Clinical Neuropsychologist最新文献

{"title":"Sex and age-related differences in vestibular/ocular motor screening (VOMS) symptom provocation following concussion.","authors":"Callie Herman, Aaron J Zynda, Bindal Makwana Mehmel, Heather A Jasper, Madeleine G Todd, Cyndi L Holland, Alicia M Trbovich, Anne Mucha, Michael W Collins, Anthony P Kontos","doi":"10.1080/13854046.2025.2500617","DOIUrl":"10.1080/13854046.2025.2500617","url":null,"abstract":"<p><p><b>Objective:</b> To examine the effects and interaction of sex and age in Vestibular/Ocular Motor Screen (VOMS) symptom provocation (i.e. change scores) at patients' initial clinic visit following concussion. <b>Method:</b> A secondary analysis of patients (10-21 years) presenting to a specialty concussion clinic from 2015-2019 with complete VOMS data at their initial clinic visit <21 days post-injury. Independent samples <i>t</i>-tests, Mann-Whitney <i>U</i>, and chi-square (χ²) tests compared descriptive characteristics and VOMS symptom provocation (Ocular Motor domain items: Smooth Pursuits [SP], Horizontal/Vertical Saccades [HSAC/VSAC], Near Point Convergence [NPC]; Vestibular domain items: Horizontal/Vertical Vestibular-Ocular Reflex [HVOR/VVOR], Visual Motion Sensitivity [VMS]) between sex (male/female) and age (younger adolescent [YA, 10-14 years]/older adolescent [OA, 15-21 years]) groups. Two-way analyses of variance and covariance examined the interaction between sex and age on VOMS overall symptom provocation (i.e. all VOMS items/domains). <b>Results:</b> 235 participants were enrolled in the study (121 [51.5%] male, 114 [48.5%] female; 75 [31.9%] YA, 160 [68.1%] OA). Females had greater odds of dizziness provocation on ocular motor (_adjOR = 3.05, <i>p</i> < 0.001) and vestibular (_adjOR =2.15, <i>p</i> = 0.01) items; headache provocation across all items (_adjOR =2.51, <i>p</i> = 0.01); and provocation on the ocular motor (_adjOR = 1.84, <i>p</i> = 0.03) domain and overall VOMS (_adjOR = 2.44, <i>p</i> = 0.025) compared to males. YAs had greater odds of dizziness provocation following SP (_adjOR =2.63, <i>p</i> = 0.04) and HSAC (_adjOR = 2.24, <i>p</i> = 0.03) and greater total provocation following HSAC (_adjOR = 2.28, <i>p</i> = 0.01) compared to OAs. The sex-by-age interaction on VOMS overall change score was not significant (<i>F</i>(1, 231)=0.09, <i>p</i> = 0.76). <b>Conclusions:</b> Females reported more dizziness and overall provocation on the VOMS than males. There were no differences in overall VOMS provocation between younger and older adolescents and no interaction between sex and age on VOMS outcomes.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"2418-2436"},"PeriodicalIF":2.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modality-specific and process-related organization of list-learning performance in principal component and network analyses.","authors":"Klemens Gutbrod, Christian Balzer, Dörthe Heinemann, Klaus Willmes, Martina Studer","doi":"10.1080/13854046.2026.2749516","DOIUrl":"https://doi.org/10.1080/13854046.2026.2749516","url":null,"abstract":"<p><p><b>Objective:</b> List-learning tests provide learning, recall, and recognition indices that are often interpreted as reflecting partly distinct memory processes. We used principal component analysis (PCA) and network analysis (NA) as complementary approaches to examine the organization of verbal and visual-design list-learning performance, with particular attention to very-long-delay memory assessed after approximately 1 week. <b>Method:</b> Data were drawn from two normative cohorts of healthy adults (<i>N</i> = 805). Analyses of the conventional learning, delayed-recall, and recognition measures were based on 800 complete cases, and 233 participants had complete data for analyses including very-long-delay recall and recognition approximately 1 week later. PCA was used to identify dominant dimensions of performance, whereas NA was used to examine relationships among individual measures. <b>Results:</b> PCA yielded two correlated components organized by stimulus modality, accounting for 73.2% of the variance for the conventional learning, delayed-recall, and recognition measures and 70.6% when very-long-delay measures were included. NA likewise showed clear modality-specific organization but additionally differentiated the relationships among learning, recall, and recognition measures, with recall measures occupying comparatively central and recognition measures more peripheral positions. Very-long-delay measures remained embedded within the modality-specific PCA structure but showed a distinctive pattern of relationships in the network. <b>Conclusions:</b> PCA and NA provided complementary descriptions of the same list-learning data. PCA primarily highlighted organization by stimulus modality, whereas NA differentiated relationships among individual learning, recall, and recognition measures. Very-long-delay assessment added information about the organization of memory performance, but the present findings do not establish a separate very-long-delay cognitive process.