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1. Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study

Author

Katherine H. Chang, Cuiling Wang, Caroline O. Nester, Mindy J. Katz, Desiree A. Byrd, Richard B. Lipton, and Laura A. Rabin

Subjects
subjective cognitive concerns, mild cognitive impairment, informant report, study partner, aging, longitudinal, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

ObjectiveThe role of subjective cognitive concerns (SCC) as a diagnostic criterion for MCI remains uncertain and limits the development of a universally (or widely)-accepted MCI definition. The optimal MCI definition should define an at-risk state and accurately predict the development of incident dementia. Questions remain about operationalization of definitions of self- and informant-reported SCCs and their individual and joint associations with incident dementia.MethodsThe present study included Einstein Aging Study participants who were non-Hispanic White or Black, free of dementia at enrollment, had follow-up, and completed neuropsychological tests and self-reported SCC at enrollment to determine MCI status. Informant-reported SCC at baseline were assessed via the CERAD clinical history questionnaire. Self-reported SCC were measured using the CERAD, items from the EAS Health Self-Assessment, and the single memory item from the Geriatric Depression Scale. Cox proportional hazards models examined the association of different operationalizations of SCC with Petersen and Jak/Bondi MCI definitions on the risk of dementia, further controlling for age, sex, education, and race/ethnicity. Time-dependent sensitivity and specificity at specific time points for each definition, and Youden’s index were calculated as an accuracy measure. Cox proportional hazards models were also used to evaluate the associations of combinations of self- and informant-reported SCC with the risk of incident dementia.Results91% of the sample endorsed at least one SCC. Youden’s index showed that not including SCC in either Jak/Bondi or Petersen classifications had the best balance between sensitivity and specificity across follow-up. A subset of individuals with informants, on average, had a lower proportion of non-Hispanic Blacks and 94% endorsed at least one self-reported SCC. Both informant-reported and self-reported SCC were significantly associated with incident dementia.ConclusionOur findings suggest that the SCC criterion may not improve the predictive validity for dementia when included in widely-employed definitions of MCI. Consistent with some prior research, informant-reported SCC was more related to risk of incident dementia than self-reported SCC. Given that requiring informant report as a diagnostic criterion may unintentionally exclude health disparate groups, additional consideration is needed to determine how best to utilize informant-report in MCI diagnosis.

Published
2023
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2. Official position of the American Academy of Clinical Neuropsychology on test security

Author

Kyle Brauer Boone, Jerry J. Sweet, Desiree A. Byrd, Robert L. Denney, Robin A. Hanks, Paul M. Kaufmann, Michael W. Kirkwood, Glenn J. Larrabee, Bernice A. Marcopulos, Joel E. Morgan, June Yu Paltzer, Monica Rivera Mindt, Ryan W. Schroeder, Anita H. Sim, and Julie A. Suhr

Subjects
Psychiatry and Mental health, Clinical Psychology, Neuropsychology and Physiological Psychology, Arts and Humanities (miscellaneous), Neuropsychology, Developmental and Educational Psychology, Academies and Institutes, Humans, Neuropsychological Tests, United States
Abstract

To provide education regarding the critical importance of test security for neuropsychological and psychological tests, and to establish recommendations for best practices for maintaining test security in forensic, clinical, teaching, and research settings. Previous test security guidelines were not adequately specified.Neuropsychologists practicing in a broad range of settings collaborated to develop detailed and specific guidance regarding test security to best ensure continued viability of neuropsychological and psychological tests. Implications of failing to maintain test security for both the practice of neuropsychology and for society at large were identified. Types of test data that can be safely disclosed to nonpsychologists are described.Specific procedures can be followed that will minimize risk of invalidating future use of neuropsychological and psychological measures.Clinical neuropsychologists must commit to protecting sensitive neuropsychological and psychological test information from exposure to nonpsychologists, and now have specific recommendations that will guide that endeavor.

Published
2022

3. Reading Ability as an Estimator of Premorbid Intelligence: Does It Remain Stable Among Ethnically Diverse HIV+ Adults?

Author

James P, Olsen, Robert P, Fellows, Monica, Rivera-Mindt, Susan, Morgello, and Desiree A, Byrd

Subjects
Adult, Male, medicine.medical_specialty, Intraclass correlation, Intelligence, Ethnic group, HIV Infections, Disease, Neuropsychological Tests, Article, Young Adult, Arts and Humanities (miscellaneous), Acquired immunodeficiency syndrome (AIDS), Developmental and Educational Psychology, medicine, Humans, Psychiatry, Reliability (statistics), Aged, Ethnic studies, Reproducibility of Results, Middle Aged, medicine.disease, Psychiatry and Mental health, Clinical Psychology, Neuropsychology and Physiological Psychology, Reading, Wide Range Achievement Test, Female, Psychology, Neurocognitive, Clinical psychology
Abstract

The Wide Range Achievement Test, 3rd edition, Reading-Recognition subtest (WRAT-3 RR) is an established measure of premorbid ability. Furthermore, its long-term reliability is not well documented, particularly in diverse populations with CNS-relevant disease. Objective: We examined test-retest reliability of the WRAT-3 RR over time in an HIV+ sample of predominantly racial/ethnic minority adults. Method: Participants (N = 88) completed a comprehensive neuropsychological battery, including the WRAT-3 RR, on at least two separate study visits. Intraclass correlation coefficients (ICCs) were computed using scores from baseline and follow-up assessments to determine the test-retest reliability of the WRAT-3 RR across racial/ethnic groups and changes in medical (immunological) and clinical (neurocognitive) factors. Additionally, Fisher’s Z tests were used to determine the significance of the differences between ICCs. Results: The average test-retest interval was 58.7 months (SD=36.4). The overall WRAT-3 RR test-retest reliability was high (r = .97, p < .001), and remained robust across all demographic, medical, and clinical variables (all r’s > .92). Intraclass correlation coefficients did not differ significantly between the subgroups tested (all Fisher’s Z p’s > .05). Conclusions: Overall, this study supports the appropriateness of word-reading tests, such as the WRAT-3 RR, for use as stable premorbid IQ estimates among ethnically diverse groups. Moreover, this study supports the reliability of this measure in the context of change in health and neurocognitive status, and in lengthy inter-test intervals. These findings offer strong rationale for reading as a “hold” test, even in the presence of a chronic, variable disease such as HIV.

Published
2015

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