Validity of the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II) as an Indicator of Neurological Disease/Injury: A Pilot Study.

PURPOSE: Although the Wechsler Abbreviated Scale of Intelligence, Second Edition is commonly used by neuropsychologists in the assessment of intellectual functioning, there is a paucity of published literature examining its utility in detecting neurological disease/injury. This study constitutes an attempt to validate the four-subtest WASI-II (4-FSIQ) for use with patients with neurological disease/injury. METHOD: Participants were 59 patients referred for outpatient neuropsychological evaluation. Thirty-two individuals with diagnoses of dementia, stroke, traumatic brain injury, and other neurological disorders constituted the neurological group. A control group was comprised of 27 individuals with diagnoses of psychiatric disorders or age-related cognitive decline. RESULTS: The WASI-II subtest and composite scores of the neurological group were all significantly (ps < .0001) lower than those of the control sample, but pattern differences between the groups were absent. When premorbid IQs and WASI-II IQs were compared, neurological patients with neurological disease/injury displayed evidence of intellectual deterioration; whereas, control participants did not. CONCLUSIONS: Findings suggest that the 4-WASI-II is sensitive to the biological condition of the brain and provide preliminary validation for its use in the neuropsychological assessment of a diagnostically heterogeneous sample of patients with neurological disorders.

Principal components analysis of the Hesitation Scale: More than just social support seeking.

The seeking of support from others during times of need is a critical strategy for overcoming challenging life events and ameliorating associated stress. The larger percentage of research examining help-seeking behaviour has been conducted with nonclinical samples, and conclusions remain somewhat unclear due to several limitations, including methodological inconsistencies across studies. The Hesitation Scale (HS) was developed to measure social support seeking in patients with traumatic brain injury but has not undergone thorough psychometric evaluation. The goal of this study primarily was to provide a clearer understanding of the specific aspects of support-seeking behaviour assessed by the HS, which is fundamental to the identification of factors that can be modified through targeted clinical interventions. A principal components analysis of the HS in an outpatient sample of 89 patients with spinal cord injury revealed that although the HS may provide an overall indication of respondents' attitudes and beliefs regarding social support seeking, the six significant extracted components of the scale appear to assess distinct aspects of support seeking behaviour. Results also suggested that the HS may have clinical utility in evaluating social support seeking in individuals with spinal cord injury.

Memory Performance and Quantitative Neuroimaging Software in Mild Cognitive Impairment: A Concurrent Validity Study.

OBJECTIVE: This study examined the relationship between patient performance on multiple memory measures and regional brain volumes using an FDA-cleared quantitative volumetric analysis program - Neuroreader™. METHOD: Ninety-two patients diagnosed with mild cognitive impairment (MCI) by a clinical neuropsychologist completed cognitive evaluations and underwent MR Neuroreader™ within 1 year of testing. Select brain regions were correlated with three widely used memory tests. Regression analyses were conducted to determine if using more than one memory measures would better predict hippocampal z-scores and to explore the added value of recognition memory to prediction models. RESULTS: Memory performances were most strongly correlated with hippocampal volumes than other brain regions. After controlling for encoding/Immediate Recall standard scores, statistically significant correlations emerged between Delayed Recall and hippocampal volumes (rs ranging from .348 to .490). Regression analysis revealed that evaluating memory performance across multiple memory measures is a better predictor of hippocampal volume than individual memory performances. Recognition memory did not add further predictive utility to regression analyses. CONCLUSIONS: This study provides support for use of MR Neuroreader™ hippocampal volumes as a clinically informative biomarker associated with memory performance, which is a critical diagnostic feature of MCI phenotype.

Handedness of healthy elderly and patients with Alzheimer's disease.

Purpose/Aim of the study: Research has suggested decreasing proportions of non-right handers in older age groups and reduced incidence of non-right handedness among individuals with Alzheimer's disease (AD). We hypothesized that healthy elderly individuals would have a higher proportion of non-right handers than individuals with AD and that the proportion of non-right handers would decrease with increasing age. Further, we investigated whether the proportions of non-right handers differed between those with early and late onset of AD.Materials and Methods: Two-hundred and fifty-six healthy elderly and 182 individuals with AD served as participants. Hand dominance was recorded based on side of writing during testing and self-report. We analyzed proportions of right handers and non-right handers for three age ranges (≤ 69, 70 - 79, and ≥ 80 years). A second analysis focused on the proportions of right and non-right handers among patients with AD classified as either early or late disease onset.Results: Handedness proportions did not differ between the controls and ADs. For AD but not for controls, there was a trend towards reduced proportions of non-right handers with increasing age. Early onset AD was associated with a larger proportion of non-right handers compared to those with late onset AD.Conclusions: Results did not support a trend of decreasing non-right handedness with increasing age in controls, but did provide support for such a trend in individuals with AD. The results provided support for the hypothesis of increased incidence of non-right handedness in early onset vs. late onset AD.

