Repeatable Battery For The Assessment Of Neuropsychological Status Total Scale Research Articles

Sex-Specific Association of Body Mass Index with Hippocampal Subfield Volume and Cognitive Function in Non-Demented Chinese Older Adults.

Recent research suggests a possible association between midlife obesity and an increased risk of dementia in later life. However, the underlying mechanisms remain unclear. Little is known about the relationship between body mass index (BMI) and hippocampal subfield atrophy. In this study, we aimed to explore the associations between BMI and hippocampal subfield volumes and cognitive function in non-demented Chinese older adults. Hippocampal volumes were assessed using structural magnetic resonance imaging. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A total of 66 participants were included in the final analysis, with 35 females and 31 males. We observed a significant correlation between BMI and the hippocampal fissure volume in older females. In addition, there was a negative association between BMI and the RBANS total scale score, the coding score, and the story recall score, whereas no significant correlations were observed in older males. In conclusion, our findings revealed sex-specific associations between BMI and hippocampal subfield volumes and cognitive performance, providing valuable insights into the development of effective interventions for the early prevention of cognitive decline.

Association between Depressive Mood, Antidepressant Therapy and Neuropsychological Performances: Results from a Cross-Sectional Study on Elderly Patients.

Currently, the global demographic landscape is undergoing a transformative shift towards an increasingly aging population. This leads to an increase in chronic pathologies, including depression and cognitive impairment. This study aimed to evaluate the association between depressive mood, whether in treatment or not, and cognitive capacities, assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). This study included 259 subjects, aged 65 years or older, evaluated at the Geriatric Outpatient Service of the University Hospital of Monserrato, Cagliari, between July 2018 and May 2022, who experienced subjective depressive mood and/or cognitive deficits. Only 25.1% of the sample showed no cognitive impairment on the RBANS. Education was a significant regressor of the RBANS Total Scale scores (p < 0.0001) and was negatively associated with mood deflection (r = -0.15, p = 0.0161). Subjects with depressive mood had more impaired attention and visuospatial/constructional abilities compared to untreated euthymic patients. Post-hoc analysis, conducted with the Conover test, showed that untreated euthymic patients (GDS-15 ≤ 5, group 2) had a higher score on the RBANS total scale than patients with mood deflection (GDS-15 > 5, group 1), and treated euthymic patients (GDS-15 ≤ 5, group 3). Finally, different logistic regression analyses revealed a significant negative coefficient for GDS as a regressor of the RBANS total scale (coefficient: -0.04, p = 0.0089), visuospatial/constructional abilities (coefficient: -0.03, p = 0.0009), language (coefficient: -0.05, p = 0.0140), and attention (coefficient: -0.05, p < 0.0001). Our analysis demonstrated that "naturally" euthymic people show better cognitive performances than people with depressive mood and subjects with acceptable mood due to antidepressants. Furthermore, the gender-based difference observed in the language domain suggests the potential utility of incorporating an alternative category for male patients in the Semantic Fluency test.

Effects of the multidomain intervention with nutritional supplements on cognition and gut microbiome in early symptomatic Alzheimer's disease: a randomized controlled trial.

The SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN) is a part of the World-Wide Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (WW-FINGERS) network. This study aimed to demonstrate the effects of the SUPERBRAIN-based multidomain intervention with nutritional supplements in amyloid positive emission tomography (PET) proven early symptomatic Alzheimer's disease patients. Forty-six participants who were diagnosed with mild cognitive impairment or mild dementia and were positive in the amyloid PET study randomized into three groups: group A, the multidomain intervention with nutritional supplements; group B, nutritional supplements only; and a control group. The primary outcome was a change in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total scale index score after an 8-week intervention. Secondary outcomes, including gut microbiome data, were also analyzed. The RBANS total scale index score improved significantly in group A compared with group B (p < 0.032) and compared with the control group (p < 0.001). After intervention, beta diversity of the gut microbiome between group A and the control group increased, and patients in group A were more enriched with Bifidobacterium. SUPERBRAIN-based multidomain intervention with nutritional supplements improves cognition and gut microbiota in patients with early symptomatic Alzheimer's disease who were amyloid-positive by PET.

