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Donders J, Maher T. Clinical Utility of the Neuropsychological Assessment Battery Judgment Subtest in the Evaluation of Older Adults. Arch Clin Neuropsychol 2024:acae035. [PMID: 38712367 DOI: 10.1093/arclin/acae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVE The purpose of this retrospective archival study was to explore the clinical utility of the Judgment subtest of the Neuropsychological Assessment Battery (NAB) in older adults who were referred because of cognitive concerns. Specifically, we were interested in how NAB Judgment covaried with other measures of executive functioning. METHOD 226 adults, aged 61-89 years (48% dementia, 35% mild cognitive impairment, 18% cognitively intact) completed NAB Judgment. They also completed Trail Making Test (TMT) A and B. In addition, Behavior Rating Inventory of Executive Function (BRIEF-A) informant and self-reports were obtained to measure executive functioning in daily life. RESULTS Scores on NAB Judgment did not correlate significantly with BRIEF-A informant ratings. However, there was a statistically significant correlation between BRIEF-A informant ratings and TMT B. Better performance on TMT B was associated with fewer informant concerns. Furthermore, subgroups with versus without informant BRIEF-A Metacognition indices in the range of impairment demonstrated a statistically significant difference on TMT B but not on Judgment. CONCLUSIONS Executive functioning in older adults should not be assessed using NAB Judgment alone. Such an evaluation should be supplemented with other in-person tests as well as informant ratings of daily functioning.
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Affiliation(s)
- Jacobus Donders
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Tracy Maher
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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Suchy Y, Simpson A, Mora MG, DesRuisseaux LA, Brothers SL, Mullen CM. Test of Practical Judgment (TOP-J): Construct, Criterion, and Incremental Validity in a Community Sample of Older Adults. Arch Clin Neuropsychol 2024; 39:355-366. [PMID: 38097261 DOI: 10.1093/arclin/acad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE The Test of Practical Judgment (TOP-J) is a stand-alone judgment measure that is considered to tap into aspects of executive functioning (EF) and inform clinical predictions of daily functioning in older adults. Past validation research is variable and has some limitations. The present study sought to examine the reliability and construct, criterion, and incremental validities of scores on TOP-J 9-item version (TOP-J/9). METHOD Participants were 95 community-dwelling older adults aged 60 to 85. Participants completed TOP-J/9, measures of EF and global cognition, and three different modalities of instrumental activities of daily living (IADLs) (self-report, performance-based tasks conducted in the laboratory, and performance-based tasks completed at home over 3 weeks). RESULTS TOP-J/9 scores showed adequate internal consistency (α = 0.73) after correcting for the low number of items. TOP-J/9 was correlated with global cognition and EF, although EF did not survive correction for lower-order processes. Finally, although TOP-J/9 scores were associated with home-based IADL tasks (but not with self-report and laboratory-based IADLs), providing some evidence of criterion validity, they did not incrementally contribute to home-based IADL performance beyond other cognitive measures. However, when two items pertaining to social/ethical judgment were removed, this modified version of TOP-J did relate to EF beyond lower-order processes and contributed uniquely to prediction of home-based IADLs beyond other measures. CONCLUSION Results suggest that TOP-J/9 taps into global cognitive status (but not necessarily EF) and predicts "real-world" functioning (but not above and beyond other cognitive measures). TOP-J psychometrics may be improved by removing two social/ethical items.