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-22"},"PeriodicalIF":2.6,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher-order executive functions are associated with financial altruism in older adults.","authors":"Cassidy P Molinare, Belinda Y Zhang, Anya Samek, Gali H Weissberger, Daisy T Noriega-Makarskyy, Emma Oyen, Melanie Leguizamon, Jenna Axelrod, Jordan T Williams, S Duke Han","doi":"10.1080/13854046.2026.2747006","DOIUrl":"https://doi.org/10.1080/13854046.2026.2747006","url":null,"abstract":"<p><p><b>Objective:</b> Executive function abilities are important for optimal financial decision making and have been shown to decline in early Alzheimer's disease (AD). Greater financial altruism has been associated with a cognitive profile characteristic of early AD that largely implicates non-executive functioning abilities. This study investigated the associations between executive functions and \"blind giving\" in older age. <b>Method:</b> One hundred and thirty-two older adults without dementia (<i>M</i> age = 69.6; <i>M</i> MMSE = 28.3) completed all-digital executive functioning tasks from the Delis-Kaplan Executive Function System Advanced (D-KEFS Advanced) battery and a behavioral economics blind giving paradigm. Linear regression models evaluated associations between executive function performance and blind giving scores. Secondary analyses used ordinal regression models to examine associations between executive function performance and blind giving groups (e.g. gave less, gave equally, or gave more). All models controlled for age, sex, years of education, and income. <b>Results:</b> Lower performance on Verbal Fluency Category-Letter Switching and Color-Word Interference Inhibition/Switching was associated with greater blind giving scores (<i>b</i> = -0.25, 95%CI [-0.43, -0.06], <i>p</i> = .009; <i>b</i> = -0.03, 95%CI [-0.06, -0.001], <i>p</i> = .045) and higher odds of being in a more altruistic group (OR= 0.87, 95%CI [0.78, 0.98], <i>p</i> = .018; OR= 0.98, 95%CI [0.96, 1.00], <i>p</i> = .048). <b>Conclusions:</b> Lower executive function abilities were associated with greater blind giving. These findings suggest a need to monitor executive functioning in older adults using more advanced measures, as executive dysfunction may contribute to financial altruism that might subsequently increase vulnerability to financial exploitation.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-15"},"PeriodicalIF":2.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary examination of sequential dual-threshold classification of performance validity findings.","authors":"Robert J Kanser, Jeremy J Davis","doi":"10.1080/13854046.2026.2747003","DOIUrl":"https://doi.org/10.1080/13854046.2026.2747003","url":null,"abstract":"<p><strong>Objective: </strong>Conventional interpretation of performance validity tests (PVTs) involves tallying failed PVTs across a test battery. Failure of a single PVT reflects a common, but diagnostically ambiguous, indeterminate outcome affecting both clinicians and researchers. This study explored whether dual-threshold classification (DTC), which integrates sensitive and specific cut-scores in a given PVT, would reduce classification uncertainty compared to the PVT failure tally method.</p><p><strong>Methods: </strong>This study used a simulation sample (<i>N</i> = 216) of healthy controls (<i>n</i> = 73) and simulators (<i>n</i> = 143) and a mixed clinical/forensic sample (<i>N</i> = 443). Participants were classified as valid, invalid, or indeterminate across PVT pairs combined using the PVT failure tally method and a sequential, two-PVT implementation of DTC. Classification outcomes were compared at observed invalidity rates and across resampled base rates of invalidity (10%-50%).</p><p><strong>Results: </strong>Sequential DTC significantly reduced indeterminate findings compared to the PVT failure tally method in 9 of 10 PVT pairs in the simulation sample and in 26 of 28 pairs in the clinical/forensic sample. At observed invalidity base rates, indeterminate classifications decreased from 13.4-30.6% to 0-12.5% in the simulation sample and from 9.9-28.7% to 0-8.1% in the clinical/forensic sample. Indeterminate classifications remained lower using DTC across resampled invalidity base rates. Sequential DTC generally increased identification of criterion-invalid cases, and classification of criterion-valid cases varied across PVT pairs.</p><p><strong>Conclusions: </strong>These findings provide preliminary support for integration of sensitive and specific PVT cutoffs to reduce diagnostic indeterminacy in performance validity assessment.