Prediction of Cognitive Abilities 1 Year Following Traumatic Brain Injury From Inpatient Rehabilitation Cognitive Screening.

Objective: To evaluate the ability of the Cognitive Log (Cog-Log) to predict neuropsychological outcome at 1 year after traumatic brain injury (TBI). Study Design: The Orientation Log (O-Log) and Cog-Log were administered during morning rounds, and a battery of neuropsychological tests was administered at 1 year postinjury. Setting: Acute rehabilitation hospital. Participants: Fifty rehabilitation inpatients. Main Outcome Measures: Composite scores for processing speed, attention, language, memory, executive functioning, and visuospatial abilities. Results: The Cog-Log was found to significantly predict 1-year outcome in attention, executive functioning, and visuospatial abilities. The O-Log contributed significantly to memory outcome. The Disability Rating Scale was not a significant predictor. Conclusions: The Cog-Log has utility as a predictor of neuropsychological outcome, particularly when used with its companion instrument, the O-Log. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The semantic and episodic subcomponents of famous person knowledge: Dissociation in healthy subjects.

Fifty-two subjects between ages 40 and 79 years were administered a questionnaire assessing their ability to recall semantic information about famous people from 4 different decades and to recollect its episodic source of acquisition together with autonoetic consciousness via the remember-know paradigm. In addition, they underwent a battery of standardized neuropsychological tests to assess episodic and semantic memory and executive functions. The analyses of age reveal differences for the episodic source score but no differences between age groups for the semantic scores within each decade. Regardless of the age of people, the analyses also show that semantic memory subcomponents of the famous person test are highly associated with each other as well as with the source component. The recall of semantic information on the famous person test relies on participants' semantic abilities, whereas the recall of its episodic source depends on their executive functions. The present findings confirm the existence of an episodic-semantic distinction in knowledge about famous people. They provide further evidence that personal source and semantic information are at once distinct and highly interactive within the framework of remote memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of working memory in six- and seven-year-old children.

Using cognitive methods to fractionate functionally distinct aspects of short-term memory, a test battery was designed to tap the A. D. Baddeley and G. Hitch (1974) model of working memory. The battery was administered to 87 children aged 6 and 7 years; other standardized attainment measures were obtained for a subgroup of the children concurrently and 1 year later. Correlations between subtest scores indicated high construct validity for the central executive and phonological loop measures, although not for the visuospatial measures. Central executive scores shared unique associations with performance on the vocabulary, literacy, and arithmetic tests, whereas phonological loop scores shared specific associations with vocabulary knowledge only. The substantial internal and external validity of the test battery establishes its suitability for guiding detailed theoretical analyses of working memory function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quality of life: theory and methodology in rehabilitation

Validity studies of neuropsychological tests have typically examined individuals with neurological disorders. The present study was designed to investigate the construct validity of neuropsychological measures in patients with schizophrenia. We used Wechsler Adult Intelligence Scale Revised (WAIS-R) factor scores that were generated from the population of interest as marker variables in the present analysis. The current study included 39 patients with schizophrenia who were evaluated with a battery of neuropsychological tests assessing attention, memory, and abstract reasoning abilities. Pearson correlations indicated significant relationships between (a) WAIS-R Verbal Comprehension factor and tests of sustained attention, verbal memory and remote memory; (b) WAIS-R Perceptual Organization factor and tests of visual memory and abstraction and problem solving; and (c) WAIS-R Freedom From Distractibility factor and neuropsychological measures of attention and concentration. These results provide support for the construct validity of the neuropsychological tests in patients with schizophrenia, and indicate that these tests evaluate essentially the same constructs in patients with schizophrenia as they do for patients with structural neurological disorders.     

Are there sex differences in neuropsychological functions among patients with schizophrenia?

OBJECTIVE: Studies of sex differences in neuropsychological performance in schizophrenia report inconsistent results, due in part to methodological artifacts. The study presented here was specifically designed to examine sex differences in neuropsychological performance. It was hypothesized that schizophrenic women would exhibit fewer neuropsychological deficits than schizophrenic men and that their performance would be more similar to that of normal women than schizophrenic men's performance would be to that of normal men. METHOD: Thirty-one outpatients with DSM-III-R-defined schizophrenia were systematically sampled from an extensive service network serving a large urban catchment area for seriously mentally ill persons. Twenty-seven normal comparison subjects were matched within sex on the basis of age, parental socioeconomic status, ethnicity, and handedness. An extensive neuropsychological test battery was administered, and multivariate analysis of variance was used to test for the effects of sex and group and sex-by-group interactions. RESULTS: Male patients were significantly impaired across all functions in comparison with normal male subjects and on tests of attention, verbal memory, and executive functions in comparison with female patients. Female patients performed significantly worse than female normal comparison subjects only on tests of attention, executive functions, visual memory, and motor functions. CONCLUSIONS: The findings suggest that women with schizophrenia may be less vulnerable to particular cognitive deficits, especially those involving verbal processing, than schizophrenic men.     

