Identifying Appropriate Neuropsychological Tests for Uneducated/Illiterate Older Individuals

Abstract Objectives: We investigated the utility of traditional neuropsychological tests in older uneducated/illiterate individuals without dementia to determine the possibility that they are likely not appropriate for this group. Methods: We assessed the neuropsychological performance of 1122 older adults [≥65 years old; mean age: 74.03 (SD = 5.46); mean education: 4.76 (SD = 2.5) years; women: n = 714], in the context of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD), a population-based study conducted in Greece. Results: We based our analyses on three groups: high-functioning/cognitively healthy (i.e., without dementia) uneducated/illiterate individuals (n = 80), high-functioning/cognitively healthy educated/literate individuals (n = 932), and low-functioning/cognitively impaired educated/literate individuals (presumably with dementia; n = 110). We used binary regression analyses with Bonferroni correction to investigate whether test performance differentiated uneducated/illiterate from educated/literate individuals. Models were adjusted for age and sex; raw test scores were the predictor variables. The uneducated/illiterate cohort was at a disadvantage relative to the healthy educated/literate group on all variables but verbal memory recognition and consolidation, congruent motor responses, and phonological fluency clustering (p > .002). Moreover, only word list learning immediate and delayed free recall and delayed cued recall differentiated the high-functioning/cognitively healthy uneducated/illiterate from the low-functioning/cognitively impaired educated/literate group, favoring the former (p’s < .002). Conclusions: Our findings suggest that only particular verbal memory test variables are fair in determining whether older uneducated/illiterate individuals have functional/cognitive impairment suggestive of a neurodegenerative process. On all other neuropsychological variables, this cohort was at a disadvantage. Therefore, we highlight the need for identifying appropriate methods of assessment for older uneducated/illiterate individuals.

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Cohort effects in verbal memory function and practice effects: a population-based study

International Psychogeriatrics ◽

10.1017/s1041610216001551 ◽

2016 ◽

Vol 29 (1) ◽

pp. 137-148 ◽

Cited By ~ 10

Author(s):

Hiroko H Dodge ◽

Jian Zhu ◽

Tiffany F. Hughes ◽

Beth E. Snitz ◽

Chung-Chou H. Chang ◽

...

Keyword(s):

Verbal Memory ◽

Test Performance ◽

Disease Incidence ◽

Memory Function ◽

Developed Countries ◽

Population Based ◽

Cohort Effects ◽

Practice Effects ◽

Birth Cohorts ◽

Delayed Recall

ABSTRACTBackground:In many developed countries, cognitive functioning (as measured by neuropsychological tests) appears to be improving over time in the population at large, in parallel with the declining age-specific incidence of dementia. Here, we investigated cohort effects in the age-associated trajectories of verbal memory function in older adults. We sought to determine whether they varied by decade of birth and, if so, whether the change would be explained by increasing educational attainment.Methods:Pooling data from two prospective US population-based studies between 1987 and 2015, we identified four birth cohorts born 1902–1911, 1912–1921, 1922–1931, and 1932–1943. Among these cohorts, we compared age-associated trajectories both of performance and of practice effects on immediate and delayed recall of a 10-item Word List. We used mixed effects models, first including birth cohorts and cohort X age interaction terms, and then controlling for education and education X age interaction.Results:We observed significant cohort effects in performance (baseline and age-associated trajectories) in both immediate recall and delayed recall, with function improving between the earliest- and latest-born cohorts. For both tests, we also observed cohort effects on practice effects with the highest levels in the latest-born cohorts. Including education in the models did not attenuate these effects.Conclusions:In this longitudinal population study, across four decade-long birth cohorts, there were significant improvements in test performance and practice effects in verbal memory tests, not explained by education. Whether this reflects declining disease incidence or other secular trends awaits further investigation.

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Cognitive Performance among Cognitively Healthy Adults Aged 30–100 Years

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000495657 ◽

2019 ◽

Vol 9 (1) ◽

pp. 11-23 ◽

Cited By ~ 5

Author(s):

Minna Alenius ◽

Sanna Koskinen ◽

Ilona Hallikainen ◽

Tiia Ngandu ◽

Jari Lipsanen ◽

...

