Color makes a difference: Two-dimensional object naming in literate and illiterate subjects

Feasibility and Clinical Effectiveness of Computer-Based Cognitive Rehabilitation in Illiterate and Low-Educated Individuals with Mild Cognitive Impairment: Preliminary Data

OBJECTIVE

We investigated the feasibility of the RehaCom cognitive rehabilitation software in illiterate and low-educated individuals with mild cognitive impairment (MCI) and its clinical effectiveness in improving cognitive functions.

METHODS

Twenty illiterate or low-educated individuals with MCI were randomly assigned to an intervention (IG; n = 10) and control group (CG; n = 10). The IG participated in the cognitive enhancement program for 6 weeks, twice a week and a duration of 50-60 min for each session, while the CG did not receive any kind of intervention.

RESULTS

The two groups were demographically matched. The IG successfully completed all sessions of the cognitive enhancement program. A within-subject comparison between baseline and post-intervention assessment of cognitive functions indicated that the IG improved significantly on all administered neuropsychological tests, in contrast to the CG, whose performance remained stable between baseline and final assessment. A between-group comparison found statistically significant differences between the IG and CG groups on the Hindi Mental State Examination, Mini-Mental State Examination, and on delayed memory and recognition tasks, in favor of the IG.

CONCLUSIONS

The findings of the present study support the feasibility of applying computerized cognitive enhancement programs to illiterate and low-educated individuals. Moreover, these programs appear to contribute positively to improving the cognitive functions of this population group. In order to generalize and confirm similar findings in a broader population of illiterate and low-educated individuals, future studies should include larger samples, possibly with longer duration of treatment and control groups that will receive non-targeted interventions as placebo interventions.

Neuropsychological application of the International Test Commission Guidelines for Translation and Adapting of Tests

OBJECTIVE

The number of test translations and adaptations has risen exponentially over the last two decades, and these processes are now becoming a common practice. The International Test Commission (ITC) Guidelines for Translating and Adapting Tests (Second Edition, 2017) offer principles and practices to ensure the quality of translated and adapted tests. However, they are not specific to the cognitive processes examined with clinical neuropsychological measures. The aim of this publication is to provide a specialized set of recommendations for guiding neuropsychological test translation and adaptation procedures.

METHODS

The International Neuropsychological Society's Cultural Neuropsychology Special Interest Group established a working group tasked with extending the ITC guidelines to offer specialized recommendations for translating/adapting neuropsychological tests. The neuropsychological application of the ITC guidelines was formulated by authors representing over ten nations, drawing upon literature concerning neuropsychological test translation, adaptation, and development, as well as their own expertise and consulting colleagues experienced in this field.

RESULTS

A summary of neuropsychological-specific commentary regarding the ITC test translation and adaptation guidelines is presented. Additionally, examples of applying these recommendations across a broad range of criteria are provided to aid test developers in attaining valid and reliable outcomes.

CONCLUSIONS

Establishing specific neuropsychological test translation and adaptation guidelines is critical to ensure that such processes produce reliable and valid psychometric measures. Given the rapid global growth experienced in neuropsychology over the last two decades, the recommendations may assist researchers and practitioners in carrying out such endeavors.

Illiterate Addenbrooke's Cognitive Examination-III in Three Indian Languages: An Adaptation and Validation Study

BACKGROUND

Literacy is an important factor that predicts cognitive performance. Existing cognitive screening tools are validated only in educated populations and are not appropriate for older adults with little or no education leading to poor performance on these tests and eventually leading to misdiagnosis. This challenge for clinicians necessitates a screening tool suitable for illiterate or low-literate older individuals.

OBJECTIVES

The objective was to adapt and validate Addenbrooke's Cognitive Examination-III (ACE-III) for screening general cognitive functions in illiterate and low-literate older populations in the Indian context in three languages.

METHOD

The Indian illiterate ACE-III was systematically adapted by modifying the original items of the Indian literate ACE-III to assess the cognitive functions of illiterates and low-literates with the consensus of an expert panel of professionals working in the area of dementia and related disorders. A total of 180 illiterate or low-literate participants (84 healthy-controls, 50 with dementia, and 46 with mild cognitive impairment [MCI]) were recruited from three different centers speaking Bengali, Hindi, and Kannada to validate the adapted version.

RESULTS

The optimal cut-off score for illiterate ACE-III to distinguish controls from dementia in all 3 languages was 75. The optimal cut-off scores in distinguishing between controls and MCI ranged from 79 to 82, with a sensitivity ranging from 93% to 99% and a specificity ranging from 72% to 99%.

CONCLUSION

The test is found to have good psychometric properties and is a reliable cognitive screening tool for identifying dementia and MCI in older adults with low educational backgrounds in the Indian context.

Gaps in clinical research in frontotemporal dementia: A call for diversity and disparities-focused research

Frontotemporal dementia (FTD) is one of the leading causes of dementia before age 65 and often manifests as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). FTD's exact clinical presentation varies by culture, language, education, social norms, and other socioeconomic factors; current research and clinical practice, however, is mainly based on studies conducted in North America and Western Europe. Changes in diagnostic criteria and procedures as well as new or adapted cognitive tests are likely needed to take into consideration global diversity. This perspective paper by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment examines how increasing global diversity impacts the clinical presentation, screening, assessment, and diagnosis of FTD and its treatment and care. It subsequently provides recommendations to address immediate needs to advance global FTD research and clinical practice.

Neuropsychological assessment in the multicultural memory clinic: Development and feasibility of the TULIPA battery

Neuropsychological assessment of culturally diverse populations is hindered by barriers in language, culture, education, and a lack of suitable tests. Furthermore, individuals from diverse backgrounds are often unfamiliar with being cognitively tested. The aim of this study was to develop a new neuropsychological test battery and study its feasibility in multicultural memory clinics.

Composition of the TULIPA battery (Towards a Universal Language: Intervention and Psychodiagnostic Assessment) entailed a literature review and consultation with experts and individuals from diverse backgrounds. Feasibility was investigated by examining administration and completion rates and the frequency of factors complicating neuropsychological assessment in 345 patients from 37 countries visiting four multicultural memory clinics in the Netherlands.

