Normative data for the dementia rating scale in the french-Quebec population

The Dementia Rating Scale-2 is used to measure cognitive status of adults with cognitive impairment, especially of the degenerative type, by assessing five cognitive functions, namely attention, initiation/perseveration, construction, conceptualization, and memory. The present study aimed to establish normative data for this test in the elderly French-Quebec population. A total of 432 French-speaking elders from the province of Quebec (Canada), aged 50 to 85 years, were administered the Dementia Rating Scale-2. Age and education were found to be associated with the total score on the test, while gender was not. Percentile ranks were then calculated for age- and education-stratified groups. Previous studies have shown that cultural background can affect performance on the DRS and the development of culture-specific norms for French-speaking Quebecers could be very useful to clinicians and researchers working with this population

Verbal Fluency Tasks: Influence of Age, Gender, and Education and Normative Data for the Spanish Native Adult Population.

Objective: Phonological and semantic verbal fluency (VF) tasks are frequently used to assess language and executive functions in both clinical and research settings. F, A, and S are the most commonly used letters in phonological tasks across languages and cultures. Unfortunately, the lack of norms for the native Spanish population for these letters, and for certain semantic categories such as “proper names,” may lead to misinterpretation of scores due to demographic differences. The aim of the present study was to provide normative data for F, A, and S and for “proper names,” “animals,” and “fruits and vegetables” for the native Spanish population. Method: 257 healthy subjects took part in the study (ages: 17–100 years, 3–20 years of education). Correlation, multiple regression, and t-tests were used to select the most appropriate variables for stratification. Results: Education was the best predictor of performance in all tasks, followed by age. Given that t-test results showed no differences related to gender, with the only exception of the semantic category “animals,” this variable was not considered for stratification. Consequently, the data were stratified in two education levels (<13, ≥13 years of education) and in two age levels (<60, ≥60) within the low-educational level group. Mean, standard deviation, and percentile scores for each group are provided. Conclusions: The present norms provide a reference for clinicians assessing VF. This data may also facilitate comparisons with other normative studies in cross-cultural and cross-linguistic research.pre-print369 K

Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale

Introduction: Neurobehavioural disability (NBD) after acquired brain injury (ABI) is often associated with poor outcome. The “St Andrew's-Swansea Neurobehavioural Outcome Scale” (SASNOS) was developed to measure NBD in a range of applications. Two of the “holy trinity” of psychometric properties, reliability and validity, have been comprehensively mapped, but the extent to which SASNOS meets the third, responsiveness, has not been investigated. Demonstrating responsiveness is essential in instruments employed in repeated measurement scenarios to confirm their ability to discriminate real change from error. However, there is no single agreed method for determining responsiveness. For some instruments, this property remains unexplored. A difference in scores attaining statistical significance for aggregate data is frequently cited as support for this construct, but this approach remains heavily criticized. This study explores responsiveness of SASNOS.Method: Consecutive SASNOS assessments completed over varying times for 145 individuals participating in neurobehavioural rehabilitation, drawn from multiple services, were compiled into a retrospective sample of convenience. Multiple methods were employed to confirm internal responsiveness, including those identifying statistically significant change, minimally detectable change and minimally important change.Results: All methods confirmed responsiveness as a psychometric property of SASNOS; the extent depended on method used and NBD domain investigated. A number of indicators are presented, which equip clinicians and researchers with options to interpret results from repeated assessments, including the individual level in the context of rehabilitation.Conclusions: SASNOS reliably measures change over time in NBD symptoms, further confirming its suitability as an instrument for investigating multidimensional outcomes of ABI

Étude de normalisation du Color Trails Test auprès d'une population adulte saine, franco-québécoise et âgée de 50 ans ou plus

