Russell L. Adams

Age- and Education-Corrected Independent Normative Data for the RBANS in a Community Dwelling Elderly Sample

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Randolph, 1998) is likely to become a popular screening instrument for measuring cognitive functioning, particularly in elderly patients. As such, the present study attempted to extend the original normative data by reporting on RBANS performances in a group of 718 community dwelling older adults. Participants were recruited from an outpatient primary care setting, and were assessed for demographic, medical status, functional status, and quality of life information. Utilizing four empirically supported overlapping midpoint age ranges, individual subtest raw scores were converted to age-corrected scaled scores based on their position within a cumulative frequency distribution. These age-corrected scaled scores were also converted into education-corrected scaled scores using the same methodology across four education levels. Independent Index and Total scores were also calculated based on the data from this large elderly sample. These data may considerably advance the clinical utility of the RBANS by allowing clinicians to interpret individual subtests and make direct comparisons between subtests. Practitioners and researchers who elect to use the current normative data are encouraged to consider the similarities and differences between the present sample and their individual patients or research participants.

Cognitive outcome in pediatric brain tumor survivors: Delayed attention deficit at long-term follow-up

Treatment of childhood brain tumors has often been associated with long‐term cognitive morbidity in children. Our previous research identified age at diagnosis, polytherapy and brain radiation dose as treatment factors affecting neuropsychological outcome most strongly in children with cancer 1 . Our current goal was to measure the change across different cognitive functions.

Estimation of WAIS-III Intelligence from Combined Performance and Demographic Variables: Development of the OPIE-3

Data from the WAIS-III standardization sample (The Psychological Corporation, 1997) was used to generate several FSIQ estimation formulas that used demographic variables and current WAIS-III subtest performance. The standardization sample (N =2,450) was randomly divided into two groups, the first was used to develop the formulas and the second group was used to validate the prediction equations. Age, education, ethnicity, gender, region of the country as well as Vocabulary, Information, Matrix Reasoning, and Picture Completion subtests raw scores were used as predictor variables. Regression formulas were generated using four subtest, two subtest, single verbal, two performance subtest, and single performance algorithms. The four-subtest model combined Information, Vocabulary, Matrix Reasoning, and Picture Completion raw scores with demographic variables. The two-subtest algorithm used Vocabulary and Matrix Reasoning raw scores with demographic variables. Formulas to estimate FSIQ using only verbal or performance subtests were developed for use with lateralized populations. The formulas for estimating premorbid FSIQ were highly significant and accurate in predicting FSIQ scores of participants in the WAISIII normative sample.

Test-Retest Stability and Practice Effects of the RBANS in a Community Dwelling Elderly Sample

Repeated neuropsychological assessments are common with older adults, and the determination of true neurocognitive change is important for diagnostic assessment. Several statistical formulas are available to assist in this determination, but they rely on access to test-retest stability coefficients and practice effect values. The current study presents data on these psychometric properties of the RBANS in a large community dwelling elderly sample. Across a one-year retest interval, stability coefficients ranged from .58 to .83 for the Index scores, and from .51 to .83 for the subtest scores. Practice effects were largely absent, with most performances slightly decreasing at retest. These psychometric properties are contrasted with those reported in the RBANS manual, and possible reasons for these differences are discussed. A case example is provided that demonstrates the use of the current findings in conjunction with existing change formulas.

Chronic renal failure, dialysis, and neuropsychological function.

Hemodialysis patients, nondialyzed azotemic patients and control subjects with chronic physical disabilities were tested in psychometric measures of attention, memory, and visuomotor speed and coordination. There was relatively little difference between the performance of dialysis patients and controls and no significant correlations were found between years of dialysis treatment and performance on any task. In contrast, nondialyzed azotemic patients were impaired on 9 of 14 tasks relative to controls and/or dialysis patients. Measured levels of blood urea nitrogen (BUN) and serum creatinine were significantly correlated with the performance of nondialyzed azotemic patients on several tasks. These results demonstrate a relationship between degree of renal failure and cognitive and perceptual-motor functioning. The mild impairments evident in dialysis patients do not seem to be directly attributable to dialysis treatments. Rather, the onset of hemodialysis appears to have beneficial effects on neuropsychological function.