59 Investigating the Relationship Between Neuropsychological Test Performance and Electrophysiological Measures of Semantic Functioning in Alzheimer's Disease.

Objective:Improving the timeline for intervention in Alzheimer's disease (AD) has considerable potential to delay and mitigate disability and suffering. Neuropsychological assessment is useful for distinguishing AD from normal aging and other dementias but is less useful in preclinical detection due to its limited sensitivity. The N400 (N4), a language-based EEG event-related potential (ERP) related to semantic functioning, is a promising candidate marker of AD with potential to improve early detection and monitoring of AD. For example, studies have shown that individuals with AD show a reduced N4 "effect"—a smaller difference in the size of the N4 to semantically congruent vs. incongruent word-pairs. The goal of this study is to assess the presence of the N4 effect in healthy seniors, and those with amnestic mild cognitive impairment (MCI) or mild AD, and to evaluate associations between performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the N4 across these samples.Participants and Methods:Fifty older adults (intact=27, combined MCI/mild AD group=23; "impaired") completed neuropsychological testing, including the RBANS, as part of a larger study. Participants were re-contacted and returned for EEG assessment between several weeks to one year later. During EEG recording, participants completed a word-pair judgement paradigm, which involved distinguishing between semantically congruent and incongruent word-pairs. Data was collected and analyzed according to customized N4 analysis scripts provided as part of ERPCORE, an online resource for acquiring and analyzing common ERP components (Kappenman et al., 2021; https://osf.io/thsqg/). The change in N4 amplitude between congruent and incongruent trials (the N4 effect) was used as an index of participants' semantic functioning. Participants' N4 effect was quantified using the mean amplitude from 300-550 milliseconds poststimulus at electrode Cz.Results:Repeated measures ANOVAs indicated a significant effect of trial type on the N400 amplitude in the intact individuals (F(1, 26)=77.66, p&lt;.001), which remained significant in the sample as a whole (F(1, 48)=65.18, p&lt;.001). Although intact participants numerically showed a larger N4 effect (intact: M=-4.02, SD=2.37; impaired: M=-2.60, SD=3.40), the expected group-by-trial interaction was not significant (F(1, 48)=3.01, p=.089). Correlational analyses revealed no significant associations between the N4 effect and the RBANS Total Scale scores (r=-.14, p=.32), nor for the Immediate Memory (r=-.002, p=.99), Visuospatial/Constructional (r=-.069, p=.63), Language (r=-.15, p=.30) Attention (r=-.21, p=.14), or Delayed Memory (r=-.18 p=.58) indexes.Conclusions:Results confirmed the presence of the N4 effect in intact participants and in the sample as a whole. Although the N4 effect was numerically smaller in the impaired group as expected, this difference was not significant in the present sample. Likewise, we observed no evidence for associations between the size of N4 effect and performance on RBANS indexes. Overall, the present study provides mixed evidence for the utility of the N4 as a biomarker in mild AD. Factors that may have contributed to the lack of associations between the N4 effect and the RBANS include the limited sample size and variable lengths of time between participants' initial cognitive assessments and EEG testing.

Practice Effect of Repeated Cognitive Tests Among Older Adults: Associations With Brain Amyloid Pathology and Other Influencing Factors.

