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D Hood E, B Boone K, S Miora D, E Cottingham M, L Victor T, A Zeigler E, A Zeller M, J Wright M. Are there differences in performance validity test scores between African American and White American neuropsychology clinic patients? J Clin Exp Neuropsychol 2022; 44:31-41. [PMID: 35670549 DOI: 10.1080/13803395.2022.2069230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The purpose of the present study was to compare performance on a wide range of PVTs in a neuropsychology clinic sample of African Americans and White Americans to determine if there are differences in mean scores or cut-off failure rates between the two groups, and to identify factors that may account for false positive PVT results in African American patients. METHOD African American and White American non-compensation-seeking neuropsychology clinic patients were compared on a wide range of standalone and embedded PVTs: Dot Counting Test, b Test, Warrington Recognition Memory Test, Rey 15-item plus recognition, Rey Word Recognition Test, Digit Span (ACSS, RDS, 3-digit time, 4-digit time), WAIS-III Picture Completion (Most discrepant index), WAIS-III Digit Symbol/Coding (recognition equation), Rey Auditory Verbal Learning Test, Rey Complex figure, WMS-III Logical Memory, Comalli Stroop Test, Trails A, and Wisconsin Card Sorting Test. RESULTS When groups were equated for age and education, African Americans obtained mean performances significantly worse than White Americans on only four of 25 PVT scores across the 14 different measures (Stroop Word Reading and Color Naming, Trails A, Digit Span 3-digit time); however, FSIQ was also significantly higher in White American patients. When subjects with borderline IQ (FSIQ = 70 to 79) were excluded (resulting in 74 White Americans and 25 African Americans), groups no longer differed in IQ and only continued to differ on a single PVT cutoff (Trails A). Further, specificity rates in African Americans were comparable to those of White Americans with the exception of the b Test, the Dot Counting Test, and Stroop B. CONCLUSIONS PVT performance generally does not differ as a function of Black versus White race once the impact of intellectual level is controlled, and most PVT cutoffs appear appropriate for use in African Americans of low average IQ or higher.
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Affiliation(s)
- Elexsia D Hood
- California School of Forensic Studies, Alliant International University, Los Angeles, USA
| | - Kyle B Boone
- California School of Forensic Studies, Alliant International University, Los Angeles, USA.,Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, USA
| | - Deborah S Miora
- California School of Forensic Studies, Alliant International University, Los Angeles, USA
| | - Maria E Cottingham
- Mental Health Care Line, Veterans Administration Tennessee Valley Healthcare System, Nashville, USA
| | - Tara L Victor
- Department of Psychology, California State University, Dominguez Hills, Carson, USA
| | | | - Michelle A Zeller
- West Los Angeles Veterans Administration Medical Center, Los Angeles, USA
| | - Matthew J Wright
- Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, USA
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Gamaldo AA, Tan SC, Sardina AL, Henzi C, Guest R, Ross LA, Willingham K, Zonderman AB, Andel RA. Older Black Adults' Satisfaction and Anxiety Levels After Completing Alternative Versus Traditional Cognitive Batteries. J Gerontol B Psychol Sci Soc Sci 2020; 75:1462-1474. [PMID: 30265365 PMCID: PMC7530491 DOI: 10.1093/geronb/gby095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The objective of this study was to examine satisfaction, test anxiety, and performance using computer-based cognitive batteries versus a paper-and-pencil neuropsychological battery among older Blacks. METHOD Self-identified Black adults (n = 87, age range: 55-86; mean education = 14) completed two computer-based tests (CogState and Joggle) and a paper-and-pencil neuropsychological battery. After each battery, participants reported their testing anxiety and satisfaction using the batteries. Descriptive, correlational, and regression analyses compared satisfaction, anxiety, and performance across the batteries. RESULTS Majority of the participants reported more satisfaction with the computer-based (Joggle: 66%; CogState: 77%) than the neuropsychological (52%) battery. Participants also reported less testing anxiety after completing the computer-based batteries than the neuropsychological battery, F(2, 172) = 22.96, p < .001. Older adults' familiarity and comfort level with the computer were not associated with their performance on the computer-based tests (p > .05). Although testing anxiety was not associated with performance across the batteries, age and education quality were uniquely associated with performance on the CogState and neuropsychological batteries. CONCLUSIONS Computer-based cognitive batteries appear to be less intimidating than the commonly used paper-and-pencil neuropsychological tests for Black adults. Thus, these cognitive batteries may be useful tools for monitoring older Blacks' cognitive status.
