William G. Snow

Wisconsin card sorting test as a measure of frontal pathology: A review

Abstract We reviewed studies of the Wisconsin Card Sorting Test (WCST) in which the test was administered to subjects with and without evidence of focal frontal-lobe dysfunction. This review indicated that few studies had investigated the differential performance of normals and those with frontal dysfunction. The evidence that frontal patients perform more poorly than nonfrontal patients is weak. There is insubstantial evidence to conclude that the WCST is a measure of dorsolateral-frontal dysfunction. The clinical utility of the test as a measure of frontal-lobe dysfunction is not supported nor is the use of the test as a marker of frontal dysfunction for research purposes.

Central-nervous-system dysfunction after warm or hypothermic cardiopulmonary bypass

The increasing popularity of warm heart surgery led us to assess the effect of temperature during cardiopulmonary bypass (CPB) on neuropsychological function after coronary surgery. 34 patients enrolled in a randomised trial of normothermic versus hypothermic CPB were subjected to a battery of psychomotor and memory tests before and after their operations. The mean nasopharyngeal temperature for warm CPB was 34.7 (SD 0.5) degrees C and that for hypothermic CPB was 27.8 (2.0) degrees C. In all seven neuropsychological tests the postoperative scores were better in the warm CPB than in the hypothermic group, although only one difference achieved significance (trial-making test A; p less than 0.023). Thus, neurological function after normothermic CPB seems to be no worse than that after hypothermic procedures.

Sex differences among non-brain-damaged adults on the wechsler adult intelligence scales : a review of the literature

We reviewed studies of the performance of non-brain-damaged men and women on the Wechsler Adult Intelligence Scales (i.e., the Wechsler-Bellevue, Wechsler Adult Intelligence Scale, and Wechsler Adult Intelligence Scale-Revised) to determine if there were sex differences on specific test items, on specific subtests, or on Verbal IQ, Performance IQ, or the Verbal-Performance Discrepancy score. There were sex differences on some items of each of the three measures, but the number of such differences was small. A number of studies suggested differences on subtests of these scales. A meta-analysis indicated that females tended to outperform males by about a third of a standard deviation on the Digit Symbol subtest, while males tended to outperform females to the same extent or greater on the Arithmetic and Information subtests. Finally, in the few studies on IQ or discrepancy-score differences, there was no evidence of any consistent differences between the sexes in the Verbal-Performance Discrepancy, although there was some tendency for males to obtain higher Verbal IQs. This review, therefore, does not suggest that there are any major differences between non-brain-damaged males and females on the Wechsler adult intelligence scales.

WAIS-R Test-retest reliability in a normal elderly sample

We examined the 1-year test-retest reliability of WAIS-R Verbal, Performance, and Full-Scale IQs in a sample of 101 older normal individuals (mean age = 67.1). The respective Pearson rs were .86, .85, and .90. The median retest reliability coefficient for the WAIS-R subtests was .71. The test-retest reliability for the Verbal-Performance Discrepancy was .69. These data indicate that IQ scores are reliable in older normal individuals for this retest interval, but less confidence can be placed in the reliability of subtest scores and the Verbal-Performance Discrepancy.

Risk factors for medication nonadherence in older adults with cognitive impairment who live alone

The aim of this study was to prospectively examine the influence of cognitive, medical, behavioral, and social risk factors on medication nonadherence in community‐dwelling older adults with cognitive impairment.

Cardiopulmonary bypass, rewarming, and central nervous system dysfunction

BACKGROUND During cardiopulmonary bypass a nasopharyngeal temperature greater than 38 degrees C at the end of rewarming may indicate cerebral hyperthermia. This could exacerbate an ischemic brain injury incurred during cardiopulmonary bypass. METHODS In a cohort of 150 aortocoronary bypass patients neuropsychologic test scores of 66 patients whose rewarming temperature exceeded 38 degrees C were compared with those who did not. There were no differences between groups with respect to demographic and intraoperative variables. RESULTS A trend was seen for hyperthermic patients to do worse on all neuropsychologic tests in the early postoperative period but not at 3-month follow-up. By analysis of covariance hyperthermic patients did worse on the visual reproduction subtest of the Weschler memory scale at 3 months (p = 0.02), but this difference was not found by linear regression (p = 0.10). CONCLUSIONS We were unable to demonstrate any significant deterioration in patients rewarmed to greater than 38 degrees C in the early postoperative period. The poorer performance in the visual reproduction subtest of the Wechsler memory scale at 3 months in the group rewarmed to more than 38 degrees C is interesting but far from conclusive. Caution with rewarming is still advised pending more in-depth study of this issue.

Standardization of test administration and scoring criteria: Some shortcomings of current practice with the halstead-reitan test battery

Abstract Although the Halstead-Reitan Test Battery (HRTB) is the most popular neuropsychological test battery in use, there are a number of potential sources of local variation in the way this battery is administered. This variation has the potential for jeopardizing the comparability of both clinical and research findings across different settings. This paper discusses several of these potential sources of variation. The existence of two generally different versions of the manual is noted and shortcomings in the instructions for administration and scoring are addressed. Additional problems posed by the proliferation of short forms of the HRTB tests and by the development of alternative stimulus materials for these tests are discussed. It is recommended that the test manual for the HRTB should be revised and that clinicians and researchers should be more precise in reporting the versions of the stimulus materials they used.