BackgroundPractice effects (PE), after repeated cognitive measurements, may mask cognitive decline and represent a challenge in clinical and research settings. However, an attenuated practice effect may indicate the presence of brain pathologies. This study aimed to evaluate practice effects on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scale, and their associations with brain amyloid status and other factors in a cohort of cognitively unimpaired older adults enrolled in the CHARIOT-PRO SubStudy.Materials and Methods502 cognitively unimpaired participants aged 60-85 years were assessed with RBANS in both screening and baseline clinic visits using alternate versions (median time gap of 3.5 months). We tested PE based on differences between test and retest scores in total scale and domain-specific indices. Multiple linear regressions were used to examine factors influencing PE, after adjusting for age, sex, education level, APOE-ε4 carriage and initial RBANS score. The latter and PE were also evaluated as predictors for amyloid positivity status based on defined thresholds, using logistic regression.ResultsParticipants’ total scale, immediate memory and delayed memory indices were significantly higher in the second test than in the initial test (Cohen’s dz = 0.48, 0.70 and 0.35, P < 0.001). On the immediate memory index, the PE was significantly lower in the amyloid positive group than the amyloid negative group (P = 0.022). Older participants (≥70 years), women, non-APOE-ε4 carriers, and those with worse initial RBANS test performance had larger PE. No associations were found between brain MRI parameters and PE. In addition, attenuated practice effects in immediate or delayed memory index were independent predictors for amyloid positivity (P < 0.05).ConclusionSignificant practice effects on RBANS total scale and memory indices were identified in cognitively unimpaired older adults. The association with amyloid status suggests that practice effects are not simply a source of measurement error but may be informative with regard to underlying neuropathology.

No effect of exercise on AD‐related cognition in older African Americans: Program for African American Cognition and Exercise (PAACE)

AbstractBackgroundLower levels of physical activity (PA) are associated with greater risk of cognitive decline and AD, and some studies suggest that interventions that increase PA engagement lower risk of cognitive decline and AD. However, interventions to date have largely not included substantial representation of African Americans.MethodThe Program for African American Cognition and Exercise (PAACE) randomized 56 sedentary African American adults in the Baton Rouge, Louisiana area (mean age ± s.d.: 69.2 ± 3.4 years) to a physical activity group (PAG) or successful aging group (SAG). The PAG aimed to increase moderate to vigorous PA to national guideline levels over 12 weeks by providing supervised PA 2 days per week (90‐120 minutes/week) at local YMCAs along with 30‐60 minutes/week of home‐based PA. The SAG completed one 60‐minute educational session on successful aging per week for 12 weeks. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was assessed before and after the intervention. ANOVA models assessed pre‐ to post‐intervention RBANS total scale and sub‐scale score changes, as well as differences between PA and control arms in these changes.ResultGroups were well matched by age, sex, BMI, employment, education, and income. The SAG increased scores on the RBANS overall scale and scales of visuospatial function, immediate memory, and delayed memory, along with the story memory, figure copying, coding, and figure recall sub‐scales (all p&lt;.05). The PAG increased scores on only the list learning sub‐scale (p=.047). Scores on the overall scale (p=.034) and story memory sub‐scale (p=.0008) increased significantly more in the SAG than in the PAG. No RBANS scores increased significantly more in the PAG compared to the SAG.ConclusionA 12‐week PA promotion program among community‐dwelling older African American adults provided significant cognitive benefits to an educational control group, and minimal benefits to those engaged in PA. Possible contributors to these results include inadequate PA stimulus in the PAG, and beneficial health behavior changes or cognitive stimulation in the SAG. Future research is needed to fully understand cognitive effects of PA interventions among older African Americans.

Predicting biomarkers in intact older adults and those with amnestic Mild Cognitive Impairment, and mild Alzheimer’s Disease using the Repeatable Battery for the Assessment of Neuropsychological Status