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Affiliation(s)
- Alyssa A Gamaldo
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
- School of Aging Studies, University of South Florida, Tampa, Florida
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland
| | - Shyuan Ching Tan
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Angie L Sardina
- School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, North Carolina
| | - Carolyn Henzi
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Rosalyn Guest
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Lesley A Ross
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Kurtis Willingham
- Aging Studies, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland
| | - Ross A Andel
- School of Aging Studies, University of South Florida, Tampa, Florida
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Lichtenberg PA, Gross E, Ficker LJ. Quantifying Risk of Financial Incapacity and Financial Exploitation in Community-dwelling Older Adults: Utility of a Scoring System for the Lichtenberg Financial Decision-making Rating Scale. Clin Gerontol 2020; 43:266-280. [PMID: 29883276 PMCID: PMC6286690 DOI: 10.1080/07317115.2018.1485812] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objectives: This work examines the clinical utility of the scoring system for the Lichtenberg Financial Decision-making Rating Scale (LFDRS) and its usefulness for decision making capacity and financial exploitation. Objective 1 was to examine the clinical utility of a person centered, empirically supported, financial decision making scale. Objective 2 was to determine whether the risk-scoring system created for this rating scale is sufficiently accurate for the use of cutoff scores in cases of decisional capacity and cases of suspected financial exploitation. Objective 3 was to examine whether cognitive decline and decisional impairment predicted suspected financial exploitation.Methods: Two hundred independently living, non-demented community-dwelling older adults comprised the sample. Participants completed the rating scale and other cognitive measures.Results: Receiver operating characteristic curves were in the good to excellent range for decisional capacity scoring, and in the fair to good range for financial exploitation.Conclusions: Analyses supported the conceptual link between decision making deficits and risk for exploitation, and supported the use of the risk-scoring system in a community-based population.Clinical Implications: This study adds to the empirical evidence supporting the use of the rating scale as a clinical tool assessing risk for financial decisional impairment and/or financial exploitation.
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Affiliation(s)
- Peter A Lichtenberg
- Institute of Gerontology & Merrill Palmer Skillman Institute, Professor of Psychology, Wayne State University, Detroit, MI, United States
| | - Evan Gross
- Institute of Gerontology & Department of Psychology, Institute of Gerontology, Detroit, MI, United States
| | - Lisa J Ficker
- Institute of Gerontology, Wayne State University, Detroit, MI, United States
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Abstract
Objectives: This article examines the convergent validity and clinical utility of the 34-item short form of the Lichtenberg Financial Decision Rating Scale (LFDRS-SF). A briefer scale can lead to enhanced and efficient use of a person-centered approach to the assessment of financial decision-making.Methods: Using data on 200 community-dwelling older adults from Lichtenberg and colleagues (2017a), convergent validity was examined with cognitive and financial management measures using a correlational and regression approach. Receiver operating curve analyses for predicting decision-making ability classification and suspected financial exploitation classification were used to evaluate clinical utility.Results: The LFDRS-SF total risk score was significantly correlated with both cognitive and financial management measures, and the regression analysis predicted 9% of the LFDRS-SF measure. These results demonstrate not only convergent validity, but also the conceptual and empirical uniqueness of financial decision-making.Conclusions: The LFDRS-SF is a valid tool to assess real-world financial decision-making abilities.Clinical Implications: The LFDRS-SF offers an efficient way to assess financial decision-making. Training on the tool and automatic scoring and recommendations for next steps can be found at https://olderadultnestegg.com.
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Affiliation(s)
| | - Evan Gross
- Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Rebecca Campbell
- Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, MI, USA
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Neuropsychological Evaluation of Culturally/Linguistically Diverse Older Adults. HANDBOOK ON THE NEUROPSYCHOLOGY OF AGING AND DEMENTIA 2019. [DOI: 10.1007/978-3-319-93497-6_3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Iatraki E, Simos PG, Bertsias A, Duijker G, Zaganas I, Tziraki C, Vgontzas AN, Lionis C. Cognitive screening tools for primary care settings: examining the 'Test Your Memory' and 'General Practitioner assessment of Cognition' tools in a rural aging population in Greece. Eur J Gen Pract 2018; 23:171-178. [PMID: 28604128 PMCID: PMC5774277 DOI: 10.1080/13814788.2017.1324845] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Under conditions of high demand for primary care services in a setting of low financial resources, there is need for brief, easily administered cognitive screening tools for use in the primary care setting, especially in rural areas. However, interpretation of these cognitive tests' results requires knowledge on their susceptibility to cultural, educational and demographic patient characteristics. OBJECTIVES To assess the clinical validity of the 'Test Your Memory' (TYM) and 'General Practitioner assessment of Cognition' (GPCog) which was specifically designed for primary care practice, in a rural primary care setting in Greece, utilizing the 'Mini Mental State Examination' (MMSE) as a reference standard. METHODS The MMSE, TYM, and GPCog were administered to a random sample of 319 community dwelling Greek adults aged 60 to 89 years in 11 rural Primary Healthcare Centres of the Prefecture of Heraklion on the island of Crete, Greece. Analyses examined (a) The association of each instrument with demographic factors and MMSE and (b) optimal cut-off scores, sensitivity and specificity against MMSE-based cognitive impairment risk using ROC analyses with the MMSE 23/24 point cut-off as a reference standard. RESULTS We found a sensitivity of 80% and a specificity of 77% for TYM (35/36 or 38/39 cut-off, depending on education). Corresponding values were 89% and 61% for GPCog (7/8 cut-off), respectively. CONCLUSION The TYM and GPCog instruments appear to be suitable for routine use in the primary care setting as tools for cognitive impairment risk detection in elderly rural populations.
