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Purpose: To examine effects of subjective perception and objective status of cognition on emotional functioning in a sample of adults with long-term neurological and neuropsychiatric disorders.Meth...

The current study explores factors predicting return to work in a sample of patients with neurological and neuropsychiatric disorders who have attended a prevocational readiness and social skills training programme many years after trauma. Participants were community-dwelling adults with long-term disabilities (N = 67). Results of univariate analyses followed by multivariate logistic regression analysis revealed that both pre-injury (prior) and post-injury (current) factors influenced the likelihood of employment in our sample: prior employment, current employment readiness, current cognitive competence (particularly memory and executive functioning) and emotional adjustment. Our findings demonstrate that both pre-trauma and current factors interact in predicting return to work not only for individuals with traumatic brain injury (TBI), but also for a broader group of patients with long-term disabilities due to a variety of neurological and neuropsychiatric conditions. Thus, our findings provide p...

Purpose To assess psychometric properties of the problem checklist (PCL) in a sample of individuals with neurological and neuropsychiatric disorders many years after trauma; to identify factors that impact life satisfaction and promote functional competence after long-term disability. Method Cross-sectional, interview- and assessment-based study. Participants were community-dwelling adults with disabilities resulting from neurological and neuropsychiatric disorders (N = 53), who participated in a pre-vocational readiness and social skills training program. The Problem Checklist from the New York University Head Injury Family Interview (PCL), a battery of self-rated and clinician-rated measures of social/emotional status, and neuropsychological tests were main outcome measures. Results PCL is a valid and reliable instrument with acceptable psychometric properties (reliability coefficients for two scales and the total score are above (0.795). Use of maladaptive coping strategies in our sample was reflected in inverse relationship between depression and denial of disability, and in the tendency to overrate self-reported symptoms by participants with acquired trauma. Considerably lower self-ratings of symptoms across all PCL scales were seen in those of our participants who live with parents. Conclusions The study offers initial support for the use of PCL as a measure of long-term functional outcome in individuals with neurological and neuropsychiatric diagnoses. The goal of rehabilitation in patients with long-term disabilities is increase in life satisfaction. Implications for Rehabilitation An important goal of rehabilitation and training programs for individuals with long-term disabilities due to dysfunction of the central nervous system is to improve their quality of life. The HI-FI Problem Checklist (PCL) is a brief and efficient instrument for assessing functional outcomes after long-term disability. This study demonstrated acceptable psychometric properties of the PCL in a sample of 53 individuals participating in a pre-vocational training program and provided initial support for its utility for patients with various diagnoses.

To investigate utility of the Community Integration Questionnaire (CIQ) in a mixed sample of adults with neurological and neuropsychiatric disorders.Cross-sectional, interview-based study. Participants were community-dwelling adults with disabilities resulting from neurological and neuropsychiatric disorders (N = 54), who participated in a pre-vocational readiness and social skills training program. Psychometric properties of the Community Integration Questionnaire (CIQ) were assessed and validated against Mayo-Portland Adaptability Inventory (MPAI) and The Problem Checklist from the New York University Head Injury Family Interview (PCL).Based on the revised scoring procedures, psychometric properties of the CIQ Home Competency scale were excellent, followed by the Total score and Social Integration scale. Productive Activity scale had low content validity and a weak association with the total score. Convergent and discriminant validity of the CIQ were demonstrated by correlation patterns with MPAI scales in the expected direction. Significant relationship was found with PCL Physical/Dependency scale. Significant associations were found with sex, living status, and record of subsequent employment.The results provide support for the use of the CIQ as a measure of participation in individuals with neurological and neuropsychiatric diagnoses and resulting disabilities.An important goal of rehabilitation and training programs for individuals with dysfunction of the central nervous system is to promote their participation in social, vocational, and domestic activities. The Community Integration Questionnaire (CIQ) is a brief and efficient instrument for measuring these participation domains. This study demonstrated good psychometric properties and high utility of the CIQ in a sample of 54 individuals participating in a prevocational training program.