ABSTRACT Introduction: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been associated, to varying degrees, with commonly used biomarkers of Alzheimer’s disease (AD). Given the ease of RBANS administration as a screening tool for clinical trials and other applications, a better understanding of how RBANS performance is associated with presence of APOE ε4 allele[s], cerebral amyloid burden, and hippocampal volume is warranted. Method: One hundred twenty-one older adults who were classified as intact, amnestic Mild Cognitive Impairment, or mild AD underwent cognitive assessment with the RBANS, genetic analysis, and quantitative brain imaging. APOE ε4 carrier status, 18F-Flutemetamol composite standardized uptake value ratio (SUVR), and hippocampal volume were each regressed on demographic variables and RBANS Total Scale score, Index scores, and subtest scores. Results: Lower RBANS Total Scale score or Delayed Memory Index (DMI) predicted the presence of APOE ε4 allele[s], higher cerebral amyloid burden, and lower hippocampal volumes. DMI was a slightly better predictor than Total Scale score for most AD biomarkers. No demographic variables consistently contributed to these models. Conclusions: The RBANS – DMI in particular – is sensitive to AD pathology. As such, it could be used as a predictive tool, particularly in clinical drug trials to enrich samples prior to less accessible AD biomarker investigation.

Facility-based and home-based multidomain interventions including cognitive training, exercise, diet, vascular risk management, and motivation for older adults: a randomized controlled feasibility trial.

We aimed to evaluate the feasibility of multidomain intervention (MI) tailored to the Korean context. In an outcome assessor-blinded, randomized controlled trial, participants without dementia and with one or more modifiable dementia risk factors, aged 60-79 years, were randomly assigned to the facility-based MI (FMI; n=51), the home-based MI (HMI; n=51), or the control group receiving general health advice (n=50). The 24-week intervention comprised vascular risk management, cognitive training, social activity, physical exercise, nutrition guidance, and motivational enhancement. The FMI participants performed all intervention programs at a facility three times a week. The HMI participants performed some programs at a facility once every 1-2 weeks and performed others at home. The primary outcome was feasibility measured through retention, adherence, and at least no differences from the control group in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). In the FMI and HMI groups, the retention rates were 88.2% and 96.1%, and adherence to the intervention was 94.5% and 96.8%, respectively. The RBANS total scale index score improved significantly in the FMI (5.46 ± 7.50, P = 0.004) and HMI (5.50 ± 8.14, P = 0.004) groups compared to the control group (-0.74 ± 11.51). The FMI and HMI are feasible and there are indicators of efficacy.

Practice effect of repeated cognitive tests among older adults: Associations with brain amyloid status and other influencing factors

AbstractBackgroundPractice effects (PE), after repeated cognitive measurements, may mask cognitive decline and remain a major issue in clinical and research settings. However, an attenuated practice effect may indicate cognitive decline or the presence of brain pathologies. Exploring factors that influence PE can inform strategies to distinguish true signal from bias in future research. This study aimed to evaluate practice effects on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scale, and their associations with brain amyloid status in a cohort of older adults enrolled in the Cognitive Health in Ageing Register: Investigational, Observational, and Trial Studies: Prospective Readiness cOhort Study (CHARIOT‐PRO) Sub‐study.Method502 cognitively healthy participants aged 60‐85 years were assessed with RBANS in both screening and baseline clinic visits (median time gap of 3.5 months). We assessed the reliability of the RBANS scale and tested PE based on differences between test and retest scores in total scale and domain‐specific indices. Multiple linear regressions were used to examine factors influencing PE, after adjusting for age, sex, educational attainment, and APOE‐ε4 carriage. PE and the initial RBANS score were also examined as predictors for amyloid positivity status based on defined thresholds, using logistic regression.ResultThe internal consistency (Cronbach's α=0.64) and test‐retest reliability (r=0.79) of RBANS were good. Participants’ Total Scale, Immediate Memory and Delayed Memory indices were significantly higher in the second test than in the initial test (d=3.8, 7.6 and 3.2, P&lt;0.001). On the Immediate Memory index, the PE was significantly lower in the amyloid positive group than the amyloid negative group (d=6.5 vs 8.6, P=0.028). Older participants (≥70 years), women, non‐APOE‐ε4 carriers, and those with worse initial RBANS test performance had larger PE. In addition, worse performance and lower practice effects in immediate or delayed memory index were independent predictors for amyloid positivity (OR=0.97, P&lt;0.05).ConclusionSignificant practice effects on RBANS total scale and memory indices were influenced by age, sex, APOE‐ε4, initial RBANS scores and amyloid status. The association with amyloid suggests that practice effects are not simply a source of measurement error but may be informative with regard to underlying neuropathology.

