Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists最新文献

{"title":"Impact of Demographic and Deployment Related Factors on Structured Inventory of Malingered Symptomatology Performance in Veterans and Service Members.","authors":"Maya Troyanskaya, Huda Abu-Suwa, Randall S Scheibel, Nicholas J Pastorek","doi":"10.1093/arclin/acaf037","DOIUrl":"https://doi.org/10.1093/arclin/acaf037","url":null,"abstract":"<p><strong>Background: </strong>Screening for feigning and exaggeration in military populations is necessary for accurate interpretation of findings in clinical and research settings. The Structured Inventory of Malingered Symptomatology (SIMS) is a commonly used symptom validity measure, but little is known about the impact of non-clinical factors on its performance. The primary objective of this study was to examine relationships among demographic and deployment-related characteristics and SIMS performance in a cohort of veterans and reservists.</p><p><strong>Methods: </strong>One hundred and sixty-two participants with a history of combat deployment completed the SIMS and a measure of combat exposure. Demographic and deployment-related information was also collected. Multiple linear regression models were created to determine the impact of demographic and deployment-related factors on the SIMS total score and scale scores.</p><p><strong>Results: </strong>Higher SIMS total scores were associated with more severe combat exposure, being unemployed, being married or divorced as opposed to being single, and fewer years of education. Higher Neurological Impairment scale scores were associated with being unemployed, being married or divorced, fewer years of education, and older age. Furthermore, higher amnestic disorders scale scores were associated with more severe combat exposure and being unemployed, and higher affective disorders scale scores were associated with more severe combat exposure, fewer years of education, and older age.</p><p><strong>Discussion: </strong>Notable relationships between SIMS scores and several demographic and deployment-related factors were identified. This was the first study that examined relations of demographic and deployment factors and SIMS performance in a military population.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributory Etiologies to Cognitive Performance in Multimorbid Post-9/11 Veterans: The Deployment Trauma Phenotype.","authors":"Sahra Kim,&nbsp;Alyssa Currao,&nbsp;John Bernstein,&nbsp;Jennifer R Fonda,&nbsp;Catherine B Fortier","doi":"10.1093/arclin/acac040","DOIUrl":"https://doi.org/10.1093/arclin/acac040","url":null,"abstract":"<p><strong>Objective: </strong>This study examined cognitive functioning in post-9/11 Veterans with the deployment trauma phenotype (DTP), comprised of co-occurring diagnoses of depressive disorder (major depressive disorder and or persistent depressive disorder/dysthymia), posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI), using objective neuropsychological measures.</p><p><strong>Method: </strong>Participants included a cross-sectional sample of 399 post-9/11 Veterans who completed clinical interviews and neuropsychological tests as part of a larger study at VA Boston Healthcare System. Confirmatory factor analysis identified four cognitive domains: attention, cognitive control/processing speed, episodic memory, and cognitive flexibility. Veterans with DTP and its constituent diagnoses in isolation, two-way diagnostic combinations, and no constituent diagnoses were compared.</p><p><strong>Results: </strong>Veterans with DTP had a twofold increased prevalence for below average performance in cognitive control/processing speed compared with those with no constituent diagnoses (prevalence ratios [PRs] = 2.04; 95% confidence interval [CI]: 1.03-4.05). The PTSD + depressive disorder group also had a twofold increased prevalence for below average performance in episodic memory (PR = 2.16; 95% CI: 1.05-4.43).</p><p><strong>Conclusions: </strong>The deployment trauma phenotype is associated with clinically significant decrease in cognitive control/processing speed in post-9/11 Veterans. Comorbid PTSD and depressive disorder negatively impacted performances in episodic memory. Mild TBI alone showed no cognitive deficits. Clinical interventions should target psychiatric symptoms with a transdiagnostic approach to address this multimorbid population.