Members of the National Academy of Neuropsychology were surveyed in 2005 to assess then current practices regarding Boston Naming Test (BNT) administration, interpretation, and reporting procedures. Nearly half of 445 respondents followed discontinuation rules that differed from instructions published with the test, and nearly 10% did not administer items in reverse order to achieve the required 8 consecutive item basal. Of further concern, between 40% and 55% of respondents indicated that they did not interpret BNT scores in light of linguistic and ethnic background, and over 25% reported that they did not consider educational level. Despite the fact that non-normal distribution of BNT test scores renders use of percentiles misleading, nearly 60% of respondents endorsed using percentiles when reporting BNT data. The implications of these results are discussed, and recommendations are provided.

(2000). The Severe Cognitive Impairment Profile (SCIP) Journal of Clinical and Experimental Neuropsychology: Vol. 22, No. 2, pp. 294-298.

The direct and indirect effects of demographic, medical, and psychological variables on neuropsychological performance in elderly individuals were examined using a LISREL structural equation model. One-hundred fifty-six geriatric subjects were individually administered a comprehensive neuropsychological battery, an extensive medical history and demographics questionnaire, and the Neuropsychology Behavior and Affect Profile (a psychological assessment instrument). The model assessed the effects of five independent latent variables (medical history, psychological functioning, global mental status, education, and gender-related functioning) on two dependent latent variables (nonverbal and verbal neuropsychological functioning). The best fitting model revealed that three latent variables (medical history, global mental status, and gender-related functioning) had direct effects on neuropsychological functioning and that all five independent variables exhibited indirect effects. These findings suggest that the influence of demographic variables on neuropsychological functioning for geriatric persons is complex and that certain variables should not be interpreted independently of each other due to their significant moderating influences. (JINS, 1996, 2, 299–305.)

The Neuropsychology Behavior and Affect Profile (NBAP) is a peer-rated inventory of behavioral and affective changes in brain injured individuals and consists of five Clinical Scales that have demonstrated strong external validity. A potential confound is the NBAP's susceptibility to rater bias. In the present investigation, four validity scales were developed and external validity and psychometric properties were examined through a dissembling paradigm. Study I describes item selection and construction of the validity scales. Study 2 demonstrates that various combinations of both the clinical and validity scales effectively differentiated dissemblers from informants of two groups of traumatic brain injury patients. Although results differed somewhat when dissemblers were grouped according to their level of neuropsychological training, highly trained dissemblers (licensed clinical neuropsychologists) could be detected.

This study compared patients across 5 psychiatric diagnostic groups: Depression, Mania, Schizophrenia, Schizoaffective Disorder, and Psychosis NOS, all of whom are psychotic. Differences in overall cognitive profiles and in dysfunctional memory mechanisms, as well as the effect of psychosis on cognitive functioning were explored using the Neurobehavioral Cognitive Status Examination (NCSE), a brief screening instrument. Results indicated pronounced deficit in memory and abstract reasoning associated with schizophrenic illness, which is not secondary to psychosis and points to localized brain dysfunction. Both encoding and postencoding memory mechanisms were affected. Results support a hypothesis of progressive dysfunction associated with the severity and chronicity of the illness. Implications of findings in aiding diagnostic determination, patient management and rehabilitation are discussed.

The Boston Naming Test is commonly viewed as a measure of language ability, particularly, confrontational naming. Its utility in detecting word-retrieval problems in clinical populations is well documented. However, studies which would explore information-processing mechanisms involved in BNT performance are not available. Results of our repeated testing of 122 subjects between the ages of 57 and 85 with the 60-item version of BNT and other measures over three annual probes revealed high stability of the BNT scores over time, which suggests a lack of the practice effect, whereas cross-sectional analysis demonstrated some decline in the BNT scores in subjects over 70 years of age. In spite of the high stability in BNT scores on repeated testing, the pattern of correlations between the BNT and measures tapping different cognitive domains shifted over time. Results suggest predominantly the verbal mode of information processing in BNT performance on the first probe, as opposed to visuo-spatial mode on the third probe in our sample of elderly individuals.

