadian-derived MACFIMS scores by allowing clinicians to correct for all relevant demographic variables simultaneously, leading to improved clinical decision making for individuals with multiple sclerosis.

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Sensitivity of conventional memory tests in multiple sclerosis: comparing the Rao Brief Repeatable Neuropsychological Battery and the Minimal Assessment of Cognitive Function in MS

Multiple Sclerosis Journal ◽

10.1177/1352458509106615 ◽

2009 ◽

Vol 15 (9) ◽

pp. 1077-1084 ◽

Cited By ~ 132

Author(s):

L Strober ◽

J Englert ◽

F Munschauer ◽

B Weinstock-Guttman ◽

S Rao ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Function ◽

Verbal Memory ◽

Verbal Learning ◽

Disease Status ◽

Relative Sensitivity ◽

Neuropsychological Battery ◽

Memory Tests ◽

Visual Spatial ◽

Selective Reminding Test

Background Cognitive impairment is common in multiple sclerosis (MS) affecting roughly 45–60% of patients. Because memory deficits have significant impact on employment, caregiver burden, and social functioning, neuropsychological (NP) assessment is often recommended. Two widely used and validated NP batteries for MS are the Rao Brief Repeatable Neuropsychological Battery (BRNB) and the Minimal Assessment of Cognitive Function in MS (MACFIMS). Although similar, these batteries differ in the specific auditory/verbal and visual/spatial memory tests employed. The relative sensitivity of these memory tests is unknown. Methods The BRNB and MACFIMS have considerable overlap but different memory tests: the former includes the Selective Reminding Test (SRT) and the 10/36 Spatial Recall Test (10/36) and the latter the California Verbal Learning Test, Second Edition (CVLT2) and Brief Visuospatial Memory Test, Revised (BVMTR). In 65 patients with MS and 46 demographically matched controls, we compared the sensitivity of these tests, and secondarily their respective batteries. Results The BRNB and MACFIMS were comparable in their overall sensitivity to disease status. Although the BVMTR showed greater discriminative validity than the 10/36, the CVLT2 and SRT were comparable in sensitivity. The SDMT was the most sensitive NP test across both batteries. Conclusions We conclude that the BRNB and MACFIMS have comparable sensitivity among patients with MS. The sensitivity of the auditory/verbal memory tests from these batteries is similar, but the BVMTR appears to be more sensitive than the 10/36. Clinical implications are discussed.

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