The test battery included existing tests such as the Cross-Cultural Dementia screening (CCD), Rowland Universal Dementia Assessment Scale (RUDAS), tests from the European Cross-Cultural Neuropsychological Test Battery, and newly developed tests. Completion rates for the test battery were generally high (82%-100%), except for CCD Dots subtest B (58%). Although tests of the "core" TULIPA battery were administered often (median: 6 of 7, IQR: 5-7), supplementary tests were administered less frequently (median: 1 of 9; IQR: 0-3). The number of administered tests correlated with disease severity (RUDAS, ρ=.33, adjusted p < .001), but not with other patient characteristics. Complicating factors were observed frequently, e.g. suboptimal effort (29%-50%), fatigue (29%), depression (37%-57%).

The TULIPA test battery is a promising new battery to assess culturally diverse populations in a feasible way, provided that complicating factors are taken into account.

Supplemental data for this article is available online at https://doi.org/10.1080/13854046.2022.2043447 .

The Naming Assessment in Multicultural Europe (NAME): Development and Validation in a Multicultural Memory Clinic

OBJECTIVE

Traditional naming tests are unsuitable to assess naming impairment in diverse populations, given the influence of culture, language, and education on naming performance. Our goal was therefore to develop and validate a new test to assess naming impairment in diverse populations: the Naming Assessment in Multicultural Europe (NAME).

METHOD

We carried out a multistage pilot study. First, we generated a list of 149 potentially suitable items - e.g. from published cross-linguistic word lists and other naming tests - and selected those with a homogeneous age of acquisition and word frequency across languages. We selected three to four colored photographs for each of the 73 remaining items; 194 controls selected the most suitable photographs. Thirteen items were removed after a pilot study in 15 diverse healthy controls. The final 60-item test was validated in 39 controls and 137 diverse memory clinic patients with subjective cognitive impairment, neurological/neurodegenerative disease or psychiatric disorders in the Netherlands and Turkey (mean age: 67, SD: 11). Patients were from 15 different countries; the majority completed primary education or less (53%).

RESULTS

The NAME showed excellent reliability (Spearman-Brown coefficient: 0.95; Kuder-Richardson coefficient: 0.94) and robust correlations with other language tests (ρ = .35-.73). Patients with AD/mixed dementia obtained lower scores on most (48/60) NAME items, with an area under the curve of 0.88. NAME scores were correlated with age and education, but not with acculturation or sex.

CONCLUSIONS

The NAME is a promising tool to assess naming impairment in culturally, educationally, and linguistically diverse individuals.

Illiteracy, Neuropsychological Assessment, and Cognitive Rehabilitation: A Narrative Review

OBJECT

Νeuropsychological assessment is particularly important for the accurate discrimination of cognitive abilities and weaknesses of patients in order to determine the appropriate therapeutic intervention. However, the reliability and validity of neuropsychological assessment appears to be influenced by a wide range of factors, including literacy and educational level.

AIM

This systematic review evaluates neuropsychological tests appropriate for the valid assessment of illiterate individuals and the effectiveness of cognitive rehabilitation programs for illiterate and/or low-educated individuals according to the results of English language studies that have been published in the PubMed/Medline electronic database until August 2022 (no initiation date).

RESULTS

49 studies were included for neuropsychological assessment and 4 studies for cognitive rehabilitation. In terms of investigating the validity and reliability of neuropsychological tests for the assessment of healthy illiterate individuals, most studies concluded that for the majority of neuropsychological tests there is a significant difference in performance between healthy illiterate and literate individuals. However, there was consensus among studies that the performance of illiterate subjects was equivalent to the performance of literate subjects on tasks depicting colored and real objects. Regarding cognitive rehabilitation programs, all four studies concluded that they are effective in improving the cognitive functions of illiterate and/or low-literate patients with mild cognitive impairment and/or mild dementia.

CONCLUSIONS

For the assessment of illiterate individuals, it is imperative that neuropsychological tests with high ecological validity (i.e., tests related to activities of daily living) be administered so as not to underestimate their cognitive functioning. At the same time, cognitive enhancement/stimulation programs seem to be effective in this population group; however, this area needs further investigation.

The Multilingual Picture Database

The growing interdisciplinary research field of psycholinguistics is in constant need of new and up-to-date tools which will allow researchers to answer complex questions, but also expand on languages other than English, which dominates the field. One type of such tools are picture datasets which provide naming norms for everyday objects. However, existing databases tend to be small in terms of the number of items they include, and have also been normed in a limited number of languages, despite the recent boom in multilingualism research. In this paper we present the Multilingual Picture (Multipic) database, containing naming norms and familiarity scores for 500 coloured pictures, in thirty-two languages or language varieties from around the world. The data was validated with standard methods that have been used for existing picture datasets. This is the first dataset to provide naming norms, and translation equivalents, for such a variety of languages; as such, it will be of particular value to psycholinguists and other interested researchers. The dataset has been made freely available.

Naming in Older Adults: Complementary Auditory and Visual Assessment

OBJECTIVES

Naming difficulty is a common symptom of multiple age-related neurodegenerative disorders. As naming difficulty increases with age, valid, up-to-date naming assessment tools are crucial for differentiating between neurotypical changes in healthy aging and pathological naming difficulty. We aimed to develop and provide normative data for complementary auditory description naming and visual naming tests for older adults. Furthermore, these measures would include not only untimed accuracy, typically the sole naming performance measure, but also additional scores that incorporate features characteristic of actual word finding difficulty.

METHODS

A normative sample of 407 healthy older adults, aged 56-100 years, were administered the Auditory Naming Test (ANT) and Visual Naming Test (VNT), and other standardized measures.

RESULTS

Item analyses resulted in 36 stimuli for both tests. Age-stratified, education-based normative data are provided for accuracy, response time, tip-of-the-tongue (i.e., delayed, yet accurate responses plus correct responses following phonemic cueing), and multiple Summary Scores. Internal and test-retest reliability coefficients were reasonable (.59-.84). Untimed accuracy scores were high across age groups, seemingly reflecting stability of naming into late adulthood; however, time- and cue-based scores revealed reduced efficiency in word retrieval with increasing age.

CONCLUSIONS

These complementary auditory and visual naming test for older adults improve upon the current standard by providing more sensitive performance measures and the addition of an auditory-verbal component for assessing naming. Detection of subtle naming changes in healthy aging holds promise for capturing symptomatic naming changes during the early stages of neurocognitive disorders involving expressive language, potentially assisting in earlier diagnoses and more timely treatment.