Hepatic Encephalopathy Is Reversible in the Long Term After Liver Transplantation.

Cognitive dysfunction caused by hepatic encephalopathy (HE) improves within the first year after liver transplantation (LT). However, cognitive restitution seems to be incomplete in a subset of patients and after LT a new-onset cognitive decline was described. Data about the longterm development of cognitive function after liver transplantation (LT) are sparse. This prospective study analyzed whether a history of hepatic encephalopathy (HE) before LT had an impact on the longterm outcome of cognitive function after LT and if patients who underwent LT 5years earlier showed worse cognitive function than healthy controls. The cognitive function of 34 patients was assessed before LT and at 1year and 5years after LT by psychometric tests, including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the portosystemic encephalopathy syndrome test, which provides the psychometric hepatic encephalopathy score (PHES). Furthermore, patients completed surveys to assess health-related quality of life (HRQOL). An 22 additional patients were included after LT. Patients were subdivided by having a history of HE before LT. The control group consisted of 55 healthy patients adjusted for age and education. Before LT, patients performed significantly worse than controls in the psychometric tests: RBANS Total Scale (TS), mean±standard deviation (SD), 92.6±13.3 versus 99.9±12.0, P=0.01; and PHES, median (interquartile range [IQR]), 0 (-3 to 1) versus 1 (0-2), P<0.001. At 1year after LT, patients with a history of HE still showed cognitive impairment compared with controls: RBANS TS, mean±SD, 89.8±15.1 versus 99.9±12.0, P<0.01; and PHES, median (IQR), 0 (-2 to 1.25) versus 1 (0-2), P=0.03. At 5years after LT, patients with and without a history of HE showed normal cognitive function and improved HRQOL. In conclusion, HE-associated cognitive impairment seems to be reversible within 5years after LT.

P: 10 Hepatic Encephalopathy Is Reversible in the Long-term after Liver Transplantation

BACKGROUND: Cognitive dysfunction caused by hepatic encephalopathy in patients with acute or chronic liver failure improves within the first year after liver transplantation. However, cognitive restitution seems to be incomplete in a subset of patients. Furthermore, a new-onset cognitive decline after liver transplantation was described. This prospective study analyzed whether a history of hepatic encephalopathy before liver transplantation had an impact on the long-term outcome of cognitive function after liver transplantation and if patients who underwent liver transplantation up to 5 five years before showed worse cognitive function than adjusted healthy controls. METHODS: 34 patients with liver cirrhosis on the waiting list for liver transplantation underwent a psychometric test battery and questionnaires assessing health-related quality of life 3.4 ± 3.1 months (T1) before liver transplantation. Further 33 patients were included directly after liver transplantation. After transplantation all patients (n = 67) underwent psychometric testing and completed questionnaires at 8.9 ± 3.6 months (T2) and at 62.1 ± 12.2 months (T3) thereafter. The psychometric test battery consisted of the Portosystemic Encephalopathy Syndrome-Test which provides the psychometric hepatic encephalopathy score (PHES), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Inhibitory Control Test and the Critical Flicker Frequency. All patients were asked to complete the self-reporting questionnaires Hospital Anxiety and Depression Scale, Beck Depression Inventory, Fatigue Impact Scale and Short Form 36 health survey to assess health-related quality of life. Patients were divided into 2 groups: Patients with and without hepatic encephalopathy before liver transplantation. Test results were compared to those of 55 adjusted healthy controls. RESULTS: Patients tested before liver transplantation performed significantly worse than controls in the psychometric tests (RBANS total scale mean 92.6 ± 13.3 vs 99.9 ± 12.0, P &lt; 0.001; PHES median 0 (interquartile range (IQR) −3; 1) vs 1 (IQR 0; 2), P &lt; 0.01). About 1 year after liver transplantation patients with a history of hepatic encephalopathy still showed cognitive impairment compared to controls (RBANS total scale mean 89.5 ± 15.6 vs 99.9 ± 12.0, P = 0.001; PHES median 0 (IQR −2; 1) vs 1 (IQE 0; 2), P &lt; 0.01) while patients without a history of hepatic encephalopathy did not. 5 years after liver transplantation both patient groups did not differ from healthy controls (Table 1). Health-related quality of life improved significantly in both patient groups after transplantation. CONCLUSIONS: Cognitive impairment associated to hepatic encephalopathy seems to be reversible within 5 years after liver transplantation.

