Computerized test‐retest of the Wisconsin Card Sorting Test in day‐to‐day consecutive performances in Mild Cognitive Impairment

Abstract

AbstractBackgroundWe examined executive functions by testing cognitive flexibility, problem solving and response maintenance by means of the Wisconsin Card Sorting Test (WCST) on two consecutive days. This could render the performance gains obtained in the second assessment in Mild Cognitive Impaired (MCI) subjects, in contrast to a preserved cognitive function group (Control, CTRL group).Method17 older adults were evaluated with several tests (Fig. 1) and with the Neuropsi battery to classify them in two groups: those with three standard deviations below the mean in at least one of the cognitive functions (MCI group, n = 7) and those without this characteristic (n = 10) (Fig. 2). The WCST was delivered twice in a day‐to‐day assessment (1 subject did not repeat his session). A computerized version of the WCST was programmed using e‐prime software, v. 1, at the same time of day. The first three categories were randomly selected, and the categories were then repeated. A special keypad was designed, which included four keys for each card option. Written feedback on the screen was provided immediately.ResultANOVAs results did not show significant differences; nevertheless, the % of correct responses was almost significant within sessions in both groups (p < 0.07) and categories also showed a tendency towards significance between groups in the first session (p < 0.06) (Figs. 3, 4 & 5). Different subgroups emerged: from the first to the second session, one subgroup increased their frequency of categories (CTRL group: 50%; MCI group: 16.66%; chi2 = 16.6; df = 1, p < 0.0001); one subgroup lacked flexibility and remained the same (CTRL group: 30%; MCI group: 66.66%; chi2 = 13; df = 1, p < 0.0001), and one subgroup decreased the number of categories (CTRL group: 20%; MCI group: 16.66%; chi2 = 0.30; df = 1, p = 0.581).ConclusionIn this study, the percentage of correct responses, and the number of categories achieved may provide a more flexible profile of the execution abilities in older adults, which could be more informative for the detection of groups and so, of transitional stages from normality to cognitive impairment.