The noun-verb distinction

The comparison between nouns and verbs has been a topic of interest for many researchers over the last 50 years. This comparison, and subsequent behavioral and (partly) anatomic dissociation, has allowed researchers to delve into many topics including the behavioral architecture of the language system and its neural correlates, the underlying nature of the linguistic impairment in individuals with different neurologic disorders, the assessment of language treatment protocols, and the proposal of new protocols aimed to protect the language system of individuals undergoing surgery for brain tumors and epilepsy. Specific to the left temporal lobe, classic accounts have shown its relevance for the processing of nouns and less for the processing of verbs. Nonetheless, more recent accounts indicate that different areas in the left temporal lobe can subserve different functions for the processing of both nouns and verbs. In this chapter, we outlined an overview of key findings of the study of nouns and verbs, with a particular focus on the left temporal lobe. This chapter contextualizes the literature on category-specific impairments and neural correlates of nouns and verbs with linguistic and psycholinguistic theories, and provides new ways to investigate and understand the intricacies of this comparison.

Cognitive Assessment in Culturally, Linguistically, and Educationally Diverse Older Populations in Europe

Due to increasing cultural, linguistic, and educational diversity in older populations across Europe, accurate assessment of cognitive functioning in people from diverse backgrounds becomes increasingly important. This paper aims to provide a state-of-the-art review of cognitive assessment in culturally, linguistically, and educationally diverse older populations in Europe, focusing on challenges and recent advances in cross-cultural assessment. Significant work has been carried out on the identification of challenges in cognitive assessment in culturally, linguistically, and educationally diverse older populations and on development and validation of cross-cultural cognitive tests. Most research has addressed the influences of language barriers, education and literacy, and culture and acculturation and in particular, the European Cross-Cultural Neuropsychological Test Battery (CNTB) and the Rowland Universal Dementia Assessment Scale (RUDAS) are well-validated across European countries. However, cross-cultural cognitive assessment is largely still a developing field in Europe, and there is a continuing need for developments within the field.

Aphasia assessment: impact of material on naming performance

BACKGROUND

Naming and lexical retrieval difficulties are common symptoms of aphasia. Naming abilities are usually evaluated by means of real objects or pictures or line drawings that are printed.

OBJECTIVE

The aim of this study was to investigate whether the ability to name objects among individuals with aphasia is influenced by the dimensions of the visual stimuli and to understand whether the order of presentation of the stimuli, number of years of education and length of time post-onset are involved in the success of naming.

METHODS

The naming abilities of healthy controls and patients with acute or chronic aphasia due to stroke were assessed through presentation of two sets of 24 stimuli consisting of real objects and color photographs of the same objects presented on a screen. The results obtained under these two conditions were compared by means of within-subject paired ANOVA, controlling for presentation order.

RESULTS

40 patients (62.4 ± 17.3 years old; 70% females; mean education level of 8.5 ± 5.3 years; and 60% evaluated within the first eight days after stroke) and 50 controls that were age, gender and education-matched were included. Object naming was significantly better than naming color photographs among the patients (p = 0.001), but no differences were observed among the controls. Age, education, length of time post-onset and presentation sequence did not have any impact on naming performance.

CONCLUSION

These results suggest that use of digital color photographs for naming objects in assessment of aphasia may be associated with lower naming performance, compared with use of real objects. This needs to be taken into account when different forms of stimuli are presented in sequential aphasia evaluations.

Cross-cultural neuropsychological assessment in the European Union: a Delphi expert study

OBJECTIVE

The increasing ethnic diversity in the European Union (EU) calls for adaptations to neuropsychological assessment practices. The aims of this study were to examine the current state of cross-cultural neuropsychological assessment in EU-15 countries and to provide recommendations for researchers and policy makers.

METHOD

Twelve experts from nine EU-15 countries participated in a Delphi consensus study involving two sequential rounds of web-based questionnaires and an in-person consensus meeting. The experts individually rated Delphi topics on the basis of importance (scale 1-10). The degree of consensus was determined by assessing first and third quartiles (Q1 and Q3) and medians.

RESULTS

Consensus outcomes showed the following priorities: (a) the development of tests (median importance rating 10, Q1-Q3: 9-10), (b) the collection of normative data (median importance rating 9, Q1-Q3: 8-10), and (c) more training, awareness, and knowledge regarding cross-cultural assessment among neuropsychologists in the EU (median importance rating 9, Q1-Q3: 8-10). Whereas memory tests were often available, tests measuring social cognition (median 9, Q1-Q3: 8-10) and language (median 9, Q1-Q3: 7-10) are particularly lacking. Recommendations were made regarding essential skills and knowledge necessary for cross-cultural neuropsychological assessment.

CONCLUSIONS

This study in a small group of experts suggests that the development and availability of cross-cultural tests and normative data should be prioritized, as well as the development and implementation of training initiatives. Furthermore, EU guidelines could be established for working with interpreters during neuropsychological assessment. Before implementing these recommendations, follow-up studies are recommended that include more minority neuropsychologists and community stakeholders.

Diagnostic Accuracy of Usual Cognitive Screening Tests Versus Appropriate Tests for Lower Education to Identify Alzheimer Disease

INTRODUCTION

The accuracy of commonly used screening tests for Alzheimer's disease (AD) has not been directly compared to those that could be more appropriate for lower schooling.

OBJECTIVE

To compare the diagnostic accuracy of usual screening tests for AD with instruments that might be more appropriate for lower schooling among older adults with low or no literacy.

METHODS

The study included a clinical sample of 117 elderly outpatients from a Geriatric Clinic classified as literate controls (n = 39), illiterate controls (n = 30), literate AD (n = 30) and illiterate AD (n = 18). The tests were compared as follows: Black and White versus Colored Figure Memory Test; Clock Drawing Test versus Clock Reading Test; Verbal Fluency (VF) animal versus grocery category; CERAD Constructional Praxis versus Stick Design Test.

RESULTS

The means of literate and illiterate controls did not differ in the Black and White Figure Memory Test (immediate recall), Colored Figure Memory Test (delayed recall), Clock Reading Test and VF animals and grocery categories. The means of the clinical groups (controls versus AD), in the 2 schooling levels, differed significantly in most of the tests, except for the CERAD Constructive Praxis and the Stick Design Test. Diagnostic accuracy was not significantly different between the compared tests.

CONCLUSION

Commonly used screening tests for AD were as accurate as those expected to overcome the education bias in a sample of older adults with lower or no education.