Neuropsychological differences between men and women with Alzheimer's disease.

BACKGROUND: It has been suggested that men and women with Alzheimer's disease (AD) at comparable levels of global cognitive impairment perform differently on neuropsychological measures. Such differences may have practical implications for designing cognitive interventions that address symptoms of dementia. METHODS: We compared men (n = 86) and women (n = 96) with AD on tests of immediate and delayed prose memory, verbal fluency, semantic fluency, semantic memory and confrontation naming. Mean years for age, education and duration of illness were 70.81 (SD = 7.55), 13.37 (SD = 3.38) and 2.17 (SD = 1.72) for men and 73.11(SD = 8.53), 12.27 (SD = 2.86) and 2.42 (SD = 1.92) for women. The groups were comparable in global cognitive functioning as indicated by Dementia Rating Scale total scores for men of 89.27 (SD = 29.80) and women of 90.86 (SD = 30.20). RESULTS: Men earned significantly better scores in immediate prose memory, semantic verbal fluency, semantic memory and response naming. Men and women performed similarly on the remaining tests. When the variables of age, education and duration of disease were controlled, the significant effect of gender was maintained only on tests of semantic fluency, semantic memory and confrontation naming. CONCLUSIONS: The hypothesis of the study was partially confirmed in that women with AD evidenced greater impairment than men with AD on three of six neuropsychological measures even after potentially confounding variables were controlled.

Prorating WAIS - IV summary scores for patients with relapsing-remitting multiple sclerosis.

We evaluated the utility of prorating appropriate combinations of two, six and eight Wechsler Adult Intelligence Scale - Fourth Edition (WAIS - IV) subtests for estimating the Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Full Scale IQ (FSIQ) and General Ability Index (GAI) in a sample of individuals diagnosed with multiple sclerosis (MS). Forty-eight outpatients completed the WAIS - IV and Wechsler Memory Scale - Fourth Edition (WMS - IV) as part of a comprehensive neuropsychological battery. Means for age, education and duration of diagnosis were 42.35, 14.21 and 8.30 years, respectively. Paired t-tests showed no significant differences between prorated and standard means for VCI (93.46 vs. 93.73), PRI (90.19 vs. 89.44), FSIQ (88.53 vs. 88.47) or GAI (90.56 vs. 90.65). Correlations between prorated and standard composites were ≥0.89 in every instance. Correlations between the standard and prorated composites and education, disability status and WMS - IV indexes did not reveal a single contrast, where the correlations were significantly different. The present findings support the use of the two-subtest VCI and PRI composites and the eight-subtest FSIQ and four-subtest GAI in the assessment of patients with MS.

Subclinical hypothyroidism, mood, and cognition in older adults: a review.

OBJECTIVES: To perform a critical review of the literature on the mood and cognitive changes associated with subclinical hypothyroidism (SCH), with an emphasis on older adults. To evaluate these data against the Consensus Statement on the management of SCH from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. METHOD: A comprehensive literature review. RESULTS: Subclinical hypothyroidism may be associated with an increased risk of mood and cognitive dysfunction, although the strength of this association and the efficacy of replacement hormone therapy require further investigation. CONCLUSION: It remains unclear whether SCH leads to significant mood and cognitive impairments in most older patients. More research is required to determine the nature and extent of this association and whether thyroid hormone replacement therapy is appropriate and effective in treating SCH-associated neurobehavioral impairments.

Age effects on Wechsler Memory Scale-Fourth Edition (WMS-IV) indexes and subtests.