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-22"},"PeriodicalIF":2.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between subjective cognitive difficulties, cognitive test performance, psychiatric symptoms, and quality of life in pediatric long COVID.","authors":"Audrey Davis, Gray Vargas, Kathleen Parker, Laura A Malone, Kavita D Nadendla, Rowena Ng","doi":"10.1080/13854046.2026.2744758","DOIUrl":"https://doi.org/10.1080/13854046.2026.2744758","url":null,"abstract":"<p><p><b>Objective</b>: This retrospective study examined the associations between subjective cognitive difficulties, performance scores on standardized cognitive tests, and quality of life (QoL) among pediatric patients with long COVID. <b>Method</b>: This study included 82 pediatric patients with long COVID referred for a neuropsychological evaluation by a specialty pediatric Post-COVID clinic (50 F, <i>M</i>_age = 14.52 years, <i>SD</i> = 3.04, range = 6-19). Patients completed standardized neuropsychological assessments of intellectual functioning, learning/memory, working memory, auditory attention, processing speed, executive function, and performance validity, as well as the Pediatric Quality of Life Inventory (PedsQL^TM). Other outcomes of interest included subjective cognitive impairment and psychiatric symptoms. Relationships between subjective cognitive difficulties and cognitive performance on QoL were analyzed using hierarchical multiple linear regressions, with COVID course factors and psychiatric symptoms as covariates. <b>Results</b>: Our pediatric cohort reported very low overall QoL (<i>M</i> = 52.41, <i>SD</i> = 16.95), with the average score surpassing the published clinical cutoff for children with major chronic health conditions. Subjective cognitive difficulties significantly predicted lower QoL, even after controlling for psychiatric symptoms. Cognitive test performance on any domain did not significantly determine QoL. <b>Conclusions</b>: These findings offer initial support that subjective cognitive difficulties, but not cognitive test performance, significantly correlate with lower QoL in pediatric patients with long COVID. The results highlight the importance of screening for perceived subjective cognitive impairment beyond mental health screening in youth with long COVID. Treatment and school planning for children with long COVID should consider self-reported cognitive difficulties and psychological health and how these impact their daily functioning across home, school, and social settings.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-18"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and care partner perspectives of a teleneuropsychology intervention: a mixed-methods evaluation.","authors":"Natalie Lopez-Esquibel, Brianne M Bettcher, Lauren B Gunn-Sandell, Michelle E Gonzalez, Nichole E Carlson, Jennifer R Unger, Samantha K Holden, Michael R Greher, Hillary D Lum","doi":"10.1080/13854046.2026.2742406","DOIUrl":"https://doi.org/10.1080/13854046.2026.2742406","url":null,"abstract":"<p><strong>Objective: </strong>While neuropsychological evaluations by telehealth are a valid alternative to face-to-face (FF) visits, teleneuropsychology has not been widely adopted. We explored patient and care partner perspectives on acceptability, appropriateness, feasibility, and use of teleneuropsychology to evaluate possible Alzheimer's disease.</p><p><strong>Methods: </strong>Using mixed methods, we evaluated patient and care partner's quantitative surveys and qualitative interviews after two neuropsychology modalities: Teleneuropsychology or FF. Surveys included acceptability, appropriateness, and feasibility measures, and the Unified Theory of Acceptance and Use of Technology questionnaire. Median scores and interquartile ranges were compared. Interviews focused on implementation outcomes and intention to use. Qualitative analyses identified salient themes, which were integrated with quantitative findings.</p><p><strong>Results: </strong>Patients and care partners (94 and 93% non-Hispanic white) reported similar positive (median score = 4.0 on a 5-point scale) ratings for Teleneuropsychology and FF. Interviews found that benefits of Teleneuropsychology were support for care partner involvement, minimization of logistical demands, reduced travel burden, and increased comfort within a patient's home. Benefits of FF included increased interpersonal connection, improved communication with the provider, and less stress with technology. Some patients tended to prefer FF, while some care partners tended to prefer Teleneuropsychology.