A-76 Specificity of the Repeatable Battery for the Assessment of Neuropsychological Status Digit Span as a Validity Indicator in Patients with Mild Cognitive Impairment and Dementia

Objective The current study sought to examine the specificity of Digit Span (DS) scaled score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as a performance validity test (PVT) in older adults with Mild Cognitive Impairment (MCI) or dementia. Method Archival data were utilized and included 195 patients (mean age = 72.8; mean education = 13.2) who underwent outpatient neuropsychological evaluations. Cases that had missing data, did not meet criteria for a neurocognitive disorder, or whose performance was deemed invalid were excluded. Participants were classified according to their evaluation diagnosis of MCI (n = 72; mean RBANS total score = 86.8) or dementia. Those diagnosed with dementia were divided by MoCA performance and categorized as mild dementia (n = 90; MoCA≥15; mean RBANS Total Score = 71.0) or moderate dementia (n = 33; MoCA < 15; mean RBANS Total Score = 55.9). Scaled score frequencies were analyzed to calculate specificity for each group. Results An RBANS DS scaled score of ≤4 occurred infrequently in older adults with MCI and mild dementia, resulting in specificity values of 0.93 and 0.90, respectively. In moderate dementia, specificity fell to 0.68 when using a scaled score of ≤4, with a cutoff of ≤2 required to maintain adequate specificity. Conclusions Findings suggest utility of RBANS DS scaled score as a PVT in dementia evaluations provided use of appropriate cutoffs. A more stringent cutoff was required in examinees with moderate dementia relative to patients with MCI and mild dementia. Future research should examine the RBANS DS sensitivity to invalid performance, as well as DS specificity across specific etiologies of MCI and dementia.