Age-related asymmetrical functional decline was tested on a sample of 64 right-handed volunteers between 60 and 64 years of age who were free from neurological illnesses and physical handicaps. Increase in functional asymmetry was explored by examining performance indexes for each hand and superiority of the dominant hand on motor tasks of different complexities: the Finger Tapping Test, the Grooved Pegboard Test, and the Pin Test. Our study revealed an increase in superiority of the right hand with age on a highly demanding task (Pin Test). This finding is discussed in light of the hypothesis of a decline in callosal functioning with age and the alternative hypothesis of a greater vulnerability of the right hemisphere in the elderly.

This study provides base rates for WAIS-R VIQ-PIQ discrepancy and for 3 indices of intersubtest scatter in a sample of high functioning normal elderly. High correlations between indices of scatter, such as (1) range of scatter; (2) Profile Variability Index; and (3) number of subtest scores that significantly deviated from the individual's own mean, indicate that easy-to-compute range can be used as an adequate measure of scatter in many clinical settings. The results suggest that bright elderly individuals display a large degree of scatter. The clinician should base judgment regarding abnormality of the WAIS-R indices on the rarity of the value demonstrated by the individual with respect to the sample of comparable age and intelligence level.

This study explored the relationship between three indices of intersubtest scatter and level of cognitive deterioration in a sample of 104 patients with dementia of Alzheimer's type, who ranged in age between 52 and 84 years. Scatter was highly related to education and premorbid level of functioning. Advancement of dementia was shown to be associated with decrease in scatter, which suggests caution in interpretation of high magnitude of inter-subtest scatter as an indication of brain dysfunction. Easy-to-calculate range of scatter proved to be adequate measure of scatter. Calculation of more complex indices, such as PVI, provides only minimal incremental gain.

The study explored differential patterns of deficits in different memory components as a function of dementia severity. Three groups of 58 subjects each were used: (1) highly functioning elderly who are free of neurological or psychiatric symptoms; (2) individuals with early signs of memory disturbance, whose MMSE scores were > or = 24; and (3) individuals with MMSE scores below 24, who meet criteria for DAT. Performance on the tests that assess different memory components was compared for the three groups. Results suggest pronounced change in acquisition component of memory at the onset of dementia, whereas retrieval from remote memory discriminates well between the mild and the more advanced phases of the disease. Retrieval from recent memory deteriorates more gradually. Based on these results, efficiency of different memory mechanisms was discussed.

The study explored encoding, storage, and retrieval components of memory functioning in four groups of subjects: (1) normal elderly; (2) elderly subjects in the early prestages of DAT; (3) elderly subjects with a more advanced DAT; (4) younger subjects in the early prestages of AIDS dementia. Each group consisted of 26 subjects, who were administered the Rey Auditory-Verbal Learning Test. The results suggest impaired encoding and retrieval in the DAT groups. The AIDS group demonstrated deficient storage and retrieval. Their pattern of memory deficits was similar to that seen in normal aging. The results speak in favor of the hypothesis of subcortical nature of neurological changes in normal aging.

The study explored the efficiency of the Neurobehavioral Cognitive Status Examination (NCSE) in predicting organic pathology in psychiatric patients.Based on history of neurological disorders, 192 psychiatric patients at a country hospital were assigned to one of two groups according to whether they did or did not have organic mental disorder. Fifty patients were determined to have the disorder, and 136 were determined not to have the disorder. The patient's performance on each of the NCSE's ten scales was rated from 1, indicating average performance, to 4, indicating severe impairment. The scores were added together to form a composite index score, with a range from 10 to 40. Composite scores for the two groups were compared.A composite index score of 13 was optimal for discriminating between patients with organic mental disorder and those without the disorder. At this cutoff level, the test had a sensitivity of .72 and specificity of .73.The NCSE can be useful in screening for organicity in a psychiatric population. However, psychiatric patients without organic mental disorder can be expected to demonstrate some impairment on one or more of the NCSE's ten scales.