</p><p><strong>Conclusions: </strong>Patients and care partners in this homogeneous sample indicated that both modalities were acceptable, appropriate, and feasible. Although quantitative ratings were similar, the \"appropriate\" choice for a particular patient and care partner dyad seemed to be a personalized consideration of tradeoffs that they navigated together. When Teleneuropsychology is adopted, attention to preferences and feasibility among diverse patients is needed.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-18"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychological assessment by videoconference: Mean score differences, individual-level agreement, and connectivity-related disruptions.","authors":"Soraia S Monteiro, Andreia Geraldo, Isabel M Santos, Nick DeFilippis, Fernando Ferreira-Santos","doi":"10.1080/13854046.2026.2741170","DOIUrl":"https://doi.org/10.1080/13854046.2026.2741170","url":null,"abstract":"<p><p><b>Objective</b>: To examine mean score differences and individual-level agreement between videoconference and in-person administration of a multidomain neuropsychological assessment battery, and associations between connectivity parameters and task-specific disruptions. <b>Method</b>: In a randomized, counterbalanced within-participant design, 110 healthy Portuguese adults completed the battery by videoconference and in person, one month apart. Participants were predominantly young to middle-aged and digitally proficient; only 2.7% were aged ≥60 years. Mean differences were examined using paired <i>t</i> tests, Cohen's <i>d</i>z, and Bayes factors, and agreement using intraclass correlation coefficients and Bland-Altman analyses. Sensitivity analyses examined administration-order effects, and logistic regression assessed latency, jitter, and packet loss as predictors of disruptions. <b>Results</b>: Mean score differences were small. MoCA scores were slightly higher by videoconference (<i>M</i> = 26.99, <i>SD</i> = 2.46) than in person (<i>M</i> = 26.42, <i>SD</i> = 2.39; <i>d</i>z = -0.26, <i>p</i> = .011), but this depended on administration order and was consistent with practice effects. No other measure differed between modalities (all <i>p</i>s > .05; |<i>d</i>z| ≤ 0.19). Individual-level agreement varied across measures (ICC = 0.20-0.82), with lower agreement for several derived verbal-memory indices. Technical disruptions were infrequent and task-specific; higher jitter was associated with disruption in MoCA Letter Series/Vigilance (OR = 1.19) and IFS Go/No-Go (OR = 1.10). <b>Conclusions</b>: Videoconference and in-person administration produced small mean score differences but variable individual-level agreement. Findings support task-specific interpretation and indicate that small mean differences do not imply consistent individual-level agreement. Generalization to older and clinical populations remains limited.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-17"},"PeriodicalIF":2.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could you be more specific? Intra-individual inconsistency variables derived from different tasks demonstrate distinct associations with clinical measures of cognition.","authors":"Libby A DesRuisseaux, Pascal Deboeck, Yana Suchy","doi":"10.1080/13854046.2025.2608036","DOIUrl":"10.1080/13854046.2025.2608036","url":null,"abstract":"<p><p><b>Objective</b> Inconsistency, or intra-individual variability in performance across time (IIV-I), is a possible marker of subtle cognitive weakness. Little neuropsychological research on IIV-I has occurred, and its neurocognitive underpinnings remain unclear. Some hypothesize IIV-I is a unique construct that taps into specific neuroanatomic/cognitive processes, regardless of the task from which IIV-I was derived. However, IIV-I could also be a novel approach to measuring the same constructs being measured by the tasks from which IIV-I was derived. The present study sought to investigate IIV-I's (a) construct validity (i.e., its relationships with standard clinical measures of cognition) and (b) incremental utility <i>beyond</i> mean performance on the same task to help elucidate the clinical utility of IIV-I variables. <b>Method</b> A sample of 72 community-dwelling older adults completed clinical measures and computerized tasks used to derive IIV-I that tapped into processing speed, inhibition, and working memory (i.e., domains that have demonstrated associations with IIV-I). <b>Results</b> In multiple linear regressions, IIV-I variables demonstrated associations with clinical measures with shared neurocognitive underpinnings as the task from which the IIV-I variable was derived. Additionally, in hierarchical regressions, one IIV-I variable demonstrated potential for incremental utility beyond mean performance. <b>Conclusions</b> The present findings suggest that IIV-I may not be an independent construct that shows consistent associations with particular cognitive processes, regardless of how it is measured. Rather, IIV-I variables may tap into the cognitive constructs being measured by the task from which they are derived. Additionally, the incremental utility of IIV-I must continue to be established.