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Austin Simpson
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Christine M Mullen
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT, USA
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Patrick KS, Gunstad J, Spitznagel MB. Pain in the Context of Virtual Neuropsychological Assessment of Older Adults. Arch Clin Neuropsychol 2024; 39:157-166. [PMID: 37644879 PMCID: PMC10879923 DOI: 10.1093/arclin/acad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE Pain and cognitive impairment are prevalent and often co-occur in older adults. Because pain may negatively affect cognitive test performance, identification of pain in the context of neuropsychological evaluation is important. However, pain detection based on self-report presents challenges, and pain is often under-detected in this population. Alternative methods (e.g., video-based automatic coding of facial biomarkers of pain) may facilitate pain identification and thus enhance interpretation of neuropsychological evaluation results. METHOD The current study examined pain in the context of virtual neuropsychological assessment in 111 community-dwelling older adults, first seeking to validate the use of software developed to automatically code biomarkers of pain. Measures of pain, including self-report of acute and chronic pain and automatic coding of pain, were compared while participants completed neuropsychological testing. RESULTS Self-reported pain was negatively associated with poorer performance on a measure of executive function (both acute and chronic pain) and a global cognitive screening measure (acute pain only). However, self-reported acute and chronic pain did not correlate significantly with most neuropsychological tests. Automatic coding of pain did not predict self-report of pain or performance on neuropsychological tests beyond the influence of demographic factors and psychological symptoms. CONCLUSIONS Though results were largely not significant, correlations warrant further exploration of the influence of pain on neuropsychological test performance in this context to ensure that pain does not influence test performance in individuals with higher levels of pain and in other samples.
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Affiliation(s)
- Karlee S Patrick
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Mary B Spitznagel
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
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Rabin LA, Guayara-Quinn CG, Nester CO, Ellis L, Paré N. Informant report of practical judgment ability in a clinical sample of older adults with subjective cognitive decline, mild cognitive impairment, and dementia. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:139-157. [PMID: 33618617 PMCID: PMC8380745 DOI: 10.1080/13825585.2020.1859081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/29/2020] [Indexed: 01/03/2023]
Abstract
Despite the importance of capturing problems with judgment and decision-making during neuropsychological evaluations of older adults, there are a limited number of validated measures and no informant rating scales. We developed an informant measure that captures compromised judgment related to safety, medical, financial, and social-ethical issues After item refinement and piloting in a memory disorders clinic, we utilized the Test of Practical Judgment-Informant (TOP-J-Informant) at two clinics in the Midwestern U.S., including 189 patient/informant dyads (mean age = 79.0, median years of education = 13, % female = 67.7) with various preclinical and clinical dementia conditions. We found psychometric support, including evidence for convergent, divergent, and criterion-related validity, and internal consistency. Importantly, we were able to discriminate between diagnostic groups in the expected direction. The TOP-J-Informant is brief (<5 minutes), easy to administer, and can reveal areas of concern related to poor judgment when administered in the context of a neuropsychological evaluation or clinic visit.
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Affiliation(s)
- Laura A Rabin
- Department of Psychology, Brooklyn College and the Graduate Center of CUNY, Brooklyn, NY, USA
- Department of Psychology, Queens College and the Graduate Center of CUNY, New York, NY, USA
| | | | - Caroline O Nester
- Department of Psychology, Queens College and the Graduate Center of CUNY, New York, NY, USA
| | - Liam Ellis
- Neuropsychology Division, Department of Neurological Sciences, Nebraska Medicine, Omaha, NE, USA
| | - Nadia Paré
- Neuropsychology Division, Department of Neurological Sciences, Nebraska Medicine, Omaha, NE, USA
- Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA
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do Vale-Britto PHF, Rabin L, Spindola L, Nitrini R, Brucki SMD. Assessment of judgment ability in a Brazilian sample of patients with mild cognitive impairment and dementia. Dement Neuropsychol 2021; 15:200-209. [PMID: 34345361 PMCID: PMC8283876 DOI: 10.1590/1980-57642021dn15-020007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/29/2020] [Indexed: 12/03/2022] Open
Abstract
Judgment is the ability to make sound decisions after consideration of relevant information, possible solutions, likely outcomes, and contextual factors. Loss of judgment is common in patients with mild cognitive impairment (MCI) and dementia. The Test of Practical Judgment (TOP-J) evaluates practical judgment in adults and the elderly, with 15- and 9-item versions that require individuals to listen to scenarios about everyday problems and report their solutions.