IMABASE: A new set of 313 colourised line drawings standardised in French for name agreement, image agreement, conceptual familiarity, age-of-acquisition, and imageability

We provide normative data for a new set of 313 colourised line drawings. The drawings were standardised on name agreement (N = 60 participants), image agreement (N = 34), conceptual familiarity (N = 36), age of acquisition (N = 35), and imageability (N = 35). Objective visual complexity measures are given for the pictures, and objective word frequencies are provided for the modal names of the drawings. Reliability measures for the collected norms are very high. There are high levels of agreement between the names given by the participants and the drawings and comparative analyses indicate that the distribution of name agreement scores is very similar in both our own database and the MultiPic database (Duñabeitia et al., 2018). A novel "picture-choice task" used to assess name-image agreement (N = 30) reveals that the great majority of the IMABASE pictures that are also present in MultiPic are rated as providing better pictorial representations of the corresponding concepts. Finally, most of the correlations are comparable with those reported in other normative studies on colourised drawings. The whole set of pictures is freely available from https://leadserv.u-bourgogne.fr/~lead/imabase/ and the norms are available as Supplementary Material.

A Systematic Review of Neuropsychological Tests for the Assessment of Dementia in Non-Western, Low-Educated or Illiterate Populations

OBJECTIVE

Neuropsychological tests are important instruments to determine a cognitive profile, giving insight into the etiology of dementia; however, these tests cannot readily be used in culturally diverse, low-educated populations, due to their dependence upon (Western) culture, education, and literacy. In this review we aim to give an overview of studies investigating domain-specific cognitive tests used to assess dementia in non-Western, low-educated populations. The second aim was to examine the quality of these studies and of the adaptations for culturally, linguistically, and educationally diverse populations.

METHOD

A systematic review was performed using six databases, without restrictions on the year or language of publication.

RESULTS

Forty-four studies were included, stemming mainly from Brazil, Hong Kong, Korea, and considering Hispanics/Latinos residing in the USA. Most studies focused on Alzheimer's disease (n = 17) or unspecified dementia (n = 16). Memory (n = 18) was studied most often, using 14 different tests. The traditional Western tests in the domains of attention (n = 8) and construction (n = 15), were unsuitable for low-educated patients. There was little variety in instruments measuring executive functioning (two tests, n = 13), and language (n = 12, of which 10 were naming tests). Many studies did not report a thorough adaptation procedure (n = 39) or blinding procedures (n = 29).

CONCLUSIONS

Various formats of memory tests seem suitable for low-educated, non-Western populations. Promising tasks in other cognitive domains are the Stick Design Test, Five Digit Test, and verbal fluency test. Further research is needed regarding cross-cultural instruments measuring executive functioning and language in low-educated people.

Standardising Dementia Diagnosis Across Linguistic and Educational Diversity: Study Design of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB)

OBJECTIVES

While the burden of dementia is increasing in low- and middle-income countries, there is a low rate of diagnosis and paucity of research in these regions. A major challenge to study dementia is the limited availability of standardised diagnostic tools for use in populations with linguistic and educational diversity. The objectives of the study were to develop a standardised and comprehensive neurocognitive test battery to diagnose dementia and mild cognitive impairment (MCI) due to varied etiologies, across different languages and educational levels in India, to facilitate research efforts in diverse settings.

METHODS

A multidisciplinary expert group formed by Indian Council of Medical Research (ICMR) collaborated towards adapting and validating a neurocognitive test battery, that is, the ICMR Neurocognitive Tool Box (ICMR-NCTB) in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam), for illiterates and literates, to standardise diagnosis of dementia and MCI in India.

RESULTS

Following a review of existing international and national efforts at standardising dementia diagnosis, the ICMR-NCTB was developed and adapted to the Indian setting of sociolinguistic diversity. The battery consisted of tests of cognition, behaviour, and functional activities. A uniform protocol for diagnosis of normal cognition, MCI, and dementia due to neurodegenerative diseases and stroke was followed in six centres. A systematic plan for validating the ICMR-NCTB and establishing cut-off values in a diverse multicentric cohort was developed.

CONCLUSIONS

A key outcome was the development of a comprehensive diagnostic tool for diagnosis of dementia and MCI due to varied etiologies, in the diverse socio-demographic setting of India.

Assessment of Visual Association Memory in Low-Educated, Non-Western Immigrants with the Modified Visual Association Test

BACKGROUND

Neuropsychological tests are influenced by culture, language, level of education, and literacy, but there are few cognitive tests of which the applicability in ethnic minority populations has been studied.

OBJECTIVES

The aim of this study was to assess the reliability and validity of the Visual Association Test (VAT), a test of visual association memory, in a non-Western, low-educated memory clinic population. Additionally, a modified version of the VAT using colored photographs instead of line drawings was studied (mVAT).

METHOD

Both the original VAT and the mVAT were administered to non-Western immigrants (n = 73) from 2 multicultural memory clinics in Rotterdam, The Netherlands, and a control sample of non-demented Turkish elderly (n = 14) with low education levels (32 and 29% illiterate, respectively).

RESULTS

Both the VAT and the mVAT were able to discriminate persons with and without dementia (area under the curve: VAT, 0.77-0.88; mVAT, 0.85-0.95). The mVAT had more homogeneous item difficulty levels than the VAT. Administration of parallel versions of the VAT and the mVAT within the same person revealed higher scores on the mVAT (Z = -3.35, p = 0.001).

CONCLUSIONS

The mVAT is a reliable and valid measure of memory in non-Western immigrants. Clinicians and researchers should be aware that the memory performance of immigrants may be systematically underestimated when using tests with black-and-white line drawings, such as the original VAT.

Educational status influences cognitive-motor learning in older adults: going to university provides greater protection against aging than going to high school

OBJECTIVE

To investigate if middle-aged and older adults with a higher education would differ from those with an average education in cognitive-motor tasks involving lower limb function.

METHODS

A walking version of the Trail Making Test (Walking Executive Function Task, [WEFT]) was used. Eighty volunteers (40: 50-65 years; 40: 66-80 years) were subdivided into average (6-11years of education) and higher education (12-17 years). They received two training sessions (session 1: eight repetitions, session 2: four repetitions), with a one week-interval between them. The Timed Up and Go (TUG) test was performed before and after the training.

RESULTS

Volunteers with an average education showed longer times on the WEFT than those with a higher education. Older adults showed lower retention than middle-aged adults (p < 0.001). The TUG was faster after the WEFT training (p < 0.001).

CONCLUSION

The impact of education was observed when locomotion was associated with cognitive tasks. Average education resulted in poorer performance and learning than higher education, mainly in older adults. Gait speed increased after training.