The present investigation examines specific aspects of frontal functioning across geriatric and nongeriatric cohorts. Subjects included 193 nongeriatric male pilots (mean age: 48.29 (SD = 6.79); mean education: 15.93 years (SD = 1.86)), and 68 geriatric males and females (mean age: 78.38 (SD = 5.07); mean education: 13.68 (SD = 2.53)). The results of a series of general linear model multivariate one-way analyses revealed poorer performance on frontal measures in the geriatric sample, although no differences were noted between the male and female samples. In contrast, variable interrelations, as assessed by a parametric statistic of betweengroup factor similarity, indicated a noteworthy similarity of factors between the geriatric and nongeriatric groups, and dissimilarities between the factor structures for males and geriatric females. These findings not only support the presence of age-related differences in frontal performance for the domains tested, they suggest the need to examine frontal functioning by multiple methods, as differences in frontal functioning may exist between groups that are undetected by analyses based on intergroup score differences or predictor-criterion correlations alone

Data are presented on the prevalence of current left-handedness and prior left-handedness (switched) in 2787 subjects from 21 to 101 years of age. In addition, data on sex differences, familial sinistrality, hand posture when writing, and education were recorded. Two hypotheses were tested. The elimination hypothesis states that reduced frequency of left-handers in old age is due to reduced longevity. The modification hypothesis states that differences in the number of left-handers between older and younger persons are due to changing patterns of social norms. The results showed a decreasing prevalence of left-handedness across the age span, with 15.22% in the youngest group (21-30 years), but only 1.67% in subjects older than 80 years. There was however a corresponding increase in the number of subjects who had switched hand for writing, 2.69% in the youngest group to 6.75% in subjects 80 years and above. This supports the modification hypothesis and questions the elimination hypothesis. However, the mean percent score was still lower in subjects above compared to below age 40 after correction for hand switching. Thus, although changes in social norms towards left-handers seem to be the most likely explanation, we have not empirically disproved the elimination hypothesis.

This study explored effect of age on encoding, retention, and retrieval components of memory functioning in a sample of 156 healthy, elderly subjects between the ages of 57 and 85, partitioned into four age groups. Memory assessment was based on subjects' performance on the RAVLT, which consisted of five free-recall trials, recall after interference, and recognition trial. Significant group differences in recall were found on all five learning trials, whereas rates of learning, forgetting, and recognition did not differ for four age groups. In addition, primacy/recency effect was equally strong for all groups. Results suggest faulty retrieval mechanisms, whereas encoding and retention processes did not prove to be affected by aging.

The present study explores age-related changes in cognitive functioning in a cohort of 122 healthy elderly volunteer subjects over a 3-year period. The sample was partitioned into four age groups: 57-65, 66-70, 71-75, 76-85 years. The results suggested high stability of factor structure over three testing probes, as well as selective attrition effect with significantly lower performance in those subjects, who dropped out from the study on the tests of verbal memory and mental speed. The results of repeated measures MANOVA on raw scores and univariate ANOVAs on factor scores comparing four age groups at each testing probe revealed a differential pattern of changes in verbal and nonverbal perception/memory versus mental speed/mental flexibility. Implications of these findings in clinical diagnostics were considered.