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Affiliation(s)
- Patrícia Helena Figueirêdo do Vale-Britto
- Behavioral and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, Hospital das Clínicas, Universidade de São Paulo ‒ São Paulo, SP, Brazil
| | - Laura Rabin
- Department of Psychology, Brooklyn College and the Graduate Center of the City University of New York ‒ Brooklyn, New York, USA
| | - Livia Spindola
- Behavioral and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, Hospital das Clínicas, Universidade de São Paulo ‒ São Paulo, SP, Brazil
| | - Ricardo Nitrini
- Behavioral and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, Hospital das Clínicas, Universidade de São Paulo ‒ São Paulo, SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Behavioral and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, Hospital das Clínicas, Universidade de São Paulo ‒ São Paulo, SP, Brazil
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Oey MJ, Brouwer VHEW, Buijs MJ, Wijnia JW, Postma A, Oudman E. Unraveling Apathy in Korsakoff Syndrome Patients Receiving Long-Term Care With and Without Cerebrovascular Comorbidity. Alcohol Clin Exp Res 2021; 45:131-139. [PMID: 33196105 PMCID: PMC7898846 DOI: 10.1111/acer.14513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/09/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Korsakoff syndrome (KS) is a severe neuropsychiatric disorder caused by acute deficiency of vitamin B1 and concomitant alcoholism. Patients with KS are particularly vulnerable for cerebrovascular comorbidity. KS is characterized by cognitive and neuropsychiatric symptoms, one of which is apathy. Apathy is a pathological lack of goal-directed behaviors, goal-directed cognitions, and goal-directed emotions. Cerebrovascular accidents are known to carry a risk for developing apathy. Apathy has a dramatic effect on the autonomy and daily lives of patients suffering from this condition. METHODS We assessed general apathy and related subconstructs in fifteen patients with KS, fifteen patients with KS and cerebrovascular comorbidity who reside in a 24-hour care facility, and fifteen healthy controls. RESULTS Compared with healthy controls, both KS patient groups showed higher levels of apathy as rated by a close informant. We found no difference between both KS patient groups and the healthy control group on the self-report section of the Pleasant Activities List, suggesting that motivation is still intact in KS patients. It is important to note a discrepancy was found between self-reporting and proxy reporting on this list. KS patients with cerebrovascular comorbidity showed more severe emotional blunting compared to both KS patients without cerebrovascular comorbidity and healthy controls. The competency to consent was lower in patients compared with healthy controls, but no difference was found between KS patients with cerebrovascular comorbidity and those without. CONCLUSIONS Our results suggest that KS patients show increased levels of general apathy compared with healthy controls. Patients show a diminished competency to consent and increased emotional blunting, while motivation is not compromised. Cerebrovascular comorbidity in KS forms a high risk for emotional blunting. The results of this study suggest that apathy is a severe problem in KS. More attention in both the literature and clinical practice would benefit this complex patient population.