Effects of age and type of picture on visuospatial working memory assessed with a computerized jigsaw-puzzle task

We investigated the effect of age and color in a computerized version of the jigsaw-puzzle task. In Experiment 1, young and older adults were presented with puzzles in color and black-and-white line drawings, varying in difficulty from 4 to 9 pieces. Older adults performed the task better with the black-and-white stimuli and younger adults performed better with the color ones. In Experiment 2, new older and young adults identified the same fragmented pictures as fast and accurately as possible. The older group identified the black-and-white stimuli faster than those presented in color, while the younger adults identified both similarly. In Experiment 3A, new older and young groups performed the puzzle task with the same color pictures and their monochrome versions. In Experiment 3B, participants performed a speeded identification task with the two sets. The findings of these experiments showed that older adults have a memory not a perceptual difficulty.

Boston Naming Test (BNT) original, Brazilian adapted version and short forms: normative data for illiterate and low-educated older adults

BACKGROUND

The aims of this study were (1) to describe and compare the performance of illiterate and low-educated older adults, without evidence of cognitive impairment, on different versions of the Boston Naming Test (BNT) original, Brazilian adapted, abbreviated 30-item (even and odd) and 15-item from the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) battery; (2) to compare performance on the original versus adapted versions of the BNT.

METHODS

A total of 180 healthy older adults (60 years or older) were stratified according to educational level (0, 1-2, and 3-4 years), and age (60-69, 70-79, and ≥ 80 years). The protocol comprised the following instruments: Mini-Mental State Examination (MMSE), Brief Cognitive Screening Battery (BCSB), Functional Activities Questionnaire (FAQ), Geriatric Depression Scale (GDS), and the BNT.

RESULTS

The illiterate participants had poorer performance than the educated participants. The performance of the two educated groups was similar on all versions of the BNT. A higher number of correct responses were observed on the adapted BNT than on the original BNT in all three education groups.

CONCLUSIONS

The adapted BNT appears to be the most suitable for use in the low-educated Brazilian population. The present study provided normative data for low-educated elderly on several different versions of the BNT, which may be helpful in diagnosing naming deficits among elderly in these strata of the population.

Normative data for the Brief Cognitive Screening Battery stratified by age and education

Introduction

Diagnosing neurocognitive disorders is challenging in low-educated individuals.

Objective

To report normative data for the Brief Cognitive Screening Battery (BCSB) and to assess the association of age and education with performance on the BCSB in 240 community-dwelling elderly from Ermelino Matarazzo, São Paulo city.

Methods

The inclusion criteria were scoring above the education-adjusted cut-off points on the Mini-Mental State Examination (MMSE) and below six points on the Geriatric Depression Scale (GDS).

Results

Age was associated with performance on the Naming, Incidental Memory, Verbal Fluency, Clock Drawing Test, Delayed Recall and Recognition subtests. Education was associated with performance on Naming, Recognition, Verbal Fluency and the Clock Drawing Test.

Conclusion

The normative values reported are relevant for diagnosing neurocognitive disorders in low-educated elderly.

Word and object recognition during reading acquisition: MEG evidence

Studies on adults suggest that reading-induced brain changes might not be limited to linguistic processes. It is still unclear whether these results can be generalized to reading development. The present study shows to which extent neural responses to verbal and nonverbal stimuli are reorganized while children learn to read. MEG data of thirty Basque children (4-8y) were collected while they were presented with written words, spoken words and visual objects. The evoked fields elicited by the experimental stimuli were compared to their scrambled counterparts. Visual words elicited left posterior (200-300ms) and temporal activations (400-800ms). The size of these effects increased as reading performance improved, suggesting a reorganization of children's visual word responses. Spoken words elicited greater left temporal responses relative to scrambles (300-700ms). No evidence for the influence of reading expertise was observed. Brain responses to objects were greater than to scrambles in bilateral posterior regions (200-500ms). There was a greater left hemisphere involvement as reading errors decreased, suggesting a strengthened verbal decoding of visual configurations with reading acquisition. The present results reveal that learning to read not only influences written word processing, but also affects visual object recognition, suggesting a non-language specific impact of reading on children's neural mechanisms.

The illiterate brain and the neuropsychological assessment: From the past knowledge to the future new instruments

The lifetime learning of illiterate and low-educated individuals shapes their cognitive skills, which are challenging to grade by the current available neuropsychological tools. Eight hundred million of the global population are illiterate. It is very challenging to interpret the cognitive performance of this population by the available formal neuropsychological tests, mainly developed for higher educated people. From extensive literature investigation, we reviewed the cognitive process and performance of illiterate and low-educated population on various cognitive domains including language, executive function, memory, visual-related function, and motor skills. We also suggested the concept in the development of the appropriate tools for the cognitive assessment among this population. Finally, we provide the available cognitive screening tools validated in the illiterate and low-educated subjects within the last three decades.

A Review about Functional Illiteracy: Definition, Cognitive, Linguistic, and Numerical Aspects

Formally, availability of education for children has increased around the world over the last decades. However, despite having a successful formal education career, adults can become functional illiterates. Functional illiteracy means that a person cannot use reading, writing, and calculation skills for his/her own and the community's development. Functional illiteracy has considerable negative effects not only on personal development, but also in economic and social terms. Although functional illiteracy has been highly publicized in mass media in the recent years, there is limited scientific knowledge about the people termed functional illiterates; definition, assessment, and differential diagnoses with respect to related numerical and linguistic impairments are rarely studied and controversial. The first goal of our review is to give a comprehensive overview of the research on functional illiteracy by describing gaps in knowledge within the field and to outline and address the basic questions concerning who can be considered as functional illiterates: (1) Do they possess basic skills? (2) In which abilities do they have the largest deficits? (3) Are numerical and linguistic deficits related? (4) What is the fundamental reason for their difficulties? (5) Are there main differences between functional illiterates, illiterates, and dyslexics? We will see that despite partial evidence, there is still much research needed to answer these questions. Secondly, we emphasize the timeliness for a new and more precise definition that results in uniform sampling, better diagnosis, conclusion, and intervention. We propose the following working definition as the result of the review: functional illiteracy is the incapability to understand complex texts despite adequate schooling, age, language skills, elementary reading skills, and IQ. These inabilities must also not be fully explained by sensory, domain-general cognitive, neurological or mental disorders. In sum, we suggest that functional illiteracy must be more thoroughly understood and assessed from a theoretical, empirical, and diagnostic perspective.