Relationship Between the Mini-Mental State Examination and the Repeatable Battery for the Assessment of Neuropsychological Status in Patients Referred for a Dementia Evaluation.

The current study examined the relationship between the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Mini-Mental State Examination (MMSE) in a large, heterogeneous sample of patients referred for dementia assessment (N = 495; 37% males, 63% females; M age = 76.8 years, SD = 7.0). The MMSE showed a significant moderate correlation with the RBANS Total Scale score (r = .65). Moderate significant correlations were found between the MMSE and the RBANS indexes (r = .41 to .49). The MMSE demonstrated moderate correlations with RBANS factor scores of .63 for Factor 1 (memory/learning) and .58 for Factor 2 (visuospatial/attention). These correlations suggest that the MMSE is best considered a measure of global cognitive functioning with the strongest correlations between broader measures.

Cognition and Competency Restoration: Using the RBANS to Predict Length of Stay for Patients Deemed Incompetent to Stand Trial

Intact cognition is a foundational component of one’s ability to be competent to stand trial. Given the cost of assessing and treating incompetence, it is recommended that clinicians develop efficient methods to identify individuals who are most likely to require intensive competence-related treatment interventions. This study sought to ascertain whether a brief cognitive screening instrument, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), could predict the length of stay required to restore trial competency among 288 forensic psychiatric inpatients undergoing competency restoration treatment. Results indicated that incompetent defendants who were older or demonstrated poorer overall RBANS performance required longer hospitalizations to be deemed restored to trial competence. Interestingly, incompetent defendants scoring in the 51–60 range on the RBANS Total Scale Index were almost three times more likely to require hospitalization beyond the average length of stay. Findings support the use of the RBANS to identify individuals early in the treatment process who may require and benefit from intensive restoration treatment.

Improved Cognitive Performance Following Aerobic Exercise Training in People With Traumatic Brain Injury

ObjectiveTo examine cognitive function in individuals with traumatic brain injury (TBI) prior to and after participation in an aerobic exercise training program. DesignPre-post intervention study. SettingMedical research center. ParticipantsVolunteer sample of individuals (N=7) (age, 33.3±7.9y) with chronic nonpenetrating TBI (injury severity: 3=mild, 4=moderate; time since most current injury: 4.0±5.5y) who were ambulatory. InterventionTwelve weeks of supervised vigorous aerobic exercise training performed 3 times a week for 30 minutes on a treadmill. Main Outcome MeasuresCognitive function was assessed using the Trail Making Test Part A (TMT-A), Trail Making Test Part B (TMT-B), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Sleep quality and depression were measured with the Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory, version 2 (BDI-II). Indices of cardiorespiratory fitness were used to examine the relation between improvements in cognitive function and cardiorespiratory fitness. ResultsAfter training, improvements in cognitive function were observed with greater scores on the TMT-A (10.3±6.8; P=.007), TMT-B (9.6±7.0; P=.011), and RBANS total scale (13.3±9.3; P=.009). No changes were observed in measures of the PSQI and BDI-II. The magnitude of cognitive improvements was also strongly related to the gains in cardiorespiratory fitness. ConclusionsThese findings suggest that vigorous aerobic exercise training may improve specific aspects of cognitive function in individuals with TBI and cardiorespiratory fitness gains may be a determinant of these improvements.