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Affiliation(s)
- Misha J. Oey
- From theExperimental Psychology(MJO, VHEWB, MJB, AP, EO)Helmholtz InstituteUtrecht UniversityUtrechtThe Netherlands
- Lelie Care Group(MJO, JWW, AP, EO)Slingedael Korsakoff CenterRotterdamThe Netherlands
| | - Veerle H. E. W. Brouwer
- From theExperimental Psychology(MJO, VHEWB, MJB, AP, EO)Helmholtz InstituteUtrecht UniversityUtrechtThe Netherlands
| | - Marie J. Buijs
- From theExperimental Psychology(MJO, VHEWB, MJB, AP, EO)Helmholtz InstituteUtrecht UniversityUtrechtThe Netherlands
| | - Jan Watze Wijnia
- Lelie Care Group(MJO, JWW, AP, EO)Slingedael Korsakoff CenterRotterdamThe Netherlands
| | - Albert Postma
- From theExperimental Psychology(MJO, VHEWB, MJB, AP, EO)Helmholtz InstituteUtrecht UniversityUtrechtThe Netherlands
- Lelie Care Group(MJO, JWW, AP, EO)Slingedael Korsakoff CenterRotterdamThe Netherlands
| | - Erik Oudman
- From theExperimental Psychology(MJO, VHEWB, MJB, AP, EO)Helmholtz InstituteUtrecht UniversityUtrechtThe Netherlands
- Lelie Care Group(MJO, JWW, AP, EO)Slingedael Korsakoff CenterRotterdamThe Netherlands
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Hergert DC, Haaland KY, Cimino CR. Evaluation of a performance-rating method to assess awareness of cognitive functioning in Huntington's disease. Clin Neuropsychol 2019; 34:477-497. [PMID: 31322031 DOI: 10.1080/13854046.2019.1640286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: Anosognosia, or lack of awareness of symptoms, is commonly observed in Huntington's disease (HD) using patient/informant-report discrepancy methods. The purpose of this study was to examine the utility of a performance-rating method for assessing awareness of cognitive performance in HD.Method: Persons with manifest HD (n = 54) rated their performance on the daily living tests from the Neuropsychological Assessment Battery (NAB) using a bell curve. We also examined patient/informant-report discrepancies of executive functioning (FrSBe) in a subset (n = 47) of patients and their informants.Results: Patients were able to reliably use our method of categorizing their performance as evidenced by significant correlations between verbal descriptions of their performance and the percentile ratings they indicated on the bell curve. Patients across the range of observed Unified HD Rating Scale motor scale scores rated their performance on the NAB tasks significantly higher than actual performance for both pretest prediction and posttest evaluation ratings. Only patients with more severe motor impairment underestimated their problems relative to informant report on the FrSBe.Conclusions: This is the first study to use a performance-rating method for examining awareness in HD. Patients could reliably use this performance-based bell curve method to provide accurate estimations of their performance and as a group they tended to overestimate performance as has been demonstrated in previous studies. Unlike previous studies using self-report methodology, we also demonstrated decreased awareness in the persons with HD with less severe motor impairment using the performance-rating method, suggesting the two methods may measure different constructs of awareness.
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Affiliation(s)
| | - Kathleen Y Haaland
- Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Cynthia R Cimino
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Mansbach WE, Mace RA, Tanner MA, Schindler F. Verbal test of practical judgment (VPJ): a new test of judgment that predicts functional skills for older adults. Aging Ment Health 2019; 23:718-726. [PMID: 29570362 DOI: 10.1080/13607863.2018.1450838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The clinical assessment of older adults' judgment is important for mitigating safety risks that often precipitate loss of independence. Our national survey of geriatric healthcare providers (N = 496; M years of experience = 17.11 ± 10.60) indicated that formal judgment tests are underutilized in clinical practice. We developed the Verbal Test of Practical Judgment (VPJ) as a new test of judgment for older adults intended to identify difficulty performing instrumental activities of daily living (IADL). METHOD In two prospective studies, participants were long-term care facility residents (age ≥ 50) in Maryland, USA (Study 1, N = 51; Study 2, N = 110) referred to licensed psychologists for neuro-cognitive and mood evaluation by facility attending physicians. Psychometric analyses were performed to examine the construct validity of the VPJ. RESULTS The VPJ evidenced adequate reliability and strong construct validity across both studies. Receiver operating characteristic analysis yielded an optimal VPJ cut score for identifying impaired judgment. The VPJ significantly predicted IADL performance beyond clinician and participant ratings. CONCLUSION The VPJ appears to be a valid tool for assessing judgment among older adults with suspected cognitive impairment. VPJ score inferences can inform clinicians on the odds of requiring assistance for specific IADLs.