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1699-1709"},"PeriodicalIF":2.6,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39998316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive and Psychosocial Characteristics of Pediatric Patients With Post-Acute/Long-COVID: A Retrospective Clinical Case Series.","authors":"Rowena Ng,&nbsp;Gray Vargas,&nbsp;Dasal Tenzin Jashar,&nbsp;Amanda Morrow,&nbsp;Laura A Malone","doi":"10.1093/arclin/acac056","DOIUrl":"https://doi.org/10.1093/arclin/acac056","url":null,"abstract":"<p><strong>Objective: </strong>Studies suggest a large number of patients have persistent symptoms following COVID-19 infection-a condition termed \"long COVID.\" Although children and parents often report cognitive difficulties after COVID, very few if any studies have been published including neuropsychological testing.</p><p><strong>Methods: </strong>A retrospective chart review was completed for the first 18 patients referred for a neuropsychological evaluation from a multidisciplinary pediatric post-COVID clinic. The neuropsychological screening battery assessed verbal fluency and category switching, attention, working memory, processing speed, and verbal learning and memory. Patients' caregivers also completed standardized questionnaires regarding day-to-day mood and behavior.</p><p><strong>Results: </strong>At intake, the most common neurologic symptoms reported by caregivers were attention problems (83.3%), fatigue/lethargy (77.7%), sleep disturbance (77.7%), dizziness/vertigo (72.2%), and headaches (72.2%). On rating scales, most caregivers endorsed concerns for depressed mood and anxiety (14/15 and 12/15). A large proportion of patients had difficulties with attention (9/18) and depressed mood/anxiety (13/18) before COVID. On cognitive testing, the majority of the patients performed within or above broad average range (≥16th percentile) across most domains. However, a little over half of the patients performed below average on auditory attention measures.</p><p><strong>Conclusions: </strong>Within our clinically referred sample, children who reported lingering cognitive symptoms after COVID-19 often had a preexisting history of attention and/or mood and anxiety concerns. Many of these patients performed below average in attention testing, but it remains to be seen whether this was due to direct effects of COVID, physical symptoms, and/or preexisting difficulties with attention or mood/anxiety.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1633-1643"},"PeriodicalIF":2.6,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9384547/pdf/acac056.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40553614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Western Australia Olfactory Memory Test: Reliability and Validity in a Sample of Older Adults.","authors":"Rasangi Seneviratne,&nbsp;Michael Weinborn,&nbsp;David R Badcock,&nbsp;Brandon E Gavett,&nbsp;Manuela Laws,&nbsp;Kevin Taddei,&nbsp;Ralph N Martins,&nbsp;Hamid R Sohrabi","doi":"10.1093/arclin/acac048","DOIUrl":"https://doi.org/10.1093/arclin/acac048","url":null,"abstract":"<p><strong>Objective: </strong>The Western Australia Olfactory Memory Test (WAOMT) is a newly developed test designed to meet a need for a comprehensive measure of olfactory episodic memory (OEM) for clinical and research applications.</p><p><strong>Method: </strong>This study aimed to establish the psychometric properties of the WAOMT in a sample of 209 community-dwelling older adults. An independent sample of 27 test-naïve participants were recruited to assess test retest reliability (between 7 and 28 days). Scale psychometric properties were examined using item response theory methods, combined samples (final N = 241). Convergent validity was assessed by comparing performance on the WAOMT with a comprehensive neuropsychological battery of domains (verbal and visual episodic memory, and odor identification), as well as other neuropsychological skills. Based on previous literature, it was predicted that the WAOMT would be positively correlated with conceptually similar cognitive domains.</p><p><strong>Results: </strong>The WAOMT is a psychometrically sound test with adequate reliability properties and demonstrated convergent validity with tests of verbal and episodic memory and smell identification. Patterns of performance highlight learning and memory characteristics unique to OEM (e.g., learning curves, cued and free recall).