Les résultats aux tests neuropsychologiques doivent être interprétés en fonction de normes adéquates représentant un groupe de personnes saines ayant des caractéristiques démographiques relativement homogènes. Sans l'existence de normes pour un test donné, l'interprétation des scores obtenus s'avère assez difficile. Il existe une influence non négligeable des facteurs sociodémographiques et de la culture sur la performance des sujets aux tests. En effet, les études ont rapporté un biais culturel pouvant être objectivé par des différences de performance (temps de complétion d'une tâche) selon les ethnies et cultures. Ce mémoire doctoral a comme objectif principal de produire un standard normatif pour le test neuropsychologique Color Trails Test (CTT) chez une population de franco-québécois cognitivement sains de 50 ans et plus. Cette étude permet de mettre en lumière une association entre l'âge et le temps de complétion au CTT temps de complétion 1 (CTT1) et CTT temps de complétion 2 (CTT2) ainsi qu'avec certains scores d'erreur et l'index d'interférence. L'incidence négative de l'âge est conforme aux résultats d'études antérieures. Par ailleurs, l'âge explique une plus grande proportion de la variabilité des performances dans la portion CTT2 que dans la portion CTT1 du test. Ces différences sont interprétées en relation avec le fait que CTT2 est plus exigeant en termes de capacités attentionnelles et exécutives. De plus, les résultats indiquent une association marginalement significative avec l'éducation au CTT1, mais pas au CTT2. Finalement, aucune association n'est relevée entre le CTT1 ou CTT2 et le sexe. Compte tenu de la nécessité de tests standardisés dans le travail du neuropsychologue, ainsi que de l'applicabilité transculturelle potentielle du CTT, il est envisagé que la normalisation de cet outil sera utile aux cliniciens et chercheurs québécois. La normalisation du CTT permettra donc d'obtenir des évaluations et des interprétations plus précises des résultats au test chez les adultes et personnes âgées franco-québécoises. Dans l'ensemble, cette recherche compense l'absence de données normatives pour le CTT auprès d'une population adulte et âgée franco-québécoise.Neuropsychological test results should be interpreted against appropriate standards representing a group of healthy people with similar demographic characteristics. Without the existence of standards for a given test, interpreting cognitive scores is quite difficult. There is also a significant influence of socio-demographic factors and culture on the neuropsychological tests' performance. Indeed, studies have reported a cultural bias that can be objectified by differences in performance (completion time) according to ethnic groups and cultures. The main objective of this doctoral work was to provide a normative standard for the neuropsychological Color Trails Test (CTT) in a population of cognitively healthy French-Quebecers aged 50 and over. This study revealed an association between age and completion time at CTT completion time 1 (CCT1) and CTT completion time 2 (CTT2) as well as with certain error partitions and the interference index. The impact of age on cognitive tests is consistent with the results of previous studies. Also, age explained a greater proportion of performance variance in CTT2 than in CTT1. These differences could be interpreted in relation to the fact that the CTT1 is less demanding at the cognitive level and that the CTT2 is more demanding in terms of attentional and executive capacities. In addition, the results indicate a marginally significant association with education at CTT1, but not with CTT2. Finally, no association was found between CTT1 or CTT2 and sex. Given the need for standardized normalized tests, as well as the potential cross-cultural applicability of CTT, it is envisioned that the normalization of this tool will be useful to Quebec clinicians and researchers. The present findings will make it possible to obtain more precise evaluations and interpretations of CTT test results among adults and elderly people in Quebec. In sum, this research compensates for the lack of normative data for the CTT in the adult and elderly population in Quebec

Using robust normative data to investigate the neuropsychology of cognitive aging

Objective: The extent to which increasing age is associated with impairment in cognitive function, termed cognitive aging, may have been overestimated in prior studies. The inclusion of individuals with severe or uncontrolled systemic medical illness or prodromal neurodegenerative disease in normal aging samples is likely to bias estimates toward lower cognitive performance and inflate estimates of variability. Method: Unbiased estimates of cognitive aging in 658 adults aged 60-84, who underwent rigorous screening to ensure their general and cognitive health, were computed. The first study screened the psychometric properties of a battery of neuropsychological tests in order to identify those with optimal properties to evaluate cognitive aging. The second study used the selected tests to compare baseline performance within 5-year age bands from 60 to 84. Results: The first study identified a battery of 12 tests that provided reliable measures of memory, psychomotor speed, attention, and executive function and were appropriate for investigating age-related cognitive changes. The second study observed moderate to large age-related impairment for performance on tests of complex psychomotor function, category fluency, verbal learning, and verbal and visual memory. No, or only small, age effects were observed for working memory, phonemic fluency, learning of visual information, and reaction time. Conclusions: These data suggested that while increasing age is associated with impairment in cognitive function, this impairment is less severe and is evident only on more complex neuropsychological tests than estimated previously in samples selected using less rigorous criteria to ensure cognitive health. Keywords: Assessment; Elderly/geriatrics/aging; Executive functions; Fluency (verbal/nonverbal); Learning and memory; Norms/normative studies