Prevalence Of Low Scores Research Articles

Brief iPad-Based Assessment of Cognitive Functioning with ImPACT® Quick Test: Prevalence of Low Scores Using Multivariate Base Rates.

The ImPACT® Quick Test is a brief iPad-based battery of neurocognitive tests that has been standardized on a sample of children, adolescents, and adults (ages 12-70). This study provides information on the prevalence of ImPACT® Quick Test scores falling below specific percentiles in the normative sample to aid in clinical interpretation and reduce the risk of over-interpreting, or misinterpreting, a single low score. Participants were 683 individuals ranging in age from 12 to 70, who were assessed individually. The ImPACT® Quick Test includes five subtests, contributing to three factor scores: motor speed, memory, and attention tracker. The prevalence of low factor scores, stratified by age and sex, were calculated using multivariate base rates. In the total sample, obtaining 1 or more scores below the 25th percentile was common (base rate, BR=47.2%), but obtaining 2 or more scores in this range was uncommon (BR=15.3%). Similarly, obtaining 1 or more scores below the 16th percentile was common (BR=31.4%), but obtaining two or more scores in this range was uncommon (BR=6.9%). There were small differences in BRs between sexes and the number of low scores was fairly similar across the age groups. Results from this study parallel previous work illustrating that a substantial percentage of healthy individuals will obtain one or more low test scores when administered a brief battery of cognitive tests. Given that some healthy individuals will obtain a single score below expected cut-offs, clinicians should caution against overinterpreting a single low test score.

The effect of bariatric surgery on female sexual function: a cross-sectional study

The generally negative impact of obesity on female sexuality is well-established. The possible association between bariatric surgery, weight loss, and female sexuality is much less described. The aim of the study was to analyse the possible association between bariatric surgery and female sexual function. It was a cross-sectional study of 623 patients who underwent bariatric surgery between 1999 and 2017. Patients were recruited on the basis of medical records from the Military Institute of Medicine in Warsaw. Patients were invited to complete a questionnaire which consisted of self-designed demographic questions and Female Sexual Function Index (FSFI). The total FSFI score, as well as each subdomain, improved significantly after surgery. The prevalence of low score (< 26.55) was significantly lower after the surgery in comparison to the status prior to the procedure (36.3% vs. 57.5%; p < .001). There were no differences regarding the number of sexually active patients before and after the surgery (75.3% vs. 76.1%; p < .63). There were observed statistically significant, positive correlations between BMI decrease and each subdomain of the FSFI score as well as the total score. Weight loss surgery seems to decrease the risk of sexual dysfunction presence and the advantages are associated with the total BMI loss.

Prevalence of low scores on language tests as a potential factor in misdiagnosis of cognitive impairment in a Spanish-speaking adult population

Objective In this study, the prevalence of low scores for two neuropsychological tests of language has been determined. Methods In total, N = 5218 healthy adults from 11 countries in Latin America (LA) were administered the Boston Naming Test (BNT) and the Verbal Fluency Test (VFT) as part of a comprehensive neuropsychological evaluation. Z-scores were calculated for BNT Total score, and phonological (letters F, A, S, M) and semantic (Animals, Fruits). Scores were adjusted for age, age2, sex, education, and interaction variables if significant for the given country. Each Z-score was converted to a percentile for each of the seven test-scores. Each participant was categorized based on his/her number of low scoring tests in specific percentile cutoff groups (25th, 16th, 10th, 5th, and 2nd). Results Between 53% (Paraguay) and 71% (Mexico) of the sample had at least 1-score below the 25th percentile, and between 41% (Paraguay) and 55% (Cuba) scored below the 16th percentile. Between 27% (Paraguay) and 39% (Peru) scored below the 10th percentile on at least 1-score, and between 17% (Chile) and 23% (Argentina) scored below the 5th percentile. Conclusions Clinicians should use these data to reduce false-positive diagnoses and to improve the neuropsychological assessments in Spanish-speaking individuals from LA countries.

Multivariate base rates for the assessment of executive functioning among children and adolescents

ABSTRACTThis study provides observed base rates of low executive functioning test scores among healthy children and adolescents, stratifies those base rates by narrow intellectual functioning and age groupings, and provides normative classification ranges to aid the interpretation of performances on the Delis-Kaplan Executive Function System (D-KEFS) in clinical practice and research. Participants included 875 children and adolescents between 8 and 19 years old from the D-KEFS normative sample (48% male; 52% female). Among these participants, 838 had complete data and were included in the current study. The racial/ethnic composition of the sample was: White (73.7%), African American (12.4%), Hispanic (11.1%), and other racial/ethnic backgrounds (2.7%). The Overall Test Battery Mean (OTBM) and the prevalence of low scores at various clinical cut-offs were calculated for the 13 primary scores from the D-KEFS Trail Making Test, Verbal Fluency Test, and Color-Word Interference Test. The OTBM and base rates were also calculated separately for those scores reflecting executive functioning (n = 7) and processing speed (n = 6). Healthy children and adolescents commonly obtained low scores on the D-KEFS tests considered here. Younger age, lower estimated full-scale intelligence quotient, and more test scores interpreted were associated with a greater frequency of low scores. Clinicians and researchers are encouraged to consider these multivariate base rates when assessing and attempting to identify executive functioning impairment among children and adolescents with the D-KEFS.