RÉSUMÉPlusieurs hypothèses ont été émises reliant les changements neuroanatomiques durant le vieillissement normal aux séquelles neuropsychologiques correspondantes. Cet article examine les observations empiriques à l'appui de l'hypothèse soutenant que les changements structuraux les plus importants du vieillissement normal surviennent au sein de l'axe frontal sous-cortical et que ceux-ci entraînent un comportement neuropsychologique semblable à celui retrouvé chez les jeunes personnes victimes de difformité sous-corticale. Pour les besoins de la présente enquête les chercheurs ont administré une série de tests neuropsychologiques à 14 personnes normales d'âge avancé, à 12 personnes plus jeunes atteintes de VIH encéphalopathie, et à 14 jeunes sujets contrôles neurologiquement intacts. Les résultats ont démontré qu'il existe une forte ressemblance entre les personnes d'âge avancé et celles atteintes de VIH encéphalopathie dans leur niveau et dans leur style de comportement neuropsychologique, et ce en dépit des écarts d'âge considérables. Ces résultats appuient done la notion que le vieillissement normal affecte de façon différentielle les fonctions favorisées par les régions frontales sous-corticales du cerveau.

Internal stability and discriminant validity of the Neuropsychology Behavior and Affect Profile (L. Nelson et al., 1989) were examined in samples of 70 stroke patients and 88 elderly controls. The test is designed to yield indices of premorbid (before-item subset) and present (now-item subset) levels of emotional functioning in each of five scales. With coefficient alphas ranging from.76 to .87, results indicated moderate to high internal stability. The test was also able to reliably distinguish between the criterion stroke sample (n = 42) and a matched group of elderly controls in terms of present levels of emotional functioning (2 weeks poststroke). When discriminant validity was examined in terms of premorbid emotional status (before-item subset), group differences were unexpectedly obtained

Test-retest reliability of the WAIS-R Satz-Mogel short form was tested on a sample of 122 normal elderly volunteer subjects with mean age of 70.4. Subjects’ performance was assessed over 3 annual probes. Reliability coefficients for sums of scaled scores on Verbal subscale and Full Scale ranged between 0.79 and 0.83. Corresponding coefficients for Performance subscale ranged between 0.70 and 0.72. The percentage of subjects who showed change between two probes of more than 1 SD was the highest for the Performance subscale. Implications for clinical use, particularly for the purpose of estimation of premorbid intellectual functioning are discussed.

The percentage of individuals who use the left hand for writing/drawing, brushing teeth, and throwing a ball was compared in 3229 subjects ranging in age from 8 to 96 years. The "elimination" versus "modification" hypotheses were tested as explanations of prior observations that there are fewer left-handers among the elderly. These hypotheses predict different numbers of left-handed elderly individuals when measured by activities not influenced by social pressure. The results suggest that there are age-related patterns among different measures of left-handedness. However, a significant decline in left-handedness among the elderly was also found when measured by less culturally determined activities.

The goal of the present study was to explore characteristic cognitive profiles which distinguish between psychiatric patients with and without organic mental disorder (OMD), using Neurobehavioral Cognitive Status Examination (NCSE), a brief screening battery. A mild degree of cognitive deficits was found to be common in the Non-OMD psychiatric group. The deficit was especially pronounced in the Memory domain. Patients in the OMD group demonstrated a higher frequency of moderate and severe impairment. The best discriminator was the scale assessing visuospatial constructional ability and visual memory. Verbal memory deficit in OMD patients was more severe than in Non-OMD patients. Implications for improving diagnostic sensitivity of cognitive screening are discussed.

The present study used a sample of 156 healthy elderly subjects between 57 and 85 years of age to examine concurrent validity of 3 MMSE components: serial seven subtractions, 3-word recall, and copying pentagons, which are most frequently used in clinical practice as indicators of specific cognitive deficits. Correlational analyses and examination of concordance rates were used to explore the relationship of 3 MMSE tasks with scores on neuropsychological tests. The results of this study indicated that performance on MMSE components by elderly individuals should be interpreted with caution due to the effect of education on individual task performance, questionable specificity of the tasks in assessing circumscribed cognitive domains, emphasis on verbal tasks and high misidentification rate. (Aging Clin. Exp. Res. 6: 427-432, 1994)

This study investigated emotional change following stroke at acute (2-week), 2-month, and 6-month time intervals. Five dimensions of emotional functioning were examined in a sample of 19 stroke subjects: indifference, inappropriateness, depression, mania, and pragnosia (a defect in the pragmatics of social communicative style). Results showed that, at the 2-month point, differential recovery rates become apparent depending on hemispheric side of the stroke lesion. Increased indifference, inappropriateness, and depression appear to account for these results and suggest a slower rate of recovery on these variables in the left hemisphere group (LH n = 9) compared to the right (RH n = 10). Results further indicate that, at the 6-month point, emotional functioning in RH subjects appears to worsen. In contrast, emotional recovery in LH subjects seems to stabilize at this time. Clinical implications of these findings in terms of type and timing of intervention are discussed.

