Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition Battery

Objective: Low scores on neuropsychological tests are considered objective evidence of mild cognitive impairment. In clinical practice and research, it can be challenging to identify a cognitive deficit or mild cognitive impairment in high-functioning people because they are much less likely to obta...

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Main Authors: Grant L. Iverson, Justin E. Karr
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-09-01
Series:Frontiers in Psychology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpsyg.2021.724888/full
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author Grant L. Iverson
Grant L. Iverson
Grant L. Iverson
Justin E. Karr
author_facet Grant L. Iverson
Grant L. Iverson
Grant L. Iverson
Justin E. Karr
author_sort Grant L. Iverson
collection DOAJ
description Objective: Low scores on neuropsychological tests are considered objective evidence of mild cognitive impairment. In clinical practice and research, it can be challenging to identify a cognitive deficit or mild cognitive impairment in high-functioning people because they are much less likely to obtain low test scores. This study was designed to improve the methodology for identifying mild cognitive impairment in adults who have above average or superior intellectual abilities.Method: Participants completed the National Institutes of Health Toolbox for the Assessment of Neurological and Behavioral Function Cognition Battery (NIHTB-CB). The sample included 384 adults between the ages of 20 and 85 who had completed either a 4-year college degree or who scored in the above average, superior, or very superior range on a measure of intellectual functioning, the Crystallized Composite score. Algorithms were developed, based on the absence of high scores and the presence of low scores, for identifying mild cognitive impairment.Results: Base rate tables for the presence of low scores and the absence of high scores are provided. The base rate for people with high average crystalized ability obtaining any one of the following, 5 scores <63rd percentile, or 4+ scores <50th percentile, or 3+ scores ≤ 25th percentile, or 2+ scores ≤ 16th percentile, is 15.5%.Conclusions: Algorithms were developed for identifying cognitive weakness or impairment in high-functioning people. Research is needed to test them in clinical groups, and to assess their association with clinical risk factors for cognitive decline and biomarkers of acquired neurological or neurodegenerative diseases.
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spelling doaj.art-e7583ab9d3be4b8baf4248f153194e682022-12-21T17:15:51ZengFrontiers Media S.A.Frontiers in Psychology1664-10782021-09-011210.3389/fpsyg.2021.724888724888Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition BatteryGrant L. Iverson0Grant L. Iverson1Grant L. Iverson2Justin E. Karr3Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United StatesSpaulding Rehabilitation Hospital and Spaulding Research Institute, Charlestown, MA, United StatesHome Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, United StatesDepartment of Psychology, University of Kentucky, Lexington, KY, United StatesObjective: Low scores on neuropsychological tests are considered objective evidence of mild cognitive impairment. In clinical practice and research, it can be challenging to identify a cognitive deficit or mild cognitive impairment in high-functioning people because they are much less likely to obtain low test scores. This study was designed to improve the methodology for identifying mild cognitive impairment in adults who have above average or superior intellectual abilities.Method: Participants completed the National Institutes of Health Toolbox for the Assessment of Neurological and Behavioral Function Cognition Battery (NIHTB-CB). The sample included 384 adults between the ages of 20 and 85 who had completed either a 4-year college degree or who scored in the above average, superior, or very superior range on a measure of intellectual functioning, the Crystallized Composite score. Algorithms were developed, based on the absence of high scores and the presence of low scores, for identifying mild cognitive impairment.Results: Base rate tables for the presence of low scores and the absence of high scores are provided. The base rate for people with high average crystalized ability obtaining any one of the following, 5 scores <63rd percentile, or 4+ scores <50th percentile, or 3+ scores ≤ 25th percentile, or 2+ scores ≤ 16th percentile, is 15.5%.Conclusions: Algorithms were developed for identifying cognitive weakness or impairment in high-functioning people. Research is needed to test them in clinical groups, and to assess their association with clinical risk factors for cognitive decline and biomarkers of acquired neurological or neurodegenerative diseases.https://www.frontiersin.org/articles/10.3389/fpsyg.2021.724888/fullcognitionneuropsychological testspsychometricscognitive dysfunctionNIH Toolbox
spellingShingle Grant L. Iverson
Grant L. Iverson
Grant L. Iverson
Justin E. Karr
Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition Battery
Frontiers in Psychology
cognition
neuropsychological tests
psychometrics
cognitive dysfunction
NIH Toolbox
title Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition Battery
title_full Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition Battery
title_fullStr Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition Battery
title_full_unstemmed Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition Battery
title_short Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition Battery
title_sort improving the methodology for identifying mild cognitive impairment in intellectually high functioning adults using the nih toolbox cognition battery
topic cognition
neuropsychological tests
psychometrics
cognitive dysfunction
NIH Toolbox
url https://www.frontiersin.org/articles/10.3389/fpsyg.2021.724888/full
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