</p><p><strong>Conclusion: </strong>Clinical and research implications include streamlining future versions of the WAOMT to ease patient and administrative burden, and the potential to reliably detect early neuropathological changes in healthy older adults with nonimpaired OEM abilities.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1720-1734"},"PeriodicalIF":2.6,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40532585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Validity Measure for the Automated Neuropsychological Assessment Metrics.","authors":"John E Meyers,&nbsp;Ronald Mellado Miller,&nbsp;Andrea S Vincent","doi":"10.1093/arclin/acac046","DOIUrl":"https://doi.org/10.1093/arclin/acac046","url":null,"abstract":"<p><p>The Automated Neuropsychological Assessment Metrics (ANAM) is one of the most widely used and validated neuropsychological instruments for assessing cognition. The ANAM Test System includes a reporting tool, the ANAM Validity Indicator Report that generates scores for the embedded effort measure, the ANAM Performance Validity Index (APVI). The current study seeks to develop a proxy for the APVI, using raw subtest summary test scores. This would be useful for situations where the APVI score is unavailable (e.g., validity report not generated at the time of the assessment) or when the item level data needed to generate this score are inaccessible. ANAM scores from a large data set of 1,000,000+ observations were used for this retrospective analysis. Results of linear regression analysis suggest that the APVI can be reasonably estimated from the raw subtest summary test scores that are presented on the ANAM Performance Report. Clinically, this means that an important step in the interpretation process, checking the validity of test data, can still be performed even when the APVI is not available.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1765-1771"},"PeriodicalIF":2.6,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40464965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Amnesia Diagnostic Accuracy with RAVLT Single Scores and Composite Indices: Italian Normative Data.","authors":"Monica Ricci,&nbsp;Massimiliano Ruggeri,&nbsp;Cristina Gnisci,&nbsp;Luca Pizzoni,&nbsp;Carmela Gerace,&nbsp;Carlo Blundo","doi":"10.1093/arclin/acac055","DOIUrl":"https://doi.org/10.1093/arclin/acac055","url":null,"abstract":"<p><strong>Objective: </strong>The Rey Auditory Verbal Learning Test (RAVLT) is a widely used verbal memory measure that provides scores for different aspects of memory. It involves repeated auditory presentation and recall of a 15-item word list (List A) followed by presentation and recall of a distractor list (List B) and then un-cued immediate and delayed recalls (at 15 min and 1 week) of List A as well as recognition testing. Aims of this study are to provide Italian normative data for certain RAVLT Scores and Composite Indices to improve the diagnostic accuracy of the test in clinical settings and to provide further evidence on how RAVLT can differentiate different amnesia profiles due to focal lesions.</p><p><strong>Methods: </strong>We enrolled 440 healthy participants and RAVLT Single Scores and Composite Indices have been analyzed by means of multiple regression to verify the influence of age, education, and gender.</p><p><strong>Results: </strong>We computed the best linear models with RAVLT Single Scores and Composite Indices, as dependent variables, and the most suitable transformation of independent variables. By reversing the signs of the regression coefficients, the adjustment factors for each level of age and, if needed, education and gender have been computed and the adjusted scores have been standardized into Equivalent Scores.</p><p><strong>Conclusion: </strong>Using these standardized measures, we differentiate three profiles of amnesia due to selective hippocampal sclerosis with severe encoding deficit, fornix lesions with source memory problems, and temporal lobe epilepsy with consolidation failure.