This study examined age effects in the standardization samples of the Wechsler Memory Scale-Fourth Edition (WMS-IV) and compared these, where appropriate, to the norms of the Wechsler Memory Scale-Third Edition (WMS-III). On the Adult (16-69 years) and Older Adult (65-90 years) batteries of the WMS-IV, the most pronounced declines were on the Visual Memory Indexes starting in the 35-44 years cohort. The Auditory Memory Indexes showed the least deterioration, which did not commence until the 85-90 years age range. Subtest scores for the Adult Battery indicated that Logical Memory I was unchanged from 16 to 69 years. Likewise, only one scaled score point decline was evidenced on Logical Memory II. Conversely, WMS-III Logical Memory I performance showed a one scaled score point decline in the 18-19 years age band and progressed to moderate (i.e., 4 scaled score points) and large (i.e., ≥6 scaled score points) reductions by the 65-69 and ≥80 years cohorts. Logical Memory II showed even greater age-related deterioration. Age decline data at each age cohort are provided for all subtests and indexes from the Adult and Older Adult batteries as well as for the WMS-III subtests in common with the WMS-IV.

Age Effects on Subtest and Composite Scores of the Wechsler Abbreviated Scale of Intelligence-Second Edition.

We evaluated age effects in the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II) standardization sample. This extends work completed using previous editions of the Wechsler Adult Intelligence Scales. Of the four subtests, Vocabulary (VC) and Similarities (SI) were most resistant to aging. VC showed minimal variation regardless of age; SI peaked at 30 to 54 years followed by a decline. Block Design (BD) and Matrix Reasoning (MR) showed substantial drops from the younger to older groups. BD peaked at 17 to 44 years and then declined; MR peaked at 20 to 29 years and then consistently deteriorated. The WASI-II Verbal Comprehension Index peak at 30 to 44 years was followed by a maximum drop at 85 to 90 years. The Perceptual Reasoning Index peaked at 20 to 29 years, with a marked decline by 65 to 69 years. The Full Scale IQ was average until age 65 years followed by a decline. Minor changes in points of peak performance and subsequent decline were seen as a function of Full Scale IQ level. Results were consistent with crystallized and fluid intelligence theory.

Wechsler memory scale-fourth edition (WMS-IV) in the neuropsychological evaluation of patients diagnosed with probable Alzheimer's disease.

There is a scarcity of research concerning Wechsler Memory Scale-Fourth Edition (WMS-IV) findings in Alzheimer's disease (AD). We provide information, beyond that in the test manual, concerning the power of the scale to detect AD-associated memory deficits. Participants were 87 individuals with diagnoses made according to criteria specified in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): 31 probable neurocognitive disorders due to AD and 33 patients with depression. Twenty-three elderly controls were also studied. The depressed and control participants had similar demographics as well as test scores and therefore were blended into a single control group (n = 56). AD patients were significantly impaired on the four WMS-IV indexes relative to controls, and the index pattern of performance differed across groups. Delayed Memory Index was a significant weakness in AD, whereas the Visual Memory Index was the lowest mean for controls. Sensitivity, specificity, hit rate, positive predictive value, and negative predictive value were strong to excellent for each index when a cutoff of 1.5 SDs below the normative mean was used to separate ADs and controls. Receiver operating characteristics curve analyses yielded excellent area under the curve statistics that ranged from .970 for the Visual Memory Index to .999 for the Delayed Memory Index. A supplementary analysis yielded similar results when the AD group was divided into mild (n = 10) and major (n = 21) subgroups.

Estimating WAIS-IV indexes: proration versus linear scaling in a clinical sample.

OBJECTIVES: We compared the accuracy of proration and linear scaling for estimating Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV), Verbal Comprehension Index (VCI), and Perceptual Reasoning Index (PRI) composites from all possible two subtest combinations. The purpose was to provide practice relevant psychometric results in a clinical sample. DESIGN: The present investigation was an archival study that used mostly within-group comparisons. We analyzed WAIS-IV data of a clinical sample comprising 104 patients with brain damage and 37 with no known neurological impairment. RESULTS: In both clinical samples, actual VCI and PRI scores were highly correlated with estimated index scores based on proration and linear scaling (all rs ≥.95). In the brain-impaired sample, significant mean score differences between the actual and estimated composites were found in two comparisons, but these differences were less than three points; no other significant differences emerged. CONCLUSIONS: Overall, findings demonstrate that proration and linear scaling methods are feasible procedures when estimating actual Indexes. There was no advantage of one computational method over the other.

Does high scatter on the Wechsler Adult Intelligence Scale-Fourth Edition general ability index reduce validity in predicting Wechsler Memory Scale-Fourth Edition indexes?