The influence of age, gender and education on the performance of healthy individuals on a battery for assessing limb apraxia

Introduction:

Apraxia is defined as a disorder of learned skilled movements, in the absence of elementary motor or sensory deficits and general cognitive impairment, such as inattention to commands, object-recognition deficits or poor oral comprehension. Limb apraxia has long been a challenge for clinical assessment and understanding and covers a wide spectrum of disorders, all involving motor cognition and the inability to perform previously learned actions. Demographic variables such as gender, age, and education can influence the performance of individuals on different neuropsychological tests.

Objective:

The present study aimed to evaluate the performance of healthy subjects on a limb apraxia battery and to determine the influence of gender, age, and education on the praxis skills assessed.

Methods:

Forty-four subjects underwent a limb apraxia battery, which was composed of numerous subtests for assessing both the semantic aspects of gestural production as well as motor performance itself. The tasks encompassed lexical-semantic aspects related to gestural production and motor activity in response to verbal commands and imitation.

Results:

We observed no gender effects on any of the subtests. Only the subtest involving visual recognition of transitive gestures showed a correlation between performance and age. However, we observed that education level influenced subject performance for all sub tests involving motor actions, and for most of these, moderate correlations were observed between education level and performance of the praxis tasks.

Conclusion:

We conclude that the education level of participants can have an important influence on the outcome of limb apraxia tests.

Literacy Independent Cognitive Assessment: Assessing Mild Cognitive Impairment in Older Adults with Low Literacy Skills

OBJECTIVE

Comprehensive neuropsychological tests are important in the diagnosis and follow-up of patients with MCI; however, most were developed without consideration of illiteracy. We developed the Literacy Independent Cognitive Assessment (LICA) as a comprehensive neuropsychological assessment battery applicable to older adults who are either literate or illiterate. This study aimed to assess the reliability and validity of the LICA for diagnosis of MCI.

METHODS

Normal controls (n=634) and patients with MCI (n=128) were recruited from 13 centers were included in this study. Participants were divided into illiterate or literate groups, based on their performance on a brief reading and writing test. The LICA, Korean Mini-Mental State Examination (K-MMSE), and Seoul Neuropsychological Screening Battery (SNSB) were administered.

RESULTS

Total LICA scores distinguished MCI patients from controls (p<0.001). They were closely and positively correlated to the K-MMSE scores (r=0.632, p<0.001) but negatively correlated to clinical dementia rating (CDR) (r=-0.358, p<0.001) and CDR sum of boxes (r=-0.339, p<0.001). Area under the receiver operating characteristic curve for patients with MCI by total LICA score was 0.827 (0.783-0.870), superior to that presented by the K-MMSE. For the classification of MCI subtypes, inter-method reliability of LICA with the SNSB was good (κ 0.773; 0.679-0.867, p<0.001).

CONCLUSION

The results of this study show that the LICA may be reliably used to distinguish MCI patients from cognitively intact adults, to identify MCI subtypes and monitor progression toward dementia, regardless of illiteracy.

Association between Educational Status and Dual-Task Performance in Young Adults

The influence of educational status on perceptual-motor performance has not been investigated. The single- and dual-task performances of 15 Low educated adults (9 men, 6 women; M age = 24.1 yr.; 6–9 yr. of education) and 15 Higher educated adults (8 men, 7 women; M age = 24.7 yr.; 10–13 yr. of education) were compared. The perceptual task consisted of verbally classifying two figures (equal or different). The motor task consisted of alternating steps from the floor to a stool. Tasks were assessed individually and simultaneously. Two analyses of variance (2 groups × 4 blocks) compared the errors and steps. The Low education group committed more errors and had less improvement on the perceptual task than the High education group. During and after the perceptual-motor task performance, errors increased only in the Low education group. Education correlated to perceptual and motor performance. The Low education group showed more errors and less step alternations on the perceptual-motor task compared to the High education group. This difference on the number of errors was also observed after the dual-task, when the perceptual task was performed alone.

Effect of age, education, and bilingualism on confrontation naming in older illiterate and low-educated populations

We investigated the effects of age as well as the linked factors of education and bilingualism on confrontation naming in rural Kashmir by creating a culturally appropriate naming test with pictures of 60 objects. We recruited 48 cognitively normal participants whose ages ranged from 18 to 28 and from 60 to 85. Participants in our study were illiterate monolinguals (N = 18) and educated Kashmiri-Urdu bilinguals (N = 30). Hierarchical multiple regression revealed that younger adults performed better than older adults (P < 0.01) and the age effect was quadratic (age(2)). It also showed Age X Education and Age X L2 Speaking interactions predicted naming performance. The Age X Education interaction indicated that the advantages of greater education increased with advancing age. Since education is in the second language (L2) in our population, this finding is no doubt linked to the Age X L2 Speaking interaction. This suggests that L2 speaking proficiency contributed more to first language (L1) naming with advancing age.

Effect of literacy level on cognitive and language tests in Korean illiterate older adults

AIM

Illiterate individuals represent a significant proportion of the world's population. Acquisition of reading and writing skills influences the functional status of the brain, and consequently alters the performance on cognitive and language tests. Thus, it is important to identify the degree of the impact of levels of both illiteracy and education as potential confounders on test performance in people with neurological communication disorders.

METHODS

A total of 203 community-dwelling older adults aged 65 years and older were recruited for the present study. Participants were classified into four groups based on the literacy level; pure illiterate (n=29), semi-illiterate (n=67), literate (n=75) and high-level literate (n=32). The participants completed the Mini-Mental State Examination, Boston Naming Test, Controlled Oral Word Association Test (animal), verb naming, and sentence comprehension tests.

RESULTS

The pure illiterate group showed the lowest performance on all five tests. Regression analysis showed that literacy level was the variable that best predicted the performance on cognitive and language tests.

CONCLUSIONS

These findings suggest that literacy in performance on cognitive and language tests is an important factor in neuropsychological evaluations for older adults.

Influence of educational status on executive function and functional balance in individuals with Parkinson disease

OBJECTIVE

This study investigated whether educational status influenced how people with Parkinson disease (PD) performed on Parts A, B, and DELTA of the Trail Making Test (TMT) and on the Berg Balance Scale (BBS).

BACKGROUND

Recent studies have shown that educational status may influence cognitive and motor test performance.

METHODS

We gave the TMT and the BBS to assess executive function and functional balance in 28 people with PD (Hoehn and Yahr score between 2 and 3) and 30 healthy elderly people. Participants reported their number of years of formal education. We divided each group of participants by educational status: low (4 to 10 years of education) or high (≥11 years).

RESULTS

In both the PD (P=0.018) and control (P=0.003) groups, participants with low educational status performed worse on the TMT Part B than did those with high educational status. Within the PD group, the less-educated participants scored worse on the BBS than did the more educated (P<0.001); this difference was not significant between the more- and less-educated controls (P=0.976).