Neuropsychological findings from older premutation carrier males and their noncarrier siblings from families with fragile X syndrome.

Objective: Carriers of the FMR1 premutation allele are at a significantly increased risk for a late-onset neurodegenerative disorder, fragile X-associated tremor/ataxia syndrome (FXTAS). The primary features of FXTAS are late-onset intention tremor and gait ataxia. Previous reports have shown global deficits in neuropsychological measures among males with FXTAS, particularly those related to executive functioning. The purpose of this study was to investigate the neuropsychological profile among older males with the premutation who are at risk for FXTAS. Method: Premutation carriers, 66 with motor symptoms and 23 without, and 18 noncarrier siblings were recruited from pedigrees diagnosed with fragile X syndrome, all over age 50. Subjects were examined with a neurological test battery to identify symptoms of FXTAS and a neuropsychological test battery to investigate cognitive and behavioral profiles. Linear regression and ANCOVA were used to determine the effect of the premutation on outcome measures adjusting for age and education. Results: We identified a significant decrease in scores of general intelligence and a marginally significant decrease in scores of logical memory among premutation carrier males with motor symptoms compared to the noncarrier male siblings. We did not identify deficits in executive functioning in our sample of premutation carrier males with motor symptoms. Conclusions: Similar to other reports, we found that the FMR1 premutation is associated with deficits in general intelligence and memory among older males with symptoms of FXTAS. However, our results differed in that we found no evidence of premutation-associated executive dysfunction. We provide possible explanations for this difference. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Construct validity of WAIS—R factors: Neuropsychological test correlates in adults referred for evaluation of possible head injury.

A 3-factor solution of the Wechsler Adult Intelligence Scale—Revised (WAIS—R; Wechsler, 1981) in 260 adults with suspected head injury suggested relatively good construct validity for the factors, based on correlations with neuropsychological tests purported to measure similar abilities. The Verbal Comprehension factor was related to verbal ability, verbal memory, and executive functioning. The Perceptual Organization factor, although measuring primarily visual–spatial perception and visual constructional ability, was related to visual–spatial memory, visual attention, and executive functioning. The Freedom From Distractibility factor was correlated with two attention measures and was not associated with memory measures. Its association with executive functioning was inconsistent. The findings are discussed in terms of the multidimensional nature of neuropsychological tests and WAIS—R factors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Measurement invariance of neuropsychological tests in diverse older persons.

Objective: Comparability of meaning of neuropsychological test results across ethnic, linguistic, and cultural groups is important for clinicians challenged with assessing increasing numbers of older ethnic minorities. We examined the dimensional structure of a neuropsychological test battery in linguistically and demographically diverse older adults. Method: The Spanish and English Neuropsychological Assessment Scales (SENAS), developed to provide psychometrically sound measures of cognition for multiethnic and multilingual applications, was administered to a community dwelling sample of 760 Whites, 443 African Americans, 451 English-speaking Hispanics, and 882 Spanish-speaking Hispanics. Cognitive function spanned a broad range from normal to mildly impaired to demented. Multiple group confirmatory factor analysis was used to examine equivalence of the dimensional structure for the SENAS across the groups defined by language and ethnicity. Results: Covariance among 16 SENAS tests was best explained by five cognitive dimensions corresponding to episodic memory, semantic memory/language, spatial ability, attention/working memory, and verbal fluency. Multiple Group confirmatory factor analysis supported a common dimensional structure in the diverse groups. Measures of episodic memory showed the most compelling evidence of measurement equivalence across groups. Measurement equivalence was observed for most but not all measures of semantic memory/language and spatial ability. Measures of attention/working memory defined a common dimension in the different groups, but results suggest that scores are not strictly comparable across groups. Conclusions: These results support the applicability of the SENAS for use with multiethnic and bilingual older adults, and more broadly, provide evidence of similar dimensions of cognition in the groups represented in the study. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Hearing loss and cognition in the Baltimore Longitudinal Study of Aging.