Keyword(s):

Cognitive Performance ◽

Verbal Memory ◽

Test Performance ◽

Verbal Fluency ◽

Word List ◽

Education Level ◽

Healthy Adults ◽

Cognitive Test ◽

Normative Values ◽

And Gender

Background/Aims: To detect cognitive decline in older adults, measures of verbal fluency and verbal memory are widely used. Less is known about performance in these measures in younger persons or according to education level and gender. We investigated cognitive performance according to age, education and gender among cognitively healthy adults aged 30–100 years. Methods: The study population comprised 4,174 cognitively healthy persons participating in the nationally representative Finnish Health 2011 survey. Cognitive assessment included verbal fluency, word list memory, word list recall and word list savings from the Consortium to Establish a Registry for Alzheimer’s Disease neuropsychological battery. Results: Total variance in the cognitive test performance explained by age, education and gender varied from 12.3 to 31.2%. A decreasing trend in cognitive performance existed in all subtests by advancing age, with differences appearing between 50 and 55 years. Persons with the highest-education level performed best for all measures. For the participants < 55 years, education explained part of the variance, while age and gender did not. Conclusions: When assessing cognition, age and education should be accounted for in more detail in research and clinical practice. Additionally, the cohort effect and its potential impact on the renewal cycle of future normative values for cognitive tests should be considered.

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A-112 Validity of In-Person Assessment of Traumatic Brain Injury Inpatients Using the Brief Test of Adult Cognition by Telephone

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.112 ◽

2020 ◽

Vol 35 (6) ◽

pp. 905-905

Author(s):

Diblasio C ◽

Novack T ◽

Cook E ◽

Kennedy R

Keyword(s):

Verbal Memory ◽

Neuropsychological Tests ◽

Digit Span ◽

Word List ◽

Inpatient Rehabilitation ◽

Semantic Fluency ◽

Delayed Recall ◽

Phonemic Fluency ◽

Composite Scores ◽

Adult Cognition

Abstract Objective Examine the correlation of the Brief Test of Adult Cognition by Telephone (BTACT) with established neuropsychological tests in an inpatient traumatic brain injury (TBI) population. Method Participants were 55 patients aged 18–76 years (M age = 37 years; 69% male) receiving inpatient rehabilitation for new-onset TBI at a level I trauma center, acute inpatient rehabilitation hospital. The BTACT is a brief cognitive test battery consisting of the following subtests: Word List Immediate and Delayed Recall (episodic verbal memory), Digits Backward (working memory), Number Series (inductive reasoning), Animal Fluency (verbal fluency), and Backward Counting (processing speed). With the intention of mirroring cognitive functions measured by the BTACT, the neuropsychological battery was comprised of the California Verbal Learning Test-2 (CVLT-2), Wechsler Adult Intelligence Scale-IV (WAIS-IV) Digit Span, Trail Making Test (TMT), semantic fluency, phonemic fluency, Symbol Digit Modalities Test, and Wisconsin Card Sorting Test. Results The BTACT was related to established neuropsychological tests across composite scores of overall cognition (r = .64, p < .001), episodic verbal memory (r = .66, p < .001), and executive function (r = .56, p < .001). For BTACT subtests, Word List Immediate Recall and Word List Delayed Recall were correlated with CVLT-2 learning trials total (r = .57, p < .01) and long delay free recall (r = .60, p < .001), respectively. BTACT Digits Backward correlated with WAIS-IV Digit Span (r = .51, p < .01). BTACT Animal Fluency was related to semantic fluency (r = .65, p < .01), phonemic fluency (r = .60, p < .01), and TMT-B (r = .39, p < .01). Conclusion BTACT composite scores of overall cognition, verbal memory, and executive function are valid measures in a TBI inpatient population.