Measures of task-dependent cortical activation were assessed by bilateral EEG recordings from frontal, temporal, parietal and occipital areas. Two pictorial tests, the Raven Advanced Progressive Matrices and the Space Relations Test were used for verbal and spatial conditions, respectively. Recordings were obtained for 20 trials of each task from 22 right-handed adult males and 16 s. trial epochs were subjected to Fast Fourier analyses. Averaged intensity values for the alpha band were compared between verbal and spatial tasks for all subjects and between subgroups of verbalizers and visualizers, allotted on the basis of subject's performance index, derived from response speed and accuracy on the two tasks. The results were as follows: (1) The most pronounced EEG discriminators between the two performance subgroups are the left and right parietal and the right frontal area; (2) The left parietal zone provides the most pronounced discrimination between two groups; (3) There were significant interactions between the left parietal and the right frontal region; (4) The two parietal areas show characteristic frequency shifts in opposite directions for the task conditions. The findings imply complex interplay among the two parietal and right frontal areas, associated with sequential and holistic strategies. The results urge researchers to take into consideration subjectively preferred cognitive strategy, which along with objective task demands influences the process of problem solving and accompanying physiological changes.

Article abstract–Previous studies have identified age as a risk factor for many neurologic disorders, and a “cerebral reserve” factor has been postulated to explain these findings. This study examined whether age represents a risk factor for HIV-1-related neuropsychological dysfunction. Subjects for study 1 were primarily asymptomatic seropositive (n = 1,066) and seronegative (n = 1,004) nonelderly male community volunteers who completed neuropsychological and reaction time measures. Data analyses revealed a significant effect for age on reaction time and timed neuropsychological measures, but no interaction between age and serostatus. Study 2, employing a similar neuropsychological battery, consisted of 76 seropositive men (29 over age 55) recruited from community outpatient clinics and 47 seronegative controls. We found serostatus and age to have main effects on a number of measures, but a trend for an effect of age-serostatus interaction on only one measure.

The validity and reliability of the NCSE were assessed on a sample of 192 psychiatric patients from a county general hospital with a mean age of 33.5 years and mean education of 12 years. The analyses revealed that demographic and general health factors need to be taken into consideration in interpreting the NCSE results. Predictive accuracy of the screening items for subsequent performance on metric items across different scales ranged from good to poor. A comparison of success versus failure on the screen for Construction scale with scores on metric items for this scale revealed a high number of false negative errors made using the screening item. Administration of both screen and metric items on this scale for all patients was recommended. Indices of internal consistency of the Orientation scale were adequate. A factor analysis on the scale scores extracted two factors. The second factor identified a subset of scales which assess the patients' functional capacity in dealing with the demands of everyday environment. Test-retest reliability of the NCSE assessed on a subsample of 28 subjects, was high for 7 scales, whereas low stability was demonstrated by Construction, Memory and Calculation scales (r = .79, .52 and .81, respectively). Practice effect and fluctuating attention might contribute to the low stability of these scales. These modifications in the test administration procedure would improve the accuracy of assessment of cognitive deficits in psychiatric patients.

Our study explored the magnitude of practice effect in repeated administration of NP measures that tap different cognitive domains in normal elderly subjects (N = 122) between ages 57 and 85, who were evaluated over three annual testing probes. Results revealed that WAIS-R PIQ, serial recall of words, WMS visual memory, and memory for logical passages (immediate and delayed) are likely to improve on the retest due to practice effect in individuals below age 75, whereas test-retest changes in older people show a different pattern. Implications of age-specific changes on retest for differential diagnosis of dementia in clinical practice were considered.