Objective: To determine the relationship between hearing loss and cognitive function as assessed with a standardized neurocognitive battery. We hypothesized a priori that greater hearing loss is associated with lower cognitive test scores on tests of memory and executive function. Method: A cross-sectional cohort of 347 participants ≥55 years in the Baltimore Longitudinal Study of Aging without mild cognitive impairment or dementia had audiometric and cognitive testing performed in 1990–1994. Hearing loss was defined by an average of hearing thresholds at 0.5, 1, 2, and 4 kHz in the better-hearing ear. Cognitive testing consisted of a standardized neurocognitive battery incorporating tests of mental status, memory, executive function, processing speed, and verbal function. Regression models were used to examine the association between hearing loss and cognition while adjusting for confounders. Results: Greater hearing loss was significantly associated with lower scores on measures of mental status (Mini-Mental State Exam), memory (Free Recall), and executive function (Stroop Mixed, Trail Making B). These results were robust to analyses accounting for potential confounders, nonlinear effects of age, and exclusion of individuals with severe hearing loss. The reduction in cognitive performance associated with a 25 dB hearing loss was equivalent to the reduction associated with an age difference of 6.8 years. Conclusion: Hearing loss is independently associated with lower scores on tests of memory and executive function. Further research examining the longitudinal association of hearing loss with cognitive functioning is needed to confirm these cross-sectional findings. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cognitive impairment in adolescents with schizophrenia

OBJECTIVE: The purpose of this study was to determine whether adolescent schizophrenia is characterized by neuropsychological deficits. METHOD: The performance on a battery of neuropsychological tests of 17 adolescents with schizophrenia (mean age = 15.71 years) was compared with that of 17 normal adolescents (mean age = 15.12 years). RESULTS: Compared with the normal subjects, the patients were impaired on 10 of the 13 measures; larger effect sizes were shown for measures involving working memory and attention than for those involving secondary memory, generative naming, and executive functions. CONCLUSIONS: Adolescents with schizophrenia have generalized cognitive dysfunction, which is most apparent on tests of attention and working memory.     

Is There Anything Special About the Aging of Source Memory?

A battery of cognitive tests designed to measure the constructs of episodic memory, perceptual speed, fluid ability, executive functioning, and vocabulary was administered to 330 adults between the ages of 18 and 89. Each participant also performed 4 different tasks designed to assess source memory. Structural equation modeling was used to evaluate the validity of a source-memory construct and to explore the relation of the source-memory construct to age and to the other cognitive variables. The variance common to the source-memory variables was strongly related to other cognitive abilities, suggesting that source memory may not have discriminant validity, and there were only small unique age-related effects on the source-memory construct after the influence of other abilities was considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Variation in blood pressure is associated with white matter microstructure but not cognition in African Americans.

Although hypertension is a major risk factor for cerebrovascular disease (CVD) and is highly prevalent in African Americans, little is known about how blood pressure (BP) affects brain–behavior relationships in this population. In predominantly Caucasian populations, high BP is associated with alterations in frontal–subcortical white matter and in executive functioning aspects of cognition. We investigated associations among BP, brain structure, and neuropsychological functioning in 52 middle–older-age African Americans without diagnosed history of CVD. All participants underwent diffusion tensor imaging for examination of white matter integrity, indexed by fractional anisotropy (FA). Three regions of interest were derived in the anterior (genu) and posterior (splenium) corpus callosum and across the whole brain. A brief neuropsychological battery was administered from which composite scores of executive function and memory were derived. Blood pressure was characterized by mean arterial blood pressure (MABP). When controlling for age, higher MABP was associated with lower FA in the genu, and there was a trend for this same relationship with regard to whole-brain FA. When the sample was broken into groups on the basis of treatment for BP regulation (medicated vs. nonmedicated), MABP was related to genu and whole-brain FA only in the nonmedicated group. Neither MABP nor FA was significantly related to either neuropsychological composite score regardless of medication use. These data provide important evidence that variation in BP may contribute to significant alterations in specific neural regions of white matter in nonmedicated individuals without symptoms of overt CVD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A study of performance on tests from the CANTAB battery sensitive to frontal lobe dysfunction in a large sample of normal volunteers: implications for theories of executive functioning and cognitive aging. Cambridge Neuropsychological Test Automated Battery