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1749-1764"},"PeriodicalIF":2.6,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40532584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Cerebrovascular Pathology on Cluster Analysis of Neuropsychological Scores in Patients With Mild Cognitive Impairment.","authors":"Kristoffer Romero,&nbsp;Natalia Ladyka-Wojcik,&nbsp;Arjan Heir,&nbsp;Buddhika Bellana,&nbsp;Larry Leach,&nbsp;Guy B Proulx","doi":"10.1093/arclin/acac043","DOIUrl":"https://doi.org/10.1093/arclin/acac043","url":null,"abstract":"<p><strong>Objectives: </strong>The diagnostic entity of mild cognitive impairment (MCI) is heterogeneous, highlighting the need for data-driven classification approaches to identify patient subgroups. However, these approaches can be strongly determined by sample characteristics and selected measures. Here, we applied a cluster analysis to an MCI patient database from a neuropsychology clinic to determine whether the inclusion of patients with MCI with vascular pathology would result in a different classification of subgroups.</p><p><strong>Methods: </strong>Participants diagnosed with MCI (n = 166), vascular cognitive impairment-no dementia (n = 26), and a group of older adults with subjective cognitive concerns but no objective impairment (n = 144) were assessed using a full neuropsychological battery and other clinical measures. Cognitive measures were analyzed using a hierarchical cluster analysis and then a k-means approach, with resulting clusters compared on a range of demographic and clinical variables.</p><p><strong>Results: </strong>We found a 4-factor solution: a cognitively intact cluster, a globally impaired cluster, an amnestic/visuospatial impairment cluster, and a mild, mixed-domain cluster. Interestingly, group differences in self-reported multilingualism emerged in the derived clusters that were not observed when comparing diagnostic groups.</p><p><strong>Conclusions: </strong>Our results were generally consistent with previous studies using cluster analysis in MCI. Including patients with primarily cerebrovascular disease resulted in subtle differences in the derived clusters and revealed new insights into shared cognitive profiles of patients beyond diagnostic categories. These profiles should be further explored to develop individualized assessment and treatment approaches.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1480-1492"},"PeriodicalIF":2.6,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40460861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation and Validation of Addenbrooke's Cognitive Examination-III in Bengali for Screening MCI and Dementia.","authors":"Bidisha Bhattacharyya,&nbsp;Ruchira Mukherjee,&nbsp;Adreesh Mukherjee,&nbsp;Gautam Das,&nbsp;Atanu Kumar Dogra,&nbsp;Sujata Das,&nbsp;Atanu Biswas","doi":"10.1093/arclin/acac041","DOIUrl":"https://doi.org/10.1093/arclin/acac041","url":null,"abstract":"<p><strong>Objective: </strong>Bengali, the 6th most spoken language globally with 268 million speakers, demands a culturally appropriate tool for screening any cognitive compromise in this population. Addenbrooke Cognitive Examination-III (ACE-III) is a standardized tool used for screening and/or diagnostic purpose worldwide. The aim of the present study was to adapt and validate ACE-III into Bengali language.</p><p><strong>Methods: </strong>The ACE-III UK Version A (2012) was adapted with linguistically and culturally appropriate items and validated on Bengali speakers. The participants consisted of 40 dementia and 22 Mild Cognitive Impairment (MCI) patients and 120 healthy-controls. Reliability and validity were examined. Discriminant function analysis was done. Sensitivity and specificity were evaluated and optimum cut-offs were established for MCI and dementia.</p><p><strong>Results: </strong>Both sensitivity and specificity of ACE-III-Bengali of identifying dementia was 1; sensitivity for MCI ranged from 0.83 to 1, specificity from 0.76 to 1. Discriminant function analysis showed a significant difference in all domains of ACE-III-Bengali between healthy individuals and persons with neurocognitive impairment. Separate optimum ACE-III-Bengali cut-off scores were established according to level of education. For low education (<Class 10) cut-off was 83 for dementia and 86 for MCI, whereas, for high education (≥Class 10) it was 85 and 88 for dementia and MCI, respectively. The area under curve for distinguishing dementia and MCI ranged from 0.949 to 0.955.</p><p><strong>Conclusion: </strong>The ACE-III-Bengali is found to have high diagnostic accuracy in identifying dementia and MCI in the Bengali population.