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Influence of Primary Auditory Cortex in the Characterization of Autism Spectrum in Young Adults using Brain Connectivity Parameters and Deep Belief Networks: An fMRI Study

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666191111142039 ◽

2020 ◽

Vol 16 (9) ◽

pp. 1059-1073

Author(s):

Vidhusha Srinivasan ◽

N. Udayakumar ◽

Kavitha Anandan

Keyword(s):

Functional Connectivity ◽

Auditory Cortex ◽

Language Processing ◽

Brain Connectivity ◽

Primary Auditory Cortex ◽

Autism Spectrum ◽

Belief Networks ◽

Deep Belief Networks ◽

High Functioning ◽

Low Functioning

Background: The spectrum of autism encompasses High Functioning Autism (HFA) and Low Functioning Autism (LFA). Brain mapping studies have revealed that autism individuals have overlaps in brain behavioural characteristics. Generally, high functioning individuals are known to exhibit higher intelligence and better language processing abilities. However, specific mechanisms associated with their functional capabilities are still under research. Objective: This work addresses the overlapping phenomenon present in autism spectrum through functional connectivity patterns along with brain connectivity parameters and distinguishes the classes using deep belief networks. Methods: The task-based functional Magnetic Resonance Images (fMRI) of both high and low functioning autistic groups were acquired from ABIDE database, for 58 low functioning against 43 high functioning individuals while they were involved in a defined language processing task. The language processing regions of the brain, along with Default Mode Network (DMN) have been considered for the analysis. The functional connectivity maps have been plotted through graph theory procedures. Brain connectivity parameters such as Granger Causality (GC) and Phase Slope Index (PSI) have been calculated for the individual groups. These parameters have been fed to Deep Belief Networks (DBN) to classify the subjects under consideration as either LFA or HFA. Results: Results showed increased functional connectivity in high functioning subjects. It was found that the additional interaction of the Primary Auditory Cortex lying in the temporal lobe, with other regions of interest complimented their enhanced connectivity. Results were validated using DBN measuring the classification accuracy of 85.85% for high functioning and 81.71% for the low functioning group. Conclusion: Since it is known that autism involves enhanced, but imbalanced components of intelligence, the reason behind the supremacy of high functioning group in language processing and region responsible for enhanced connectivity has been recognized. Therefore, this work that suggests the effect of Primary Auditory Cortex in characterizing the dominance of language processing in high functioning young adults seems to be highly significant in discriminating different groups in autism spectrum.

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The Primacy of Beauty in Music, Visual Arts and Literature: Not Just a Replication Study in the Greek Language Exploring the Effects of Verbal Fluency, Age and Gender

Psychological Reports ◽

10.1177/00332941211026836 ◽

2021 ◽

pp. 003329412110268

Author(s):

Vaitsa Giannouli ◽

Juliana Yordanova ◽

Vasil Kolev

Keyword(s):

Visual Arts ◽

Verbal Memory ◽

Cognitive Factors ◽

Semantic Field ◽

Older Individuals ◽

Greek Language ◽

Age And Gender ◽

Music And Literature ◽

Young Females ◽

And Gender

Research on aesthetic descriptors of art in different languages is scarce. The aim of the present study was to elucidate the conceptual structure of aesthetic experiences of three forms of art (music, visual arts and literature) in the Greek language, which has not been explored so far. It was further aimed to study if biological and cognitive factors such as age and gender might produce differences in art appreciation. A total of 467 younger and older individuals from Greece were asked to generate verbal descriptors (adjectives) in free word-listing conditions in order to collect terms reflecting the aesthetics-related semantic field of art. The capacity of verbal memory was controlled by using a battery of neuropsychological tests. Analysis of generated adjectives’ frequency and salience revealed that ‘beautiful’ was the most prominent descriptor that was selected with a distinctive primacy for all three forms of arts. The primacy of ‘beautiful’ was significantly more pronounced for visual arts relative to music and literature. Although the aging-related decline of verbal capacity was similar for males and females, the primacy of ‘beautiful’ depended on age and gender by being more emphasized for young females than males, and for old males than females. Analysis of secondary descriptors and pairs of adjectives revealed that affective and hedonic experiences are essentially fixed in the semantic field of art reflection. It is concluded that although the concept of the aesthetics seems to be diversified and rich, a clear primacy of beauty is found for the Greek cultural environment and across different forms of art. The results also highlight the presence of complex influences of biological and cognitive factors on aesthetic art experiences.

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Neuropsychological Test Performance in Framingham: A Descriptive Study

Psychological Reports ◽

10.1177/0033294187060003-201.1 ◽

1987 ◽

Vol 60 (3_part_2) ◽

pp. 1023-1040

Author(s):

Mary E. Farmer ◽

Lon R. White ◽

Steven J. Kittner ◽

Edith Kaplan ◽

Elizabeth Moes ◽

...