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Affiliation(s)
- Eliza Iatraki
- a Clinic of Social and Family Medicine, Faculty of Medicine , University of Crete , Heraklion , Greece
| | - Panagiotis G Simos
- b Department of Psychiatry, Faculty of Medicine , University of Crete , Heraklion , Greece
| | - Antonios Bertsias
- a Clinic of Social and Family Medicine, Faculty of Medicine , University of Crete , Heraklion , Greece
| | - George Duijker
- a Clinic of Social and Family Medicine, Faculty of Medicine , University of Crete , Heraklion , Greece
| | - Ioannis Zaganas
- c Department of Neurology, Faculty of Medicine , University of Crete , Heraklion , Greece
| | - Chariklia Tziraki
- d MELEBEV Community Elders Clubs , Research Department , Jerusalem , Israel
| | - Alexandros N Vgontzas
- b Department of Psychiatry, Faculty of Medicine , University of Crete , Heraklion , Greece
| | - Christos Lionis
- a Clinic of Social and Family Medicine, Faculty of Medicine , University of Crete , Heraklion , Greece
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Lichtenberg PA, Ocepek-Welikson K, Ficker LJ, Gross E, Rahman-Filipiak A, Teresi JA. Conceptual and Empirical Approaches to Financial Decision-making by Older Adults: Results from a Financial Decision-making Rating Scale. Clin Gerontol 2018; 41:42-65. [PMID: 29077531 PMCID: PMC5766370 DOI: 10.1080/07317115.2017.1367748] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The objectives of this study were threefold: (1) to empirically test the conceptual model proposed by the Lichtenberg Financial Decision-making Rating Scale (LFDRS); (2) to examine the psychometric properties of the LFDRS contextual factors in financial decision-making by investigating both the reliability and convergent validity of the subscales and total scale, and (3) extending previous work on the scale through the collection of normative data on financial decision-making. METHODS A convenience sample of 200 independent function and community dwelling older adults underwent cognitive and financial management testing and were interviewed using the LFDRS. Confirmatory factor analysis, internal consistency measures, and hierarchical regression were used in a sample of 200 community-dwelling older adults, all of whom were making or had recently made a significant financial decision. RESULTS Results confirmed the scale's reliability and supported the conceptual model. Convergent validity analyses indicate that as hypothesized, cognition is a significant predictor of risk scores. Financial management scores, however, were not predictive of decision-making risk scores. CONCLUSIONS The psychometric properties of the LFDRS support the scale's use as it was proposed. CLINICAL IMPLICATIONS The LFDRS instructions and scale are provided for clinicians to use in financial capacity assessments.
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Affiliation(s)
- Peter A Lichtenberg
- a Institute of Gerontology, Wayne State University , Detroit , Michigan , USA.,b Merrill Palmer Skillman Institute, Wayne State University , Detroit , Michigan , USA
| | - Katja Ocepek-Welikson
- c Research Division , Hebrew Home at Riverdale; RiverSpring Health, New York , New York , USA
| | - Lisa J Ficker
- a Institute of Gerontology, Wayne State University , Detroit , Michigan , USA
| | - Evan Gross
- a Institute of Gerontology, Wayne State University , Detroit , Michigan , USA.,d Department of Psychology , Wayne State University , Detroit , Michigan , USA
| | - Analise Rahman-Filipiak
- e Neuropsychology Section , University of Michigan Health System , Ann Arbor , Michigan , USA
| | - Jeanne A Teresi
- c Research Division , Hebrew Home at Riverdale; RiverSpring Health, New York , New York , USA.,f Columbia University Stroud Center at New York State Psychiatric Institute, New York , New York , USA.,g Department of Geriatrics and Palliative Medicine , Weill Cornell Medical Center, New York , New York , USA
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Sayegh P, Arentoft A, Thaler NS, Dean AC, Thames AD. Quality of education predicts performance on the Wide Range Achievement Test-4th Edition Word Reading subtest. Arch Clin Neuropsychol 2015; 29:731-6. [PMID: 25404004 DOI: 10.1093/arclin/acu059] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The current study examined whether self-rated education quality predicts Wide Range Achievement Test-4th Edition (WRAT-4) Word Reading subtest and neurocognitive performance, and aimed to establish this subtest's construct validity as an educational quality measure. In a community-based adult sample (N = 106), we tested whether education quality both increased the prediction of Word Reading scores beyond demographic variables and predicted global neurocognitive functioning after adjusting for WRAT-4. As expected, race/ethnicity and education predicted WRAT-4 reading performance. Hierarchical regression revealed that when including education quality, the amount of WRAT-4's explained variance increased significantly, with race/ethnicity and both education quality and years as significant predictors. Finally, WRAT-4 scores, but not education quality, predicted neurocognitive performance. Results support WRAT-4 Word Reading as a valid proxy measure for education quality and a key predictor of neurocognitive performance. Future research should examine these findings in larger, more diverse samples to determine their robust nature.
