Abstract

Abstract Objective The Hopkins Verbal Learning Test–Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) are memory tests with embedded measures of performance validity (Recognition Discrimination [RD] and Discrimination Index [DI], respectively). We evaluated whether cognitive ability and age influenced embedded measures of effort. Methods Participants included 30 young adults (YA) and 29 older adults (dichotomized into unimpaired [OAu] and impaired [OAi]). Participants completed a medication management ability assessment (MMAA), daily memory lapses survey (DM), digit span, and the Transverse Patterning (TP) and Reversal Learning (RL) computerized tests. Two Repeated-Measures MANOVAs were conducted to determine if Passing PVT and Age/Cognitive Ability influenced performance. An ROC analysis was conducted for HVLT-RD and BVMT-DI to determine pass/fail, and false positives/negatives on embedded measures. Results Those in the YA group who failed RDS (YA-fail), performed better than OAi-fail and OAi-pass groups on RT Errors (p < .0001). On TP Errors, the YA group differed from all four OA groups (p < .0001). On MMAA a significant difference was observed between OAi-fail and all other groups (p < .001). On RD, YA groups differed from both OAi groups (p = .0008). On DI, the YA groups differed from the OAi-fail group (p = .002). A logistic regression classified 43/57 participants successfully into the three cognitive groups using the six predictors (χ2 = 55.73, p < .0001, R2 = .468). RT Errors and TP were significant (Likelihood χ2 = 7.25, p = .027). Conclusion HVLT-RD failed to detect validity for OAi, as did BVMT-DI for YA and OAu. Instead, impairment effects are seen on HVLT-RD and BVMT-DI where YA groups differed from some combination of both/one of the OA groups.

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