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1952-1977"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ups and downs matter: Magnitudes of fluctuations in executive functions predict daily functioning in older adults.","authors":"Yana Suchy, Allie R Geiger, Libby A DesRuisseaux, Michelle Gereau Mora, Stacey Lipio Brothers","doi":"10.1080/13854046.2026.2674737","DOIUrl":"10.1080/13854046.2026.2674737","url":null,"abstract":"<p><p><b>Objective:</b> Intra-individual variability in executive functions (EF), assessed both behaviorally and <i>via</i> self-report, may serve as a predictor of instrumental activities of daily living (IADLs), whereas mean self-reported EF levels typically do not. No prior research has simultaneously examined associations among (a) day-to-day mean levels <i>and</i> fluctuations of EF self-report, (b) day-to-day mean levels <i>and</i> fluctuations of EF performance, and (c) performance of IADL tasks at home. This study examined the extent to which EF performance and EF self-report (both mean levels and daily fluctuations) relate to each other and to at-home IADL performance. <b>Method:</b> One-hundred and twenty-seven community dwelling older adults responded to daily questions about their EF abilities and completed daily EF and IADL tasks, all independently at home across 18 days. <b>Results:</b> IADL performance was predicted by overall mean EF performance and by the magnitude of fluctuations in both EF performance and EF self-report, with all three variables contributing uniquely to the model and together accounting for 27% of IADL variance (reflecting a large effect size), although fluctuations in self-report did not survive covariate analyses. Mean levels of self-reported EF did not correlate with performance on EF or IADL tasks. <b>Conclusion:</b> Both mean levels and fluctuations in EF performance across days uniquely contributed to the prediction of daily functioning, demonstrating incremental validity of each variable. Self-report of EF (both fluctuations and mean levels) did not incrementally improve prediction beyond covariates.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"2173-2191"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Montefiore Einstein Robust Geriatric Normative Project (MERGER-NP): Base rates of score discrepancies, cognitive dispersion, and impairment thresholds on the RBANS and select neuropsychological tests.","authors":"Bryan M Freilich, Roee Holtzer","doi":"10.1080/13854046.2025.2547932","DOIUrl":"10.1080/13854046.2025.2547932","url":null,"abstract":"<p><p><b>Objective:</b> This study developed and validated multivariate base rates for interpreting neuropsychological tests in older adults. We extended the clinical utility of the Montefiore Einstein Robust Geriatric (MERGER) norms by quantifying score discrepancies, cognitive dispersion, and low scores at different impairment thresholds on the RBANS and select neuropsychological tests. <b>Method:</b> The normative (MERGER) sample comprised 420 community-residing older adults. Base rates were calculated for select score discrepancies, cognitive dispersion (intraindividual standard deviation [ISD] and coefficient of variation [CoV]), and low scores at different impairment thresholds. Clinical validation analyses examined the sensitivity of base rate-derived cutoffs for cognitive dispersion and low scores at different impairment thresholds in identifying MCI and dementia, fixing specificity at 90% by selecting cutoffs corresponding to a 10% base rate in the MERGER sample. <b>Results:</b> Convenient look-up tables provide base rates for score discrepancies, dispersion, and low scores. Validation analyses showed that impairment thresholds and CoV from the full battery were highly effective at identifying dementia (sensitivity up to 87%, AUC up to 0.96) and moderately sensitive to MCI (sensitivity up to 54%, AUC up to 0.80). ISD, however, demonstrated modest sensitivity (23-31%) with lower AUCs (0.63-0.75). Diagnostic ability for domain-specific dispersion indices was generally lower than for the full battery. <b>Conclusions:</b> These multivariate base rates enhance the clinical interpretation of neuropsychological data in older adults by quantifying the likelihood of observed performance patterns, specifically score discrepancies, cognitive dispersion, and low score thresholds. The high sensitivity of impairment thresholds highlight their potential as diagnostic markers of dementia.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"2011-2039"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}