We examined whether significant scatter in WAIS-IV GAI will reduce its validity to predict performance on WMS-IV indexes. Participants were 330 individuals with neurological, psychiatric, or neurodevelopmental disorders and 59 referrals who were found to be free of a diagnosable disorder. For VCI > PRI, 59.32% were significant at p < .05 and 12.29% were >22 points. For VCI < PRI, 48.37% were significant at p < .05 and 7.19% were >22 points. Inter-subtest scatter across GAI subtests indicated 82.26% of individuals had a significant scatter range and 13.88% had an unusually large range (≥8). For the VCI, 49.10% had significant scatter (≥3) and 12.08% had an unusually large scatter range (≥5). On the PRI, 43.19% had a significant scatter range (≥4) and 12.85% had an unusually large degree of scatter (≥6). Moderation analyses revealed GAI was a significant predictor of each WMS-IV index. The interaction term of GAI with GAI scatter was not significant for any indexes, indicating that regression equations for predicting WMS-IV scores from GAI did not vary significantly across levels of scatter. Estimation of WMS-IV indexes from the GAI is justified even when significant VCI-PRI discrepancies are present and there is unusual variability across the GAI subtests.

Relative subtest scatter on the WAIS-IV in a clinical sample referred for outpatient neuropsychological evaluation.

OBJECTIVE: The primary aim of this study was to examine relative inter-subtest variability, or scatter, on the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) in a clinical sample of patients referred for neuropsychological evaluation and compare the findings to corresponding data from the scale's standardization sample. METHOD: Participants were 638 individuals diagnosed primarily with neurological, psychiatric, or neurodevelopmental disorders who completed the 10 core subtests of the WAIS-IV as part of a comprehensive assessment battery. RESULTS: Mean participant scores on the WAIS-IV Full Scale IQ and all index composites were within the average range, overall, but were significantly below those of the standardization sample. The correlation between scatter range and highest subtest scaled score was significant, r = .65, indicating a greater degree of subtest scaled score variability in participants with higher than average peak subtest scaled scores than participants with average or below peak subtest scaled scores. Mean variability by highest subtest scaled score was, in most cases, larger in this clinical sample relative to the scale's standardization sample. Exploratory secondary analyses also revealed specific differences in relative scatter based on diagnostic group classification. CONCLUSIONS: Subtest scatter on the WAIS-IV is common among both healthy individuals and clinical patients. Although somewhat higher in this investigation's clinical sample, the significance of this finding generally appears to be of nominal value during interpretation of individual cases but may have some utility in formulating hypotheses when considered in conjunction with reliability data and other approaches for analyzing test scores. High scatter is not pathognomonic of abnormality, and at least some degree of caution is warranted when interpreting subtest scaled score differences on the WAIS-IV.

Stability of the WISC-IV in a sample of elementary and middle school children.

This study investigated test-retest stability of the Wechsler Intelligence Scale for Children, Fourth Edition, in 43 elementary/middle school students tested on two occasions approximately 11 months apart. Subtest stability coefficients ranged from .26 (Picture Concepts) to .84 (Vocabulary [VC]). Composite stabilities ranged from .54 (Processing Speed Index) to .88 (Full Scale Intelligence Quotient [FSIQ]). On 11 subtests and three indexes, the standardization sample stability coefficients were significantly larger than those of the present sample, with only the VC subtest and FSIQ having high levels of test-retest stability. Mean practice effects were not significant, but range of gain or loss for some individuals was large. On the FSIQ, 42% changed > +/-5 points on retest. The FSIQ is less stable than one might infer from the large stability coefficient and small mean practice effect.

Administration order effects on the test of memory malingering.

Using a sample of 72 university students, we determined whether administering the Boston Naming Test (BNT) before the Test of Memory Malingering (TOMM) affects scores on the latter test and whether administration of a visual test during the interval between TOMM Trial 2 and the TOMM Retention Trial (TOMM-R) influences results on TOMM-R. Four orders of administration were used. A series of nonparametric tests indicated that when the BNT was given before the TOMM, a lower median TOMM Trial 1 (TOMM-1) score emerged. However, of the 36 participants who completed the BNT prior to administration of the TOMM, only one achieved a score < 45 on TOMM-1. There were no other significant findings. Overall, the results suggest that order of test administration is probably not a determinant of TOMM scores.

Substitution of supplementary subtests for core subtests on composite reliability of WAIS--IV Indexes.