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Utility in Detection and Characterization of Mild Cognitive Impairment due to Alzheimer's Disease

Current diagnostic criteria for mild cognitive impairment (MCI) due to Alzheimer's disease (AD) require standardized tests that are capable of measuring a range of neurocognitive abilities in healthy elderly individuals and sensitive to detect change over time. There currently is no clearly-established "gold standard" for this purpose. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used neuropsychological test battery for the clinical diagnosis/tracking of dementia also recently incorporated into clinical trials of new investigational medications for AD treatment. The RBANS has a number of design features that suggest possible utility in diagnosis/tracking of MCI. Eighty-one patients with MCI completed the RBANS and their scores were compared with 81 demographically matched healthy controls. RBANS Total Scale scores in both groups were normally distributed, demonstrating no floor/ceiling effects. The MCI group was most impaired on the Delayed Memory Index (DMI). Receiver operating characteristic analyses reflected good discrimination, with an area under the curve of 0.88 for the Total Scale score and 0.90 for the DMI score. The profile of performance for the MCI group was similar to that previously reported for mild AD patients. The RBANS may be a suitable neurocognitive battery for the detection and tracking of MCI presumed to be due to AD.

Sensitivity of the RBANS to acute traumatic brain injury and length of post-traumatic amnesia

Objective: Although the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been shown to be a useful tool in evaluating the cognitive status of patients with dementia, stroke, schizophrenia and post-acute traumatic brain injury (TBI), no studies have examined its utility in an acute TBI setting. The current study investigates the RBANS’ sensitivity to acute TBI, hypothesizing that the presence and severity of injury is predictive of worse RBANS performance.Method: Neuropsychological testing was conducted an average of 6.1 days after emergence from post-traumatic amnesia (PTA). RBANS results were evaluated based on a normative basis, pre-injury estimates, and brain injury severity.Results: In this sample of acute TBI patients (n = 51), the mean index scores on the RBANS ranged from 1.59–2.36 SD below the mean of the standardization sample. Each WRAT-4 Reading sub-test score was above the corresponding RBANS Total Scale Index score (t(31) = 10.32, p < 0.001). Regression analyses revealed that Delayed Memory (β = − 0.365, p < 0.007) and Total Score (β = −0.297, p < 0.023) indices were significantly predicted by PTA length after controlling for age and education.Conclusions: The RBANS appears to be a useful tool in assessing the presence and severity of acute TBI.

Effect of carotid endarterectomy on cognitive function in patients with asymptomatic carotid artery stenosis

This study was conducted to determine if patients with asymptomatic carotid artery stenosis show cognitive function decline, and if they experience any changes in cognitive function after carotid endarterectomy (CEA). Cognitive function was examined in 15 patients (12 males and three females, 70.0 ± 6.5 years) with asymptomatic carotid artery stenosis before and 3 months after CEA. Cognitive function was assessed with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), two subtests of the Wechsler Adult Intelligence Scale-Revised (WAIS-R 2 subtests), and the Japanese version of National Adult Reading Test (JART). The patients' average scores were compared with the normal average by one-sample t-tests, and the before and after scores were compared with paired t-tests. Changes in each patient were calculated from difference before and after CEA using 95 % confidence intervals. Before surgery, patients showed significant cognitive decline in RBANS total scale and immediate memory, language, and attention. At 3 months after CEA, the total scale and the immediate memory were not significantly different from the normal average. The average total scale score, the immediate memory and attention, and the WAIS-R 2 subtests scores were increased after treatment. Changes in each patient were calculated from the scores before and after CEA. At 3 months after CEA, the rate of increase in RBANS scores were 60.0 % of the patients for immediate memory, 26.7 % for visuospatial/constructional, 33.3 % for language and attention, 26.7 % for delayed memory, 47.7 % for total scale and 26.7 % for WAIS-R 2 subtests. Thus, so-called asymptomatic patients exhibit mild cognitive impairment before surgery, but after CEA, patients recover normal memory abilities. Our findings of mild cognitive dysfunction in asymptomatic patients suggest that they might be symptomatic after all.