Several tests from the CANTAB neuropsychological test battery previously shown to be sensitive to frontal lobe dysfunction were administered to a large group of normal volunteers (N = 341) ranging in age from 21 to 79 years. The main tests included a computerized form of the Tower of London test of planning, a self-ordered spatial working memory task, and a test of attentional set formation and shifting. A computerized form of the Corsi spatial span task was also given. Age-related graded declines in performance were seen, sometimes in a discontinuous manner, especially for the attentional set shifting task (at the extradimensional shift stage). Patterns of deficits reminiscent of frontal lobe or basal ganglia damage were observed in the oldest age group (74-79). However, overall the data were only partially consistent with the hypothesis that frontal lobe functions are the most sensitive to effects of aging. Factor analyses showed that performance in the executive tests was not simply related to a measure of fluid intelligence, and their performance had a factor loading structure distinct from that for the CANTAB tests of visual memory and learning previously administered to the same sample. Finally, only limited support was found for the hypothesis that cognitive aging depends on slowed information processing.     

Neuropsychological mediators of the links among age, chronic illness, and everyday problem solving.

Reductions in everyday problem solving (EPS) are often reported in older age, although the underlying mechanisms remain unclear. The authors examined the role of 2 variables predicted to mediate (neuropsychological abilities and health status) or moderate (health status) the relationship between age and EPS performance. Toward these ends, they compared EPS and neuropsychological performance in 50 functionally independent adults with chronic kidney disease (CKD) and 64 control participants matched on age and education. Both older age and CKD were associated with worse performance on measures of EPS and memory/executive abilities. Neuropsychological abilities were positively associated with EPS performance. In both the full sample and control participants only, memory/executive functioning mediated the association between presence of chronic illness and EPS. Furthermore, memory/executive functioning partially mediated the link between age and EPS. Findings indicate that relations among age, health status, and EPS are not straightforward. Although performance on neuropsychological measures appeared to underlie EPS declines in chronic illness, increasing age remained independently associated with reduced EPS. The authors discuss implications for models of adult developmental changes in everyday cognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive function and MRI prefrontal volumes among healthy older adults.

Brain atrophy and decline in executive functioning have been reported during late life, but the relationship between the 2 phenomena is not clear. To examine associations between executive tasks and morphometry, MRIs of the prefrontal cortex from 23 healthy elders were manually masked and automatically segmented. Total brain matter of the bilateral orbitofrontal, anterior cingulate, gyrus rectus, precentral gyrus, and middle frontal gyrus were computed as ratios of intracranial volume. A neuropsychological battery of five clinical tests of executive function was administered. Better performance on a response inhibition task was associated with larger volume in anterior cingulate, and performance on a nonverbal inductive reasoning task was associated with larger gyrus rectus volumes. In contrast, larger orbitofrontal volumes were associated with lower verbal and nonverbal generative output. An aggregated error index from 4 executive tests correlated negatively with a regional composite brain index. In conclusion, some executive abilities correlate with volumes of specific prefrontal subregions despite a robust neural interconnectedness between the subregions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selectivity of executive function deficits in mild cognitive impairment.

Impairment in executive cognition (EC) is now recognized as relatively common among older persons with mild cognitive impairment (MCI) and may be predictive of the development of dementia. However, both MCI and executive functioning are broad and heterogeneous constructs. The present study sought to determine whether impairments in specific domains of EC are associated with specific subtypes of MCI. MCI patients (n = 124) were divided into 4 subgroups (amnestic vs. nonamnestic, and single- vs. multiple-domain) on the basis of their performance of widely used neuropsychological screening tests. These patients and 68 normal older persons were administered 18 clinical and experimental tests of executive function. Principal components analysis suggested 2 highly reliable EC components, planning/problem solving and working memory, and a less reliable 3rd component, judgment. Planning/problem solving and working memory, but not judgment, were impaired among the MCI patients. This was true even among those with “pure amnestic” MCI, the least impaired group overall. Multiple-domain MCI patients had more severe impairments in planning/problem solving and working memory than single-domain patients, leading to the supposition that they, not pure amnestic MCIs, are at highest risk of imminent dementia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Construct validity of WAIS—R factors: Neuropsychological test correlates in adults referred for evaluation of possible head injury": Erratum.