Performance of Cognitively Normal African Americans on the RBANS in Community Dwelling Older Adults

Recent research suggests that cognitively normal African Americans are more likely to be misdiagnosed as impaired compared to Caucasians due to lower neuropsychological test scores (e.g., Manly et al., 1998). Given this, the present study sought to determine whether such racial discrepancies exist on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Performances of 50 cognitively normal older African Americans on the RBANS were compared to those of 50 Caucasians matched on age, education, and gender. The African Americans scored significantly lower on 10 of 12 subtests, 3 of 5 Index scores, and the Total Scale score. Results underscored the utility of demographically appropriate norms when serving minority clients. Given that there remains a paucity of normative data for minority groups, RBANS normative data for older African Americans are provided. Although preliminary, it is hoped that data presented will offer the practitioner assistance with clinical diagnosis and decision-making in a manner that will help minimize diagnostic errors.

The importance of demographic adjustments on neuropsychological test performance: A response to reitan and wolf son (1995)

Abstract Recently, Reitan and Wolfson (1995) questioned the validity of using age and education adjustments in the clinical practice of neuropsychology based on a study of the effects of age and education on the General Neuropsychological Deficit Scale (GNDS) score. We critique their findings and conclusions on both theoretical and methodological grounds. We then present the results of a similar investigation on the effects of age and education on three different neuropsychological summary scores. In contrast to Reitan and Wolf-sons findings, in the present study age and education had similar effects on neuropsychological summary scores (GNDS, HII, and AIR) whether or not subjects were brain-damaged. Younger or more educated subjects consistently performed better than did older or less educated subjects. This was true even though correlations between age and education with neuropsychological summary scores were low and often statistically nonsignificant in both brain-damaged and pseudoneurologic samples....

An evaluation of the clinical utility of the OPIE-3 as an estimate of premorbid WAIS-III FSIQ.

The clinical utility of the Oklahoma Premorbid Intelligence Estimate – 3 (OPIE-3; Schoenberg, Scott, Duff, & Adams, 2002) in estimating premorbid FSIQ was investigated with the WAIS-III standardization sample. The OPIE-3 algorithms combine Vocabulary, Information, Matrix Reasoning, and Picture Completion subtest raw scores with demographic variables to predict FSIQ. Estimated WAIS-III FSIQ scores are presented for patients’ diagnosed with dementia, traumatic brain injury, Huntington’s disease, Korsakoff’s disease, chronic alcohol use, temporal lobectomy, and schizophrenia. A group of patients with depression was employed as a clinical control group. The OPIE-3Vand OPIE-3MR algorithms performed well, with the average predicted FSIQ of the combined clinical sample approximating the mean FSIQ of healthy adults. The OPIE-3(Best), which is a procedure that employs either the OPIE-3V, OPIE-3MR, or OPIE-3(2ST) algorithms in a best performance method, is presented. Recommendations in the application of the OPIE-3 are made and future research is proposed.

Coping behavior in depression: Report on a new scale

Abstract The Coping Strategies Scales (COSTS) were developed to provide a means of measuring how depressed persons cope with depression and to identify the behavior which they find to be most or least helpful. Items were rated by eight psychologists, psychiatrists and social workers. Those items achieving 75% level of agreement on scale assignments were included. The COSTS was then administered to 100 depressed outpatients and inpatients currently in psychotherapy. A replication study of 64 patients was also completed. Nine of the 10 scales had acceptable internal reliability, ranging from 0.70 to 0.86. An initial factor analysis of the 10 scale scores showed there to be three primary factors. Internal reliability coefficients for these three factorially-derived scales ranged from 0.86 to 0.91.

Oklahoma premorbid intelligence estimation (opie): Utilization in clinical samples

Abstract The present research is an effort to evaluate a new method of estimating premorbid IQ in which both demographic and current performance methods are utilized in a regression algorithm. Two hundred and twenty-seven patient files from the archives of the University of Oklahoma Health Sciences Center were used to evaluate the Oklahoma Premorbid Intelligence Estimation (OPIE) procedure. This procedure combines both premorbid demographic variables of age, education, occupation, and race with current performance on the WAIS-R Vocabulary and Picture Completion subtests in estimating premorbid IQ. The results are presented for clinical populations including those with dementia, traumatic brain injury, cerebral vascular accident, neoplasm, epilepsy, and a medical control chronic pain group. Results indicate that the OPIE produces a less restricted range of scores than other currently available methods of estimating premorbid IQ without systematic under or over-estimation of IQ. Considerations for the use o...