Neuropsychological patterns differ by type of left ventricle dysfunction in heart failure.

Cognitive impairment is common among individuals with heart failure. The purpose of this study was to compare cognitive profiles of individuals with systolic and diastolic dysfunction. Eighty individuals with heart failure completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Mini-Mental State Examination, Trail Making Test, and letter fluency. Approximately 25% of individuals with systolic dysfunction were impaired on the RBANS Total Scale score, compared with only 3% in the diastolic group. Additionally, individuals with systolic dysfunction scored lower than those with diastolic dysfunction on tests of immediate and delayed memory. The groups did not differ on tests of visuospatial skills, but there were mixed results on the RBANS Attention and Language subtests. Overall, the results of this study suggest that individuals with different types of cardiac dysfunction (systolic and diastolic dysfunction) demonstrate differential patterns of performance on neuropsychological tests. These findings have important clinical implications.

Premorbid Intellect and Current RBANS Performance: Discrepancy Scores in Three Geriatric Samples

Assessing cognitive change during a single visit requires the comparison of estimated premorbid abilities and current neuropsychological functioning. As newer instruments are developed to measure current cognitive functioning, their relationships with premorbid estimates need to be evaluated. The current study examined the clinical utility of discrepancy scores between an estimate of premorbid intellect derived from demographic variables (i.e., Barona) and the Total score on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in three geriatric samples. A large community-dwelling “control” sample and two clinical samples were examined. As expected, there was little difference between estimated premorbid intellect and current RBANS Total Scale scores in the community-dwelling sample, while estimated premorbid intellect obtained from the two clinical samples significantly differed from obtained RBANS Total scores. Similar findings were observed on Discrepancy scores for the five Indexes of RBANS. The current findings, along with normative data on these discrepancy scores, can provide additional confidence for clinicians and researchers who need to determine cognitive decline when using these screening measures of neuropsychological status.

Brief cognitive assessment in schizophrenia: normative data for the Repeatable Battery for the Assessment of Neuropsychological Status

Background: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief, standardized cognitive screening instrument that assesses several domains of interest and offers an efficient approach to screening for cognitive impairment in schizophrenia (SC). Prior studies have established the clinical validity and test–retest reliability of the RBANS in SC. Aims: The purpose of the current study was to guide clinical interpretation by providing normative data for the use of the RBANS as a measure of cognitive impairment in SC. We also sought to evaluate the role of demographic factors and to present percentile data accordingly. Methods: 575 patients (391 male, 184 female) meeting the diagnostic criteria for SC or schizoaffective disorder were recruited from 4 inpatient ( n=117) and 6 outpatient ( n=458) sites in 2 different mental health treatment systems. All participants were administered the RBANS according to standardized instructions and a subgroup of 242 patients were also administered the Wide Range Achievement Test (3rd Edition) (WRAT-3) Reading subtest. Results: RBANS Total Scale score for patients with SC was approximately 2 standard deviations below the normal mean, was approximately 1 standard deviation below WRAT-3 Reading scores, and expected patterns of impairment were observed: measures of language and visuospatial ability were preserved relative to those of memory and attention. Aside from weak associations with Language (0.139) and Attention (0.112), age was not significantly associated with RBANS Index scores (which are age adjusted in healthy controls). Education was significantly associated with all RBANS scores and one-way ANOVA indicates that those with more than high school education scored consistently higher than the other two groups (less than and equal to a complete high school education). Normative tables with age and education based percentiles are presented. Conclusions: The RBANS is an efficient screening tool for assessing cognitive impairment in patients with SC thereby making it a useful instrument for clinical and research applications.