Reliability and validity of MMSE were explored in a sample of 122 healthy, community-residing elderly volunteers between the ages of 57 and 85, who were tested with a battery of neuropsychological tests over three annual probes. Test-retest reliability ranged between .45 and .50 over a 1-year interval and was .38 over a 2-year period. Change on the MMSE of more than 5 points over a 2-year period was associated with a neurological disorder. Significant correlations were found with many neuropsychological measures, especially with a measure of verbal learning.

The relationship between self-rated health status and age group, gender, self-reported number of physical symptoms, functional capacity and level of activity was explored in a group of 133 elderly subjects ranging in age from 57 to 85 years. Self-rating of health was found to be a useful measure of health status, which is highly related to a number of physical symptoms and evidence of disruption in everyday functioning due to health problems. Women’s overall ratings of health were interpreted as reflecting a more optimistic appraisal of their self-ratings of health. (Aging 3: 73-77,1991)

Based on current theories in psycholinguistics and neuropsychology, this article explores changes in episodic‐semantic structure of declarative memory associated with aging and dementia‐related deficits. A qualitative scoring of verbatim responses on the Wechsler Adult Intelligence Scale‐Revised (WAIS‐R) Vocabulary subtest allowed us to investigate relationships of language processing level to age and education in 156 healthy 58‐ to 85‐year‐olds. We also compared response patterns of two groups hypothesized to be at‐risk for dementia to a well group individually matched to the at‐risk groups on age, education, and sex (n = 19 per group). Results revealed that both at‐risk groups differed significantly from the well group on frequency of responses falling into the “semantic field” subcategory, which is also sensitive to general educational level, but not to aging per se. These findings suggest that a decline in frequency of semantic‐field responses may be an early marker of dementia, a critically important...

This series of 4 studies describes the psychometric properties of the Neuropsychology Behavior and Affect Profile, which consists of 5 peer-rated scales (106 items) designed to measure personality change in brain-impaired individuals. Study 1 pertains to item derivation. Study 2 used relatives of 61 Ss identified as demented to determine the test's internal consistency. Results showed moderate levels of internal consistency across the 5 scales, with slightly higher coefficients (.6S-.82) obtained for present (vs. premorbid) emotional status. High test-retest reliability was demonstrated in Study 3 (intraclass correlation coefficients ranged from .92 to .99). Study 4 established discriminant validity; the instrument differentiated 61 demented Ss from 88 normal elderly controls on the basis of present behavioral affective style.

Virtually no data exists on the early cognitive precursors of dementia, primarily SDAT. This paper presents preliminary cross-sectional data on two elderly groups hypothesized to be at risk for SDAT and a well group matched individually on age, education and gender. The neuropsychological results, based on factor scores and individual t-test comparisons, revealed significant differences between the well group and the two at risk groups, each of which revealed a different pattern of cognitive impairment (specific vs. general). These results stimulated a number of hypotheses concerning the early precursors of SDAT that will be tested in the annual follow-up investigation of these subjects.

A specific WAIS subtest pattern has recently been shown to occur more frequently in cases of dementia of the Alzheimer's type (DAT) than in cases of multi-infarct dementia (Fuld, 1984; Brinkman & Braun, 1984). To date, only one study has examined the frequency of this WAIS pattern in a normal elderly sample and found it to be infrequent (Tuokko & Crocket, 1987). If replicated on a larger sample of normals, it would increase the potential of this pattern as a behavioral marker of DAT. WAIS-R scores (age-corrected) were analyzed on a sample of 149 healthy volunteers (ages 60–94) who were part of an ongoing aging study. Because only 12% of the sample revealed this WAIS pattern, its utility as a conditional marker of DAT in three different hypothetical clinical base rate settings was evaluated. Results provided cautious optimism for the application of this marker in certain clinical settings.