Brief iPad-Based Assessment of Cognitive Functioning with ImPACT® Pediatric

ABSTRACTImPACT® Pediatric is an examiner-administered iOS-based battery of neuropsychological tests designed to measure neurocognitive functioning in children ages 5–11. This study documented Multivariate Base Rates (prevalence of low scores when multiple test scores are considered simultaneously) in the ImPACT® Pediatric standardization sample (N = 892). In the total sample, it was common for children to obtain at least one low factor score using the 25th percentile [T 43; base rate (BR) = 54.2%], 16th percentile (T40, BR = 38.1%), and the 10th percentile (T37, BR = 31.1%). However, it was uncommon for children to obtain two (or more) low factor scores using any of the above-listed cutoff score.

The RAPID Neuropsychological Test Battery for Subjects Aged 50–89: From Norms to Cognitive Profile

Background/Aims: It is well established that healthy adults obtain low performances when simultaneously interpreting the results of multiple tests. The aim of this study was to estimate the proportion of French-speaking healthy older adults with low scores for the RAPID (Réseau d’Aide au diagnostic et à la PrIse en charge des Détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et au niveau national) battery test and consider different combinations of test scores within a specific domain and across different domains. Methods: The prevalence of low scores (i.e., ≤5th percentile) on the 14 RAPID primary measures was calculated from the RAPID normative sample (n = 476), based on 4 ages (50–89 years) and 3 levels of education. Results: A high percentage (40.1%) of the normative sample obtained at least one or more low scores (i.e., false positives). In contrast, the risk of having low scores was much less important (<2%) when considering the combinations of 2 test-scores. Conclusion: Low scores are very common in healthy older subjects and are thus not necessarily pathological or indicative of truly impaired functioning. The information derived from a cognitive profile may provide a greater clinical relevance in an individual, since very few of the healthy older adults obtained low scores on combinations of 2 test-scores.

Considering the base rates of low performance in cognitively healthy older adults improves the accuracy to identify neurocognitive impairment with the Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological Assessment Battery (CERAD-NAB).

It is common for some healthy older adults to obtain low test scores when a battery of neuropsychological tests is administered, which increases the risk of the clinician misdiagnosing cognitive impairment. Thus, base rates of healthy individuals’ low scores are required to more accurately interpret neuropsychological results. At present, this information is not available for the German version of the Consortium to Establish a Registry for Alzheimer’s Disease-Neuropsychological Assessment Battery (CERAD-NAB), a frequently used battery in the USA and in German-speaking Europe. This study aimed to determine the base rates of low scores for the CERAD-NAB and to tabulate a summary figure of cut-off scores and numbers of low scores to aid in clinical decision making. The base rates of low scores on the ten German CERAD-NAB subscores were calculated from the German CERAD-NAB normative sample (N = 1,081) using six different cut-off scores (i.e., 1st, 2.5th, 7th, 10th, 16th, and 25th percentile). Results indicate that high percentages of one or more “abnormal” scores were obtained, irrespective of the cut-off criterion. For example, 60.6 % of the normative sample obtained one or more scores at or below the 10th percentile. These findings illustrate the importance of considering the prevalence of low scores in healthy individuals. The summary figure of CERAD-NAB base rates is an important supplement for test interpretation and can be used to improve the diagnostic accuracy of neurocognitive disorders. Electronic supplementary materialThe online version of this article (doi:10.1007/s00406-014-0571-z) contains supplementary material, which is available to authorized users.

Prevalence of Low Scores in Children and Adolescents on the Test of Verbal Conceptualization and Fluency

It is important to consider the prevalence of low scores when administering a battery of psychological tests. Understanding the prevalence of low scores is important for minimizing false-positive diagnoses of cognitive deficits in clinical practice. The purpose of this study was to expand the literature on base rates for use in children and adolescents. Participants were 408 healthy children and adolescents (Mage = 13.1 years, SD = 3.7) and 139 children and adolescents (Mage = 12.4 years, SD = 3.1) diagnosed with a medical, neurological, or learning condition. All participants were administered the Test of Verbal Conceptualization and Fluency (TVCF; Reynolds & Horton, 2006). The clinical sample performed significantly lower compared with the healthy control participants on three of the five TVCF scores. When all scores were considered simultaneously, 38% of healthy children obtained one or more scores below the 16th percentile and 15% had one or more scores in the 5th percentile or lower. By comparison, significantly higher proportions of children in the clinical sample had low scores below each of the five cutoffs (i.e., 63% had one or more test scores below the 16th percentile and 37% had one or more scores in the 5th percentile or lower). Our findings illustrate the importance of considering the prevalence of low TVCF scores in everyday clinical practice with children and adolescents.