Keyword(s):

Test Performance ◽

Neuropsychological Tests ◽

Language Skills ◽

Community Sample ◽

Neuropsychological Test ◽

Descriptive Study ◽

Community Dwelling ◽

Abstract Thinking ◽

Framingham Study ◽

Hearing Impairments

In 1976–1978, a battery of eight neuropsychologic tests was administered to 2,123 participants in the Framingham Study aged 55 to 89 yr. The battery was designed to sample multiple areas of cognitive function including language skills, memory, learning, reproduction of designs, attention, and abstract thinking. Performance is described for several groups in this population: a large community-dwelling sample, those with hearing impairments, and those with documented strokes. Performance is described by age, sex, and education strata for the community sample. This normative information should be useful for interpreting individual test performance on neuropsychological tests.

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The Relation between Inflammation and Neuropsychological Test Performance

International Journal of Alzheimer s Disease ◽

10.1155/2012/703871 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Valerie H. Balldin ◽

James R. Hall ◽

Robert C. Barber ◽

Linda Hynan ◽

Ramon Diaz-Arrastia ◽

...

Keyword(s):

Verbal Memory ◽

Test Performance ◽

Inflammatory Markers ◽

Visual Memory ◽

Longitudinal Research ◽

Neuropsychological Functioning ◽

Neuropsychological Test ◽

Differential Relation ◽

Markers Of Inflammation ◽

Anti Inflammatory

Background. Considerable research documents an association between pro- and anti-inflammatory markers and Alzheimer's disease (AD), yet the differential relation between these markers and neuropsychological functioning in AD and nondemented controls has received less attention. The current study sought to evaluate the relationship between peripheral markers of inflammation (both pro- and anti-inflammatory) and neuropsychological functioning through the Texas Alzheimer's Research and Care Consortium (TARCC) cohort.Methods. There were 320 participants (Probable ADn=124, Controlsn=196) in the TARCC Longitudinal Research Cohort available for analysis. Regression analyses were utilized to examine the relation between proinflammatory and anti-inflammatory markers and neuropsychological functioning. Follow-up analyses were conducted separately by case versus control status.Results. Proinflammatory and anti-inflammatory markers were found to be associated with neuropsychological testing. Third tertile proinflammatory markers were negatively associated with measures of attention and language, and anti-inflammatory markers were positively associated with measures of immediate verbal memory and delayed verbal and visual memory.Conclusions. These findings support the link between peripheral inflammatory markers and neuropsychological functioning and suggest the utility of examining profiles of inflammatory markers in the future.

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Sleep Duration, Sleep Apnea, and Gray Matter Volume

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988720988918 ◽

2021 ◽

pp. 089198872098891

Author(s):

Regina Eun Young Kim ◽

Robert Douglas Abbott ◽

Soriul Kim ◽

Robert Joseph Thomas ◽

Chang-Ho Yun ◽

...

Keyword(s):

Sleep Apnea ◽

Sleep Duration ◽

Gray Matter ◽

Gray Matter Volume ◽

Brain Structures ◽

Brain Regions ◽

Population Based ◽

Older Individuals ◽

Bootstrap Sampling ◽

Matter Volume

This study aimed to evaluate the effect of sleep duration on brain structures in the presence versus absence of sleep apnea in middle-aged and older individuals. The study investigated a population-based sample of 2,560 individuals, aged 49-80 years. The presence of sleep apnea and self-reported sleep duration were examined in relation to gray matter volume (GMV) in total and lobar brain regions. We identified ranges of sleep duration associated with maximal GMV using quadratic regression and bootstrap sampling. A significant quadratic association between sleep duration and GMV was observed in total and lobar brain regions of men with sleep apnea. In the fully adjusted model, optimal sleep durations associated with peak GMV between brain regions ranged from 6.7 to 7.0 hours. Shorter and longer sleep durations were associated with lower GMV in total and 4 sub-regions of the brain in men with sleep apnea.