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Affiliation(s)
| | | | - Melissa A Tanner
- a Mansbach Health Tools , LLC , Simpsonville , MD , United States
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The Association of Judgement Ability and Functional Status in Older Adult Rehabilitation Inpatients. BRAIN IMPAIR 2018. [DOI: 10.1017/brimp.2018.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose: Older adults have an increased likelihood of requiring rehabilitative care due to cognitive and physical risk factors. Research has found a link between executive functioning performance and functional outcomes; however, there is a dearth of research on the assessment of judgement ability. In the current pilot study, we investigated the clinical utility of the Test of Practical Judgment (TOP-J) in an older adult rehabilitation sample.Methods: Inpatients of mixed diagnoses (n= 25, mean age = 72.60) completed the TOP-J and Functional Independence Measure (FIM). We assessed TOP-J performance in the entire sample and in those with intact vs. impaired global cognition (on the Mini-Mental State Examination; MMSE). Correlational analyses were conducted between the TOP-J, MMSE and relevant FIM items.Results: TOP-J performance fell between the means typically observed in individuals with mild cognitive impairment and mild Alzheimer's disease. Participants with intact global cognition obtained significantly higher TOP-J scores than those with impaired global cognition. Moderate to strong positive correlations emerged between TOP-J, MMSE and FIM items of problem solving, comprehension and memory.Conclusions: Results provide support for the clinical utility and validity of the TOP-J among older adults in the rehabilitation setting. Administering the TOP-J may help identify patients at risk for future injury and facilitate role transitions.
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Ashendorf L, Alosco ML, Bing-Canar H, Chapman KR, Martin B, Chaisson CE, Dixon D, Steinberg EG, Tripodis Y, Kowall NW, Stern RA. Clinical Utility of Select Neuropsychological Assessment Battery Tests in Predicting Functional Abilities in Dementia. Arch Clin Neuropsychol 2018; 33:530-540. [PMID: 29126099 PMCID: PMC6116785 DOI: 10.1093/arclin/acx100] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 08/21/2017] [Accepted: 10/02/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Neuropsychological test performance can provide insight into functional abilities in patients with dementia, particularly in the absence of an informant. The relationship between neuropsychological measures and instrumental activities of daily living (IADLs) is unclear due to hetereogeneity in cognitive domains assessed and neuropsychological tests administered. Practical and ecologically valid performance-based measures of IADLs are also limited. The Neuropsychological Assessment Battery (NAB) is uniquely positioned to provide a dual-purpose assessment of cognitive and IADL function, as it includes Daily Living tests that simulate real-world functional tasks. We examined the utility of select NAB tests in predicting informant-reported IADLs in mild cognitive impairment and dementia. METHODS The sample of 327 participants included 128 normal controls, 97 individuals with mild cognitive impairment, and 102 individuals with Alzheimer's disease dementia from the Boston University Alzheimer's Disease Center research registry. Informants completed the Lawton Brody Instrumental Activities of Daily Living Scale, and study participants were administered selected NAB tests that were complementary to the existing protocol. RESULTS ROC curves showed strongest prediction of IADL (AUC > 0.90) for memory measures (List Learning delayed recall and Daily Living Memory delayed recall) and Daily Living Driving Scenes. At a predetermined level of specificity (95%), List Learning delayed recall (71%) and Daily Living Memory delayed recall (88%) were the most sensitive. The Daily Living Memory and Driving Scenes tests strongly predicted IADL status, and the other Daily Living tests contributed unique variance. CONCLUSIONS NAB memory measures and Daily Living Tests may have clinical utility in detecting informant-rated functional impairment in dementia.
