Friday, July 05, 2013

Neuropsychology Abstract of the Day: Neuropsychological Assessment

A pilot evaluation of a brief non-verbal executive function assessment in Parkinson's disease.
International Journal of Geriatric Psychiatry. 2013 Jul 4;
Hobson PJ, Meara RJ, & Evans R


OBJECTIVE: Screening for cognitive impairment in the clinical or community setting is often hampered by the lack of a suitable assessment that is not overburdened with complex administration and scoring methods. We have developed non-verbal cognitive screening instrument: the Weigl Token Test (WTT) from two existing instruments, the Weigl's Colour-Form Sorting Test (WCFST) and the Token Test. The aim of this investigation is to compare the modified WTT with a battery of 'Gold Standard' cognitive assessments, to determine its utility, sensitivity and specificity as a brief cognitive screen in a cohort of Parkinson's disease (PD) patients.
METHODS: A total of 50 PD patients consented to participate in this investigation. All participants were assessed with a battery of cognitive screening instruments including the WCFST, Mini Mental Status Examination, Addenbrooke's Cognitive Examination-Revised and Delis Kaplan Executive Function Systems. The sensitivity and specificity of the WTT to detect cognitive impairment were based upon psychiatric interview, neuropsychological assessment and application of DSM-IV criteria.
RESULTS: The optimal cut-point of the WTT was 116/120, and its sensitivity and specificity to detect cognitive impairment were 88% and 89%, respectively. The diagnostic accuracy of the WTT as calculated by the area under the receiver operating curve was 0.83 (95% CI 0.76-0.95), suggesting that this instrument has acceptable psychometric properties to discriminate between case and non-cases of cognitive impairment.
CONCLUSIONS: The WTT demonstrated excellent concurrent validity with existing 'Gold Standard' assessments of cognitive impairment. We believe that this instrument will prove to be a valuable additional screening assessment in epidemiological, primary care, specialist mental health or clinical investigations. Copyright © 2013 John Wiley & Sons, Ltd.

PMID: 23824787 [PubMed - as supplied by publisher]

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