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Verbal Recall After Mild Traumatic Brain Injury: Sensitivity of the Rapid Screen of Concussion

Brain Impairment ◽

10.1375/brim.4.2.155.27027 ◽

2003 ◽

Vol 4 (2) ◽

pp. 155-167 ◽

Cited By ~ 6

Author(s):

Karleigh Jayne Kwapil ◽

Gina Geffen ◽

Ken McFarland ◽

Veronica Eileen DeMonte

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Verbal Memory ◽

Test Performance ◽

Verbal Learning ◽

Clinical Samples ◽

Classification Rate ◽

Delayed Recall ◽

Learning Test

AbstractThe present study aimed to determine whether including a sensitive test of immediate and delayed recall would improve the diagnostic validity of the Rapid Screen of Concussion (RSC) in mild Traumatic Brain Injury (mTBI) versus orthopaedic clinical samples. Two studies were undertaken. In Study 1, the performance of 156 mTBI and 145 orthopaedic participants was analysed to identify the number of individuals who performed at ceiling on the verbal memory subtest of the RSC, as this test required immediate and delayed recall of only five words. A second aim was to determine the sensitivity and specificity levels of the RSC. Study 2 aimed to examine whether replacement of the verbal memory subtest with the 12-word Hopkins Verbal Learning Test (HVLT) could improve the sensitivity of the RSC in a new sample of 26 mTBI and 30 orthopaedic participants. Both studies showed that orthopaedic participants outperformed mTBI participants on each of the selected measures. Study 1 showed that 14% of mTBI participants performed at ceiling on the immediate and 21.2% on delayed recall test. Performance on the original battery yielded a sensitivity of 82%, specificity of 80% and overall correct classification of 81.5% participants. In Study 2, inclusion of the HVLT improved sensitivity to a level of 88.5%, decreased specificity to a level of 70% and resulted in an overall classification rate of 80%. It was concluded that although inclusion of the five-word subtest in the RSC can successfully distinguish concussed from non-concussed individuals, use of the HVLT in this protocol yields a more sensitive measure of subtle cognitive deficits following mTBI.

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Endogenous subclinical thyroid disorders, physical and cognitive function, depression, and mortality in older individuals

Acta Endocrinologica ◽

10.1530/eje-11-0430 ◽

2011 ◽

Vol 165 (4) ◽

pp. 545-554 ◽

Cited By ~ 95

Author(s):

Renate T de Jongh ◽

Paul Lips ◽

Natasja M van Schoor ◽

Kelly J Rijs ◽

Dorly J H Deeg ◽

...

Keyword(s):

Cognitive Function ◽

Subclinical Hypothyroidism ◽

Population Based ◽

Thyroid Disorders ◽

Older Individuals ◽

Cross Sectional ◽

Thyroid Medication ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Subclinical Thyroid Disorders

ObjectiveTo what extent endogenous subclinical thyroid disorders contribute to impaired physical and cognitive function, depression, and mortality in older individuals remains a matter of debate.DesignA population-based, prospective cohort of the Longitudinal Aging Study Amsterdam.MethodsTSH and, if necessary, thyroxine and triiodothyronine levels were measured in individuals aged 65 years or older. Participants were classified according to clinical categories of thyroid function. Participants with overt thyroid disease or use of thyroid medication were excluded, leaving 1219 participants for analyses. Outcome measures were physical and cognitive function, depressive symptoms (cross-sectional), and mortality (longitudinal)ResultsSixty-four (5.3%) individuals had subclinical hypothyroidism and 34 (2.8%) individuals had subclinical hyperthyroidism. Compared with euthyroidism (n=1121), subclinical hypo-, and hyper-thyroidism were not significantly associated with impairment of physical or cognitive function, or depression. On the contrary, participants with subclinical hypothyroidism did less often report more than one activity limitation (odds ratio 0.44, 95% confidence interval (CI) 0.22–0.86). After a median follow-up of 10.7 years, 601 participants were deceased. Subclinical hypo- and hyper-thyroidism were not associated with increased overall mortality risk (hazard ratio 0.89, 95% CI 0.59–1.35 and 0.69, 95% CI 0.40–1.20 respectively).ConclusionsThis study does not support disadvantageous effects of subclinical thyroid disorders on physical or cognitive function, depression, or mortality in an older population.

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