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Affiliation(s)
- Lee Ashendorf
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA
| | - Michael L Alosco
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Hanaan Bing-Canar
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kimberly R Chapman
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Brett Martin
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Christine E Chaisson
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Diane Dixon
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Eric G Steinberg
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Yorghos Tripodis
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Neil W Kowall
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Pathology, Boston University School of Medicine, Boston, Massachusetts, USA
- Neurology Service, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Robert A Stern
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Departments of Neurosurgery, and Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA
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Durant J, Berg JL, Banks SJ, Miller JB. Comparing the test of practical judgment with the neuropsychological assessment battery judgment subtest in a neurodegenerative disease clinic population. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 25:489-496. [PMID: 28605212 DOI: 10.1080/23279095.2017.1329147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The Test of Practical Judgment (TOP-J) and the Judgment subtest from the Neuropsychological Assessment Battery (NAB-JDG) are both brief interview-based measures that assess judgment. This study compared estimates of judgment obtained from these measures in a neurodegenerative disease population. Records from 61 referrals seen for neuropsychological evaluation in a neurodegenerative disorders clinic were reviewed. Measures of interest included the TOP-J and NAB-JDG. Concordance correlation coefficients (CCC) and root mean square differences (RMSD) were calculated between judgment T-scores. Discrepancy scores were calculated by subtracting NAB-JDG scores from TOP-J scores. CCC showed poor agreement between the judgment measures, with evidence of fixed bias, such that the NAB-JDG systematically generates higher scores than the TOP-J. This fixed bias was present whether NAB-JDG scores are demographically adjusted or unadjusted. There was no evidence of proportional bias. In a neurodegenerative disease clinic population, the TOP-J and NAB-JDG provide estimates of judgment ability that are systematically different. These two measures may be assessing different aspects within the larger construct of judgment and the inconsistency between measures would contraindicate using them interchangeably. Clinicians will need to carefully consider patient characteristics, clinical needs, and review specific item content when selecting between these measures.
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Affiliation(s)
- January Durant
- a Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , Nevada , USA
| | - Jody-Lynn Berg
- a Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , Nevada , USA
| | - Sarah Jane Banks
- a Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , Nevada , USA
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Gavett BE, Zhao R, John SE, Bussell CA, Roberts JR, Yue C. Phishing suspiciousness in older and younger adults: The role of executive functioning. PLoS One 2017; 12:e0171620. [PMID: 28158316 PMCID: PMC5291531 DOI: 10.1371/journal.pone.0171620] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/23/2017] [Indexed: 11/21/2022] Open
Abstract
Phishing is the spoofing of Internet websites or emails aimed at tricking users into entering sensitive information, with such goals as financial or identity theft. The current study sought to determine whether age is associated with increased susceptibility to phishing and whether tests of executive functioning can predict phishing susceptibility. A total of 193 cognitively intact participants, 91 younger adults and 102 older adults, were primarily recruited through a Psychology department undergraduate subject pool and a gerontology research registry, respectively. The Executive Functions Module from the Neuropsychological Assessment Battery and the Iowa Gambling Task were the primary cognitive predictors of reported phishing suspiciousness. Other predictors included age group (older vs. younger), sex, education, race, ethnicity, prior knowledge of phishing, prior susceptibility to phishing, and whether or not browsing behaviors were reportedly different in the laboratory setting versus at home. A logistic regression, which accounted for a 22.7% reduction in error variance compared to the null model and predicted phishing suspiciousness with 73.1% (95% CI [66.0, 80.3]) accuracy, revealed three statistically significant predictors: the main effect of education (b = 0.58, SE = 0.27) and the interactions of age group with prior awareness of phishing (b = 2.31, SE = 1.12) and performance on the Neuropsychological Assessment Battery Mazes test (b = 0.16, SE = 0.07). Whether or not older adults reported being suspicious of the phishing attacks used in this study was partially explained by educational history and prior phishing knowledge. This suggests that simple educational interventions may be effective in reducing phishing vulnerability. Although one test of executive functioning was found useful for identifying those at risk of phishing susceptibility, four tests were not found to be useful; these results speak to the need for more ecologically valid tools in clinical neuropsychology.