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Affiliation(s)
- Philip Sayegh
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Alyssa Arentoft
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Nicholas S Thaler
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - April D Thames
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Iles RA, Rose JM. Stated Choice design comparison in a developing country: recall and attribute nonattendance. HEALTH ECONOMICS REVIEW 2014; 4:25. [PMID: 25386388 PMCID: PMC4209457 DOI: 10.1186/s13561-014-0025-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 09/18/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Experimental designs constitute a vital component of all Stated Choice (aka discrete choice experiment) studies. However, there exists limited empirical evaluation of the statistical benefits of Stated Choice (SC) experimental designs that employ non-zero prior estimates in constructing non-orthogonal constrained designs. This paper statistically compares the performance of contrasting SC experimental designs. In so doing, the effect of respondent literacy on patterns of Attribute non-Attendance (ANA) across fractional factorial orthogonal and efficient designs is also evaluated. The study uses a 'real' SC design to model consumer choice of primary health care providers in rural north India. A total of 623 respondents were sampled across four villages in Uttar Pradesh, India. METHODS Comparison of orthogonal and efficient SC experimental designs is based on several measures. Appropriate comparison of each design's respective efficiency measure is made using D-error results. Standardised Akaike Information Criteria are compared between designs and across recall periods. Comparisons control for stated and inferred ANA. Coefficient and standard error estimates are also compared. RESULTS The added complexity of the efficient SC design, theorised elsewhere, is reflected in higher estimated amounts of ANA among illiterate respondents. However, controlling for ANA using stated and inferred methods consistently shows that the efficient design performs statistically better. Modelling SC data from the orthogonal and efficient design shows that model-fit of the efficient design outperform the orthogonal design when using a 14-day recall period. The performance of the orthogonal design, with respect to standardised AIC model-fit, is better when longer recall periods of 30-days, 6-months and 12-months are used. CONCLUSIONS The effect of the efficient design's cognitive demand is apparent among literate and illiterate respondents, although, more pronounced among illiterate respondents. This study empirically confirms that relaxing the orthogonality constraint of SC experimental designs increases the information collected in choice tasks, subject to the accuracy of the non-zero priors in the design and the correct specification of a 'real' SC recall period.
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Affiliation(s)
- Richard A Iles
- Department of Accounting, Finance and Economics, Griffith University, 170 Kessels Road, Brisbane, Australia
| | - John M Rose
- Institute of Choice, University of South Australia, Arthur Street, North Sydney, Australia
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Silverberg ND, Hanks RA, Tompkins SC. Education quality, reading recognition, and racial differences in the neuropsychological outcome from traumatic brain injury. Arch Clin Neuropsychol 2014; 28:485-91. [PMID: 23858087 DOI: 10.1093/arclin/act023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Ethnically diverse examinees tend to perform lower on neuropsychological tests. The practice of adjusting normative comparisons for the education level and/or race to prevent overpathologizing low scores is problematic. Education quality, as measured by reading recognition, appears to be a more accurate benchmark for premorbid functioning in certain populations. The present study aimed to extend this line of research to traumatic brain injury (TBI). We hypothesized that a measure of reading recognition, the Wechsler Test of Adult Reading (WTAR), would account for racial differences in neuropsychological performance after TBI. Fifty participants (72% African American, 28% Caucasian) with moderate to severe TBI underwent neuropsychological testing at 1-year post-injury. Reading recognition accounted for all the same variance in neuropsychological performance as race and education (together), as well as considerable additional variance. Estimation of premorbid functioning in African Americans with TBI could be refined by considering reading recognition.
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