P2‐273: Can memory profiling predict progression to Alzheimer's disease in amnestic mild cognitive impairment?

12, 8.5% with 13-15, and 10.2% with 16+ years. Using normative data adjusted for age, education, sex, and ethnicity reduces, but does not eliminate, the prevalence of low scores in adults with below average intelligence.Conclusions: Current guidelines and recommendations for MCI either do not explicitly define the psychometric criteria for defining memory impairment, or they recommend applying a cutoff score of 1.5 standard deviations below ageand education-adjusted normative data. False positive diagnoses in high functioning older adults, and false negative diagnoses in low functioning people, can be reduced by refining the psychometric criteria for MCI based on the number of tests administered and the level of intelligence of the patient.

Improving Test Interpretation for Detecting Executive Dysfunction in Adults and Older Adults: Prevalence of Low Scores on the Test of Verbal Conceptualization and Fluency

Knowing the prevalence of low scores on a battery of executive-functioning tests supplements clinical interpretation and can reduce the likelihood of misdiagnosing deficits in executive functioning. The purpose of this study is to examine the base rates of low scores on the Test of Verbal Conceptualization and Fluency (TVCF; Reynolds & Horton, 2006) in healthy adults (n = 332; M age = 33.0 years, SD = 10.5, range = 20–59) and older adults (n = 138; M age = 74.9 years, SD = 7.8, range = 60–89) from the TVCF standardization sample. The TVCF consists of four tests of executive functioning (i.e., Category Fluency, Letter Naming, Classification, and Trails C) that provide five age-adjusted T-scores. The prevalence of low scores was examined in the total sample and was stratified by educational level. When the five T-scores were considered simultaneously, having one or more scores that were 1 standard deviation (SD) below the mean was found in 28% of healthy adults and 38% of older adults. Education-based differences were also present with more lenient cutoff scores (e.g., 1 SD) but not with more conservative cutoffs. Consistent with the existing literature on other test batteries, at least one low subtest score on the TVCF is common in healthy adults and older adults.

Minimizing Misdiagnosis: Psychometric Criteria for Possible or Probable Memory Impairment

Background/Aims: Memory impairment can be easily misdiagnosed in older adults because obtaining some low scores is common. The objective of the present study is to present new psychometric criteria for determining ‘possible’ and ‘probable’ memory impairment. Methods: We propose criteria based on an analysis of performance from 450 healthy older adults (55–87 years old) on 3 measures from the WMS-III: Logical Memory, Word List, and Visual Reproduction. These measures yield 8 age-adjusted scores for learning, recall, and recognition. The proposed criteria for memory impairment are based on the prevalence of low scores when simultaneously examining all 8 scores and are stratified by current intelligence, estimated premorbid intelligence, and education. The criteria are subsequently validated on 100 healthy older adults and 34 patients with ‘possible’ or ‘probable’ Alzheimer’s Disease (AD). Results: Tables with cutoffs and false-positive rates are presented for clinical use. In the validation cohort there were no misclassifications in AD patients. Conclusion: This study presents steps in the development of proposed psychometric criteria that, in conjunction with clinical judgment, could minimize the misdiagnosis of memory impairment. It is important to reduce misdiagnosis in order to (a) optimize patient care, (b) provide an accurate foundation for identifying biological and neurological markers, and (c) successfully develop disease-modifying treatments. Further validation in a sample of older adults with lesser degrees of cognitive impairment is needed.

Depressive symptoms during late pregnancy and early parenthood following assisted reproductive technology

To evaluate the relationship between assisted reproduction technology (ART) and depressive symptoms during late pregnancy and early parenthood. Case-control longitudinal study. The Center of Reproductive Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. Women who conceived by ART compared with men and compared with women following spontaneous conceptions. The sample of 87 subjects, 48 ART (25 mothers, 23 fathers; response rate of 30%) and 39 non-ART mothers were evaluated by the Edinburgh Postnatal Depression Scale (EPDS) at 30-32 weeks of gestation, and at 1 week and 3 months after delivery. Mean scores and prevalence of low scores. The main sociodemographic and obstetric characteristics were similar between groups. Edinburgh Postnatal Depression Scale scores were higher in ART women compared with non-ART women during all assessments and higher during the third trimester of pregnancy and at 1 week postpartum compared with ART men. The prevalence of depressed subjects was significantly higher in ART women compared with non-ART women during the antenatal assessment. Assisted reproductive technology pregnancies are more frequently associated with depressive symptoms that may persist after delivery, suggesting a greater emotional vulnerability of these women. The risk of depression during and following ART pregnancies needs monitoring to avoid adverse effects of postpartum depression on the mother-infant relationship and infant's psychologic development.