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Affiliation(s)
- Brandon E. Gavett
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States of America
- * E-mail:
| | - Rui Zhao
- Division of Computer Science, Colorado School of Mines, Golden, CO, United States of America
| | - Samantha E. John
- Alzheimer’s Disease Research Center, Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Cara A. Bussell
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States of America
| | - Jennifer R. Roberts
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States of America
| | - Chuan Yue
- Division of Computer Science, Colorado School of Mines, Golden, CO, United States of America
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Buczylowska D, Daseking M, Petermann F. Age-related differences in the predictive ability of executive functions for intelligence. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2016. [DOI: 10.1024/1016-264x/a000179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. The Executive Functions Module of the Neuropsychological Assessment Battery (NAB) and the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) were used to investigate age-related differences in the predictability of intelligence with executive functions. The NAB subtests age and sex better predicted the WAIS-IV index scales and the Full Scale IQ in the older than in the younger age group, with total variance explained up to 75 % in 60- to 88-year-olds and up to 46 % in 18- to 59-year-olds. The NAB subtests Categories and Word Generation were most frequently included, whereas Letter Fluency was least frequently included in the best-fitting models of WAIS-IV prediction. Mazes predicted better in the younger age group, whereas Judgment predicted better in the older age group.
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Affiliation(s)
- Dorota Buczylowska
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Germany
| | - Monika Daseking
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Germany
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Germany
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Buczylowska D, Petermann F. Age-related commonalities and differences in the relationship between executive functions and intelligence: Analysis of the NAB executive functions module and WAIS-IV scores. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 24:465-480. [DOI: 10.1080/23279095.2016.1211528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Dorota Buczylowska
- Center for Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
| | - Franz Petermann
- Center for Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
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Mansbach WE, MacDougall EE, Clark KM, Mace RA. Preliminary investigation of the Kitchen Picture Test (KPT): A new screening test of practical judgment for older adults. AGING NEUROPSYCHOLOGY AND COGNITION 2013; 21:674-92. [DOI: 10.1080/13825585.2013.865698] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Buczylowska D, Bornschlegl M, Daseking M, Jäncke L, Petermann F. Zur deutschen Adaptation der Neuropsychological Assessment Battery (NAB). ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2013. [DOI: 10.1024/1016-264x/a000108] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Standardisierte Testverfahren bilden einen wichtigen Bestandteil neuropsychologischer Diagnostik. Im deutschsprachigen Raum besteht ein großer Bedarf für eine einheitlich normierte neuropsychologische Testbatterie. Die Neuropsychological Assessment Battery (NAB) ist ein in den USA entwickeltes Verfahren zur Beurteilung der neuropsychologischen Funktionen bei Erwachsenen (Alter 18 – 97 Jahre). Die NAB besteht aus zwei äquivalenten Parallelformen, die jeweils in sechs Module untergliedert sind: Screening, Aufmerksamkeit, Sprache, Gedächtnis, Wahrnehmung und Exekutive Funktionen. Das Verfahren ermöglicht eine umfangreiche, psychometrisch fundierte und ökologisch valide Diagnostik. Die NAB wird im Hinblick auf die Entstehungsgeschichte, psychometrische Güte und bisherige Rezeption präsentiert. Die Autorengruppe arbeitet zurzeit an der deutschen Adaptation und Normierung der NAB.
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Affiliation(s)
- Dorota Buczylowska
- Zentrum für Klinische Psychologie und Rehabilitation (ZKPR), Universität Bremen
| | - Mona Bornschlegl
- Zentrum für Klinische Psychologie und Rehabilitation (ZKPR), Universität Bremen
| | - Monika Daseking
- Zentrum für Klinische Psychologie und Rehabilitation (ZKPR), Universität Bremen
| | - Lutz Jäncke
- Lehrstuhl für Neuropsychologie, Pädagogisches Institut, Universität Zürich
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation (ZKPR), Universität Bremen
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