Reports an error in the original article by E. M. S. Sherman et al (Psychological Assessment, 1995[Dec], Vol 7[4], 440–444. On page 444, line 36 of the reference list incorrectly reads, "Reitan, R. M., & Davidson, L. A.' The correct spelling is Davison. (The following abstract of this article originally appeared in record 1996-10111-001.) A 3-factor solution of the Wechsler Adult Intelligence Scale—Revised (WAIS—R; Wechsler, 1981) in 260 adults with suspected head injury suggested relatively good construct validity for the factors, based on correlations with neuropsychological tests purported to measure similar abilities. The Verbal Comprehension factor was related to verbal ability, verbal memory, and executive functioning. The Perceptual Organization factor, although measuring primarily visual-spatial perception and visual construction ability, was related to visual-spatial memory, visual attention, and executive functioning. The Freedom From Distractibility factor was correlated with two attention measures and was not associated with memory measures. Its association with executive functioning was inconsistent. The findings are discussed in terms of the multidimensional nature of neuropsychological tests and WAIS—R factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Estimating the percentage of the population with abnormally low scores (or abnormally large score differences) on standardized neuropsychological test batteries: A generic method with applications.

Information on the rarity or abnormality of an individual's test scores (or test score differences) is fundamental in interpreting the results of a neuropsychological assessment. If a standardized battery of tests is administered, the question arises as to what percentage of the healthy population would be expected to exhibit one or more abnormally low test scores (and, in general, j or more abnormally low scores). Similar issues arise when the concern is with the number of abnormal pairwise differences between an individual's scores on the battery, or when an individual's scores on each component of the battery are compared with the individual's mean score. A generic Monte Carlo simulation method for tackling such problems is described (it requires only that the matrix of correlations between tests be available) and is contrasted with the use of binomial probabilities. The method is then applied to Index scores for the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III; D. Wechsler, 1997) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV; D. Wechsler, 2003). Three computer programs that implement the methods are made available. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Explicit and implicit memory in the elderly: Evidence for double dissociation involving medial temporal- and frontal-lobe functions.

Groups of normal old people living in institutions or in the community and young adults were administered tests of implicit (IM) and explicit (EM) memory with word-stem (WSC) and word-fragment (WFC) completion paradigms. Neuropsychological tests sensitive to frontal and medial temporal lobe function were also administered. Age differences were observed on both tests of EM and on all neuropsychological tests. Priming effects on WSC were smaller in the institutionalized group than the other 2 groups. Comparisons of EM and IM test results with neuropsychological test scores revealed several effects, including significant correlations (a) between EM scores on both tests and performance on standard memory tests in both aged groups and (b) between IM scores of both aged groups on WSC and frontal-lobe test performance. The results provide evidence of a double dissociation with respect to involvement of brain regions in EM and IM. They also indicate that repetition priming in WSC and WFC involve different mechanisms and that frontal-lobe dysfunction is a factor in reduced priming on the WSC test. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mammoplasty for symmetry of the contralateral breast and its oncologic value]

Although a broad range of neuropsychological deficits has been reported in patients with severe sleep disordered breathing (SDB), little is known about the impact of mild SDB on neuropsychological performance. In this study, we compared neuropsychological test performance in two groups of carefully screened volunteers who differed clearly according to the respiratory disturbance index (RDI). Controls (n = 20) were identified on the basis of an RDI < 5; cases (n = 32) had an RDI in the range of 10-30. Cases and controls were well matched with regard to IQ, age, and sex. Cases had significantly more self-reported snorting and apneas and a higher body mass index than controls but did not differ according to sleepiness as measured by either the multiple sleep latency test or the Epworth sleepiness scale. An extensive battery of neuropsychological and performance tests was administered after an overnight sleep study. Cases performed significantly more poorly on a visual vigilance task (perceptual sensitivity, d': 2.24 +/- 0.64 vs. 2.70 +/- 0.53, p = 0.01, for cases and controls, respectively) and a test of working memory, the Wechsler adult intelligence scale-revised digits backwards test (6.12 +/- 2.20 vs. 7.55 +/- 2.22, p = 0.02), than controls. The groups did not differ in their performance on other tests of memory, information processing, and executive functioning. In summary, subjects with mild SDB may manifest a vigilance deficit in the absence of substantial sleepiness. Subjects with a mildly elevated RDI (10-30) without sleepiness do not appear to suffer appreciable deficits in more complex neuropsychological processes (e.g. executive functions).