CONCLUSIONS

Whether or not they had PD, less-educated people performed worse than more-educated people on the TMT Part B. Educational status affected executive function, but PD status did not. Among individuals with PD, educational status influenced functional balance.

Differentiating illiteracy from Alzheimer's disease by using neuropsychological assessments

BACKGROUND

In Asia, where illiteracy rates are high, determining the degree to which neuropsychological measures can be used to identify cognitive impairment in illiterate elders is important. The aim of this study was to evaluate the effectiveness of using formal neuropsychological assessments to distinguish healthy illiterate elders from dementia patients.

METHODS

We compared the cognitive performance of healthy elders who were illiterate (illiterate NC, n = 25) with those who were literate (literate NC, n = 25), literate patients with mild Alzheimer's disease (literate AD, n = 25), and illiterate patients with mild AD (illiterate AD, n = 25). Neuropsychological measures included the Mini-Mental State Examination (MMSE), the verbal fluency test, the Boston naming test, the Rosen drawing test, and the verbal learning test.

RESULTS

In the between-group analyses, the scores on all tests, except verbal fluency and recognition memory, were lower for illiterate NC compared to the literate NC. The scores on the MMSE, Boston naming test, Rosen drawing test, and immediate free recall could not distinguish the illiterate NC from literate AD. However, the scores on all tests, except the Rosen drawing test, could distinguish illiterate NC from illiterate AD. ROC analyses showed the same pattern of results. In addition, age-, sex-, and education-matched cut-off scores of all tests, except immediate recall and delayed recall trials of the verbal learning test, showed good specificities in participants who were illiterate compared to those in participants who were literate.

CONCLUSION

These findings suggest that the impact of literacy on neuropsychological test performance is an important aspect of cognitive evaluations for elders who are illiterate.

Language-mediated visual orienting behavior in low and high literates

The influence of formal literacy on spoken language-mediated visual orienting was investigated by using a simple look and listen task which resembles every day behavior. In Experiment 1, high and low literates listened to spoken sentences containing a target word (e.g., "magar," crocodile) while at the same time looking at a visual display of four objects (a phonological competitor of the target word, e.g., "matar," peas; a semantic competitor, e.g., "kachuwa," turtle, and two unrelated distractors). In Experiment 2 the semantic competitor was replaced with another unrelated distractor. Both groups of participants shifted their eye gaze to the semantic competitors (Experiment 1). In both experiments high literates shifted their eye gaze toward phonological competitors as soon as phonological information became available and moved their eyes away as soon as the acoustic information mismatched. Low literates in contrast only used phonological information when semantic matches between spoken word and visual referent were not present (Experiment 2) but in contrast to high literates these phonologically mediated shifts in eye gaze were not closely time-locked to the speech input. These data provide further evidence that in high literates language-mediated shifts in overt attention are co-determined by the type of information in the visual environment, the timing of cascaded processing in the word- and object-recognition systems, and the temporal unfolding of the spoken language. Our findings indicate that low literates exhibit a similar cognitive behavior but instead of participating in a tug-of-war among multiple types of cognitive representations, word-object mapping is achieved primarily at the semantic level. If forced, for instance by a situation in which semantic matches are not present (Experiment 2), low literates may on occasion have to rely on phonological information but do so in a much less proficient manner than their highly literate counterparts.

The role of color information on object recognition: a review and meta-analysis

In this study, we systematically review the scientific literature on the effect of color on object recognition. Thirty-five independent experiments, comprising 1535 participants, were included in a meta-analysis. We found a moderate effect of color on object recognition (d=0.28). Specific effects of moderator variables were analyzed and we found that color diagnosticity is the factor with the greatest moderator effect on the influence of color in object recognition; studies using color diagnostic objects showed a significant color effect (d=0.43), whereas a marginal color effect was found in studies that used non-color diagnostic objects (d=0.18). The present study did not permit the drawing of specific conclusions about the moderator effect of the object recognition task; while the meta-analytic review showed that color information improves object recognition mainly in studies using naming tasks (d=0.36), the literature review revealed a large body of evidence showing positive effects of color information on object recognition in studies using a large variety of visual recognition tasks. We also found that color is important for the ability to recognize artifacts and natural objects, to recognize objects presented as types (line-drawings) or as tokens (photographs), and to recognize objects that are presented without surface details, such as texture or shadow. Taken together, the results of the meta-analysis strongly support the contention that color plays a role in object recognition. This suggests that the role of color should be taken into account in models of visual object recognition.

Validation of the Literacy Independent Cognitive Assessment

BACKGROUND

Low education and illiteracy are associated with an increased risk of dementia. This study aimed to develop a neuropsychological test battery applicable to both illiterate and literate elderly and to assess its reliability and validity for a diagnosis of dementia.

METHODS

We developed the Literacy Independent Cognitive Assessment (LICA), which consists of 13 subtests assessing memory, language, visuoconstruction, executive function, attention and calculation. We investigated its reliability and validity on 152 patients with dementia, 66 with mild cognitive impairment and 639 normal controls.

RESULTS

The subtests were found to be applicable to most of the illiterate normal controls (97.3%) and were found to have high inter-rater reliabilities (r = 0.85-1.00, p < 0.001) and moderate to high test-retest reliabilities (r = 0.50-0.86, p < 0.001). The LICA performed well in discriminating participants across Clinical Dementia Rating stages and showed excellent internal consistency and good concurrent validity with the Korean Mini-mental State Examination in both literate and illiterate participants. The area under the curve of the receiver operating characteristic was 0.985 in each of the two literacy groups. Sensitivity and specificity of the LICA to make a diagnosis of dementia was 91.9% and 91.8% at the cutoff point of 186.0 in the literate subjects and 96.2% and 91.1% at the cutoff point of 154.5 in the illiterate subjects. The battery was factored into two separate factors consisting of verbal memory tests and tests for other cognitive domains.

CONCLUSION

The LICA is a valid and reliable instrument for a diagnosis of dementia in both illiterate and literate elderly.

The influence of color information on the recognition of color diagnostic and noncolor diagnostic objects

In the present study, the authors explore in detail the level of visual object recognition at which perceptual color information improves the recognition of color diagnostic and noncolor diagnostic objects. To address this issue, 3 object recognition tasks with different cognitive demands were designed: (a) an object verification task; (b) a category verification task; and (c) a name verification task. The authors found that perceptual color information improved color diagnostic object recognition mainly in tasks for which access to the semantic knowledge about the object was necessary to perform the task; that is, in category and name verification. In contrast, the authors found that perceptual color information facilitates noncolor diagnostic object recognition when access to the object's structural description from long-term memory was necessary--that is, object verification. In summary, the present study shows that the role of perceptual color information in object recognition is dependent on color diagnosticity.

