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.

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.

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.

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.

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.

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.

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.

Preliminary Validation of the Rey 15-Item Test and Reliable Digit Span in Native Japanese Samples.

The Rey 15-Item Test and reliable digit span were evaluated in Japan. Participants were controls (n = 15), healthy volunteers instructed to simulate memory impairment (n = 12; 5 of 17 volunteers did not comply with instructions and were dropped), healthy elderly (n = 12), and cognitively disabled nursing home residents (n = 8). On the 15-Item Test, controls and elderly performed similarly and were combined. Nursing home residents could not cope with the 15-Item Test and were dropped. Total score was a fair predictor of dissimulation using a cutoff ≤ 8. Rows were fair predictors using a ≤2 cutoff. Sensitivities were low and specificities were excellent. Reliable digit span contrasts between simulators and each of the other groups demonstrated that reliable digit span discriminated controls and elderly from simulators (≤6 and ≤5 cutoffs). Sensitivities were moderate and specificities were excellent. Reliable digit span did not differentiate simulators from nursing home residents.

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.

Use of the 21-Item Test with children and adolescents 5 to 16 years of age.

The goals of the present study were to: (a) collect preliminary normative data on the 21-Item Test in children and adolescents and to determine if cutoffs for biased responding in adults can be generalized to a younger population; (b) determine if Caucasian and Hispanic children perform differently on the test; and (c) ascertain the relationships of age and verbal intelligence with effort test performance. The 21-Item Test was administered to 153 children attending either a public (n = 96) or private (n = 57) school. The Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was also administered to the private school sample. The results indicated that the 21-Item Test has potential as a tool for identifying children who do not put forth maximal effort during formal assessment and that the adult cutoffs appear applicable to children 8 years and older. Caucasian and Hispanic participants performed similarly on the test. Forced-choice scores ≤12 were associated with age and lower levels of performance on the Verbal Comprehension Index of the WISC-IV.

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.

Classification Accuracy of Sequentially Administered WAIS-IV Short Forms.

A Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) short form (SF) may be effective for ruling out subnormal intelligence. To create a useful SF, subtest administration should follow the order prescribed in the manual and, depending upon individual performance, be terminated after completion of 2, 3, 4, or 5 subtests. One hundred and twenty-two patients completed the WAIS-IV. In two analyses, Full-Scale IQs (FSIQs) ≤69 and ≤79 were classified as impairment. Classification accuracy statistics indicated that all SFs using both cutoff scores exceeded the base rate (i.e., 14% and 34%) of subnormal intelligence, with hit rates ranging from 84% to 95%. The FSIQ cutoff of ≤69 had poor sensitivity for detecting impaired intellectual functioning with the 2-, 3-, 4-, and 5-subtest SFs; specificity, positive predictive value (PPV), and negative predictive value (NPV) were excellent for each SF. With the FSIQ cutoff of ≤79, sensitivity was strong to excellent for the 3-, 4-, and 5-subtest SFs as were specificity, PPV, and NPV.

Sensitivity and specificity of memory and naming tests for identifying left temporal-lobe epilepsy.

The sensitivity and specificity of the Selective Reminding Test (SRT) Delayed Recall, Wechsler Memory Scale (WMS) Logical Memory, the Boston Naming Test (BNT), and two nonverbal memory measures for detecting lateralized dysfunction in association with side of seizure focus was examined in a sample of 143 patients with left or right temporal-lobe epilepsy (TLE). Scores on the SRT and BNT were statistically significantly lower in the left TLE group compared with the right TLE group, whereas no group differences emerged on the Logical Memory subtest. No significant group differences were found with nonverbal memory measures. When the SRT and BNT were both entered as predictors in a logistic regression, the BNT, although significant, added minimal value to the model beyond the variance accounted for by the SRT Delayed Recall. Both variables emerged as significant predictors of side of seizure focus when entered into separate regressions. Sensitivity and specificity of the SRT and BNT ranged from 56% to 65%. The WMS Logical Memory and nonverbal memory measures were not significant predictors of the side of seizure focus.

WAIS-IV administration errors: effects of altered response requirements on Symbol Search and violation of standard surface-variety patterns on Block Design.

This study utilized a sample of 50 college students to assess the possibility that responding to the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Symbol Search subtest items with an "x" instead of a "single slash mark" would affect performance. A second sample of 50 college students was used to assess the impact on WAIS-IV Block Design performance of presenting all the items with only red surfaces facing up. The modified Symbol Search and Block Design administrations yielded mean scaled scores and raw scores that did not differ significantly from mean scores obtained with standard administrations. Findings should not be generalized beyond healthy, well-educated young adults.

Comparison of oral, written, and pointing responses to WAIS-IV digit span.

The Digit Span (DS) subtest cannot be administered to individuals who are unable to effectively vocalize their responses. This study determined the feasibility of altering DS response requirements to accommodate such individuals. A total of 78 healthy adults served as participants. Twenty-six completed the DS using the standard oral response format, 26 wrote their responses to each DS item, and 26 were instructed to point to their responses on a stimulus board. Results indicated similar performance on all DS components regardless of whether responses were given orally, in writing, or by pointing. Research with vocally impaired clinical populations (e.g., stutterers) appears warranted.

Neurocognitive performance and symptom profiles of Spanish-speaking Hispanic athletes on the ImPACT test.

This study documented baseline neurocognitive performance of 23,815 athletes on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test. Specifically, 9,733 Hispanic, Spanish-speaking athletes who completed the ImPACT test in English and 2,087 Hispanic, Spanish-speaking athletes who completed the test in Spanish were compared with 11,955 English-speaking athletes who completed the test in English. Athletes were assigned to age groups (13-15, 16-18). Results revealed a significant effect of language group (p < .001; partial η(2) = 0.06) and age (p < .001; partial η(2) = 0.01) on test performance. Younger athletes performed more poorly than older athletes, and Spanish-speaking athletes completing the test in Spanish scored more poorly than Spanish-speaking and English-speaking athletes completing the test in English, on all Composite scores and Total Symptom scores. Spanish-speaking athletes completing the test in English also performed more poorly than English-speaking athletes completing the test in English on three Composite scores. These differences in performance and reported symptoms highlight the need for caution in interpreting ImPACT test data for Hispanic Americans.

Comparison of nondominant and dominant hand performances on the Wechsler Memory Scale-Fourth Edition Visual Reproduction subtest copy and memory components.

Using both clinical and nonclinical samples, we investigated the effects of nondominant hand completion of copy and memory components on the Wechsler Memory Scale-Fourth Edition (WMS-IV) Visual Reproduction (VR) subtest. Part I of the study revealed statistically significant intermanual differences on the copy component, though discrepancies were not clinically meaningful. Part II showed similar memory scores between the group who used their nondominant hand and the group who used their dominant hand. Findings suggest that when a standard administration is precluded, it is reasonable to use the nondominant hand to complete the VR subtest and to make use of the WMS-IV norms for interpretation.