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1619-1627"},"PeriodicalIF":2.6,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avoidant Coping Is Associated with Quality of Life in Persons with Multiple Sclerosis with High Cognitive Reserve.","authors":"Samantha M Vervoordt,&nbsp;Megan L Bradson,&nbsp;Peter A Arnett","doi":"10.1093/arclin/acac049","DOIUrl":"https://doi.org/10.1093/arclin/acac049","url":null,"abstract":"<p><strong>Objective: </strong>The goal of this study was to determine the impact of the relationship between cognitive reserve and coping strategy on quality of life (QoL) outcomes in persons with MS (PwMS) across multiple domains.</p><p><strong>Methods: </strong>We examined the effect of the interactions between coping style and cognitive reserve on QoL and disease burden in 97 persons with MS (PwMS). Coping strategy, either active or avoidant, was measured using the COPE inventory. We defined cognitive reserve as a composite measure of years of education and scores on the Shipley-2 Vocabulary subtest. QoL and disease burden were assessed using the Functional Assessment of MS (FAMS) scale and the Expanded Disability Status Scale, respectively. We examined both the FAMS individual subscales and the overall QoL score.</p><p><strong>Results: </strong>For those with higher cognitive reserve, greater avoidant coping was associated with lower QoL for the thinking and fatigue subscale (p < 0.001) and poorer overall QoL (p = 0.03); greater active coping was associated with poorer QoL for mobility (p = 0.001). However, these associations did not hold for those with lower cognitive reserve. Furthermore, there were no associations between coping strategy and cognitive reserve with disease burden.</p><p><strong>Conclusions: </strong>This study extends previous findings by demonstrating that avoidant coping, rather than active coping, is associated with poorer thinking and fatigue and overall QoL only for PwMS with greater cognitive reserve. Counseling PwMS on the impact of coping strategies on QoL outcomes, especially for those with greater cognitive reserve, may improve quality of life outcomes in this population.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1527-1535"},"PeriodicalIF":2.6,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40518088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multivariate Base Rates of Low Neuropsychological Test Scores in Cognitively Intact Older Adults with Subjective Cognitive Decline from a Specialist Memory Clinic.","authors":"Kristoffer Romero,&nbsp;Astrid Coleman,&nbsp;Arjan Heir,&nbsp;Larry Leach,&nbsp;Guy B Proulx","doi":"10.1093/arclin/acac050","DOIUrl":"https://doi.org/10.1093/arclin/acac050","url":null,"abstract":"<p><strong>Objective: </strong>To avoid misdiagnosing mild cognitive impairment (MCI), knowledge of the multivariate base rates (MVBRs) of low scores on neuropsychological tests is crucial. Base rates have typically been determined from normative population samples, which may differ from clinically referred samples. The current study addresses this limitation by calculating the MVBR of low or high cognitive scores in older adults who presented to a memory clinic experiencing subjective cognitive decline but were not diagnosed with MCI.</p><p><strong>Method: </strong>We determined the MVBRs on the Kaplan-Baycrest Neurocognitive Assessment for 107 cognitively healthy older adults (M age = 75.81), by calculating the frequency of patients producing n scores below or above different cut-off values (i.e., 1, 1.5, 2.0, 2.5 SD from the mean), stratifying by education and gender.</p><p><strong>Results: </strong>Performing below or above cut-off was common, with more stringent cut-offs leading to lower base rates (≥1 low scores occurred in 84.1% of older adults at -1 SD, 55.1% at -1.5 SD, and 39.3% at -2 SD below the mean; ≥1 high scores occurred in 80.4% of older adults at +1 SD, 35.5% at +1.5 SD, and 16.8% at +2 SD above the mean). Higher education was associated with varying base rates. Overall, the MVBR of obtaining a low cognitive test score was higher in this clinic sample, compared with prior studies of normative samples.</p><p><strong>Conclusions: </strong>MVBRs for clinically referred older adults experiencing memory complaints provide a diagnostic benefit, helping to prevent attributing normal variability to cognitive impairment and limiting false positive diagnoses.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":"1467-1479"},"PeriodicalIF":2.6,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40515910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}