A short-form version of the Boston Naming Test for language screening in dementia in a bilingual rural community in Galicia (Spain)

BACKGROUND

Aphasia, one of the core symptoms of cortical dementia, is routinely evaluated using graded naming tests like the Boston Naming Test (BNT). However, the application of this 60-item test is time-consuming and shortened versions have been devised for screening. The hypothesis of this research is that a specifically designed shortened version of the BNT could replace the original 60-item BNT as part of a mini-battery for screening for dementia. The objective of this study was to design a short version of the BNT for a rural population in Galicia (Spain).

METHODS

A clinic group of 102 patients including 43 with dementia was recruited along with 78 healthy volunteers. The clinic and control groups were scored on the Spanish version of the Mini-mental State Examination (MMSE) and BNT. In addition, the clinic group was tested with standard neuropsychological instruments and underwent brain investigations and routine neurological examination. BNT items with specificity and sensitivity above 0.5 were selected to compose a short battery of 11 pictures named BNTOu11. ANOVA and mean comparisons were made for MMSE and BNT versions. Receiver operating characteristics (ROC) curves and internal consistency were calculated.

RESULTS

Areas under ROC curves (AUC) did not show statistically significant differences; therefore BNTOu11's AUC (0.814) was similar to the 60-item BNT versions (0.785 and 0.779), to the short versions from Argentina (0.772) and Andalusia (0.799) and to the Spanish MMSE (0.866). BNTOu11 had higher internal consistency than the other short versions.

CONCLUSIONS

BNTOu11 is a useful and time-saving method as part of a battery for screening for dementia in a psychogeriatric outpatient unit.

The influence of surface color information and color knowledge information in object recognition

In order to clarify whether the influence of color knowledge information in object recognition depends on the presence of the appropriate surface color, we designed a name-object verification task. The relationship between color and shape information provided by the name and by the object photo was manipulated in order to assess color interference independently of shape interference. We tested three different versions for each object: typically colored, black and white, and nontypically colored. The response times on the nonmatching trials were used to measure the interference between the name and the photo. We predicted that the more similar the name and the photo are, the longer it would take to respond. Overall, the color similarity effect disappeared in the black-and-white and nontypical color conditions, suggesting that the influence of color knowledge on object recognition depends on the presence of the appropriate surface color information.

Coding of visual object features and feature conjunctions in the human brain

Object recognition is achieved through neural mechanisms reliant on the activity of distributed coordinated neural assemblies. In the initial steps of this process, an object's features are thought to be coded very rapidly in distinct neural assemblies. These features play different functional roles in the recognition process--while colour facilitates recognition, additional contours and edges delay it. Here, we selectively varied the amount and role of object features in an entry-level categorization paradigm and related them to the electrical activity of the human brain. We found that early synchronizations (approx. 100 ms) increased quantitatively when more image features had to be coded, without reflecting their qualitative contribution to the recognition process. Later activity (approx. 200-400 ms) was modulated by the representational role of object features. These findings demonstrate that although early synchronizations may be sufficient for relatively crude discrimination of objects in visual scenes, they cannot support entry-level categorization. This was subserved by later processes of object model selection, which utilized the representational value of object features such as colour or edges to select the appropriate model and achieve identification.

Influence of age, gender and educational level on performance in the Brief Cognitive Battery-Edu

The Brief Cognitive Battery-Edu (BCB-Edu) contains nine tests, seven of which are related to the memory of drawings, and has good accuracy in the diagnosis of cognitive impairment.

OBJECTIVES

To evaluate the influence of age, gender and educational level on the performance in tests related to memory of drawings of the BCB-Edu in healthy subjects.

METHODS

Participants were adult volunteers; exclusion criteria were illiteracy, neurologic or psychiatric disorders, visual or hearing impairment, untreated chronic clinical conditions, alcoholism, use of drugs, and for those aged 65 or over, an informant report of cognitive or functional impairment. We evaluated 325 individuals (207 women), with a mean age of 47.1 (±16.8) years, ranging from 19 to 81, and a mean of 9.8 (±5.0) schooling-years. Univariate analyses, correlations and logistic regression were employed (α=0.05).

RESULTS

There were significant negative correlations between age and the scores in four of the seven tests. However, schooling-years were positively correlated to the scores, where schooling-years decreased with age in this sample (rho= -0.323; p<0.001). Logistic regression confirmed that gender influenced the learning of drawings, where women performed better, while age influenced incidental memory, immediate memory, learning and delayed recall of the drawings, and schooling-years influenced visual identification, immediate memory, learning, delayed recall and recognition of the drawings.

CONCLUSION

Gender, age and education influence the performance on the memory of drawings of the BCB-Edu, although the extent of these influences differs according to the nature of the test.

Independent Processing of Form, Colour, and Texture in Object Perception

Most investigations of object recognition have focused on the form rather than the material properties of objects. Nevertheless, knowledge of the material properties of an object (via its surface cues) can provide important information about that object's identity. In this study, we used Garner's speeded-classification task to explore whether or not the processing of form and the processing of surface properties are independent. In experiment 1, participants made length and width classifications in an initial form task. Participants were unable to ignore length while making width classifications, and were unable to ignore width while making length classifications. This suggests that the perception of length and the perception of width share common processing resources. In a subsequent task, we examined possible interactions between the processing of form and the processing of surface properties. In contrast to the findings with the form task, participants were able to ignore form while making surface-property classifications, and to ignore surface properties while making form classifications. This suggests that the form of objects and their surface properties are processed independently. In experiment 2, we went on to show that the two prominent surface-property dimensions of colour and texture can also be processed independently. In other words, participants were able to ignore colour while making texture classifications, and vice versa. Finally, in experiment 3, we examined the possibility that the stimuli and required responses that we used in experiment 2 were too categorical and thus not optimal for assessing whether or not colour and texture share common processing resources. Using a different stimulus set, participants were again able to ignore colour while making texture classifications, and vice versa. Taken together, these results provided convincing evidence that the separate ventral-stream brain regions identified for form, texture, and colour in a recent neuroimaging study (Cant and Goodale, 2007 Cerebral Cortex17 713–731) can indeed function independently.