The effects of replacing core subtests with supplementary subtests on composite-score reliabilities were evaluated for the WAIS-IV Indexes. Composite score reliabilities and SEMs (i.e., confidence intervals around obtained scores) are provided for the 13 unique Index scores calculated following the subtest substitution guidelines of Wechsler in 2008. In all instances, unique Index composite-score reliabilities were comparable to their respective core Index score composite reliabilities, and measurement error never increased by more than 1 point. Using the standard Verbal Comprehension Index and Perceptual Reasoning Index and the unique subtest combinations for the Working Memory and Processing Speed indexes, which have the lowest composite-score reliabilities, decreased Full Scale composite reliability by .01, while the associated confidence interval of +/- 6 represents an increase in measurement error of 1 IQ point.

Associations between climate and IQ in the United States of America.

Relations between average temperature of each of the 48 contiguous states and estimates of state IQ were inspected. Additional state variables were controlled in the correlational analyses, namely gross state product, percent Hispanic, Black, and Asian in the state population, and the pupil-to-teacher ratio for each state. A significant correlation between average temperature and state IQ was found (r = -.70, p < .001). Possible explanations are discussed.

Frequency of occurrence of four- and five-factor WAIS-IV profiles.

Interpretive strategies for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) include Wechsler's four-factor structure and the five-factor Cattell-Horn-Carroll (CHC) model. The frequency of profile occurrence and the contribution of demographic- and ability-related variables to their incidence are unknown. Current participants were 291 referrals (males = 134; female = 157) for neuropsychological evaluation with mean years for age and education of 34.94 (SD = 13.53) and 12.74 (SD = 2.46), respectively. Lichtenberger and Kaufman's guidelines for selecting each model were applied. Of the total, 67.3% were four-factor and 32.6% were five-factor profiles. The same pattern emerged when participants were subdivided by gender, education, ethnicity, IQ, and diagnosis. A noteworthy association between IQ and profile type emerged. When IQ increased, four-factor profiles declined and five-factors increased. A logistic regression, using demographics, IQ, and diagnosis as predictors, correctly classified 64.8% of participants. The average subtest intercorrelations and g saturations in the four-factor group were substantially larger than those for five-factor participants. These findings were consistent with Spearman's differentiation by ability hypothesis.

Physical Activity Across the Curriculum (PAAC): a randomized controlled trial to promote physical activity and diminish overweight and obesity in elementary school children.

BACKGROUND: Physical Activity Across the Curriculum (PAAC) was a three-year cluster randomized controlled trial to promote physical activity and diminish increases in overweight and obesity in elementary school children. METHODS: Twenty-four elementary schools were cluster randomized to the Physical Activity Across the Curriculum intervention or served as control. All children in grades two and three were followed to grades four and five. Physical Activity Across the Curriculum promoted 90 min/wk of moderate to vigorous intensity physically active academic lessons delivered by classroom teachers. Body Mass Index was the primary outcome, daily Physical activity and academic achievement were secondary outcomes. RESULTS: The three-year change in Body Mass Index for Physical Activity Across the Curriculum was 2.0+/-1.9 and control 1.9+/-1.9, respectively (NS). However, change in Body Mass Index from baseline to 3 years was significantly influenced by exposure to Physical Activity Across the Curriculum. Schools with > or =75 min of Physical Activity Across the Curriculum/wk showed significantly less increase in Body Mass Index at 3 years compared to schools that had <75 min of Physical Activity Across the Curriculum (1.8+/-1.8 vs. 2.4+/-2.0, p=0.02). Physical Activity Across the Curriculum schools had significantly greater changes in daily Physical activity and academic achievement scores. CONCLUSIONS: The Physical Activity Across the Curriculum approach may promote daily Physical activity and academic achievement in elementary school children. Additionally, 75 min of Physical Activity Across the Curriculum activities may attenuate increases in Body Mass Index.

WAIS-III FSIQ and GAI in ability-memory discrepancy analysis.

The present investigation compares WAIS-III FSIQ-WMS-III with GAI-WMS-III discrepancies in 135 male inpatients with suspected memory impairment. Full Scale IQ and GAI scores were highly correlated, r= .96, with mean values of 92.10 and 93.59, respectively. Additional analyses with the ability composites compared to each WMS-III index (IMI, GMI, and DMI), the GAI consistently produced larger difference scores than did the FSIQ; however, effect sizes were relatively small (ES= .12). Lastly, case-by-case analyses demonstrated concordance rates of 86% for the FSIQ-IMI and GAI-IMI comparisons, 85% for the FSIQ-GMI and GAI-GMI, and 82% for the FSIQ-DMI and GAI-DMI.