Mayo's Older Americans Normative Studies: Category Fluency Norms

Age-adjusted normative data are presented for persons over age 55 years on a common measure of category fluency. Further adjustment for education is also provided. These data were obtained as part of a series of projects known collectively as Mayo's Older Americans Normative Studies (MOANS). The normative information provided here should prove useful for characterizing performance on the individual measure of category fluency. In addition, these data should promote greater accuracy in comparing category fluency scores with performance on any other measures with MOANS norms, including tests of letter fluency. Limitations and unique features of MOANS normative data are also discussed.     

Normative Data for the Mattis Dementia Rating Scale

Age-adjusted normative data are presented for persons over age 55 on the Mattis Dementia Rating Scale. Additional adjustment for the effect of education on test performance is also provided. These data were collected as part of Mayo's Older Americans Normative Studies (MOANS) in a continuing effort to develop age-appropriate norms for older persons on commonly used neuropsychological tests. The normative data presented here should prove more useful in characterizing the presence and severity of general cognitive dysfunction than currently available norms. Limitations and unique features of MOANS normative data are also discussed.     

Neuropsychological tests' norms above age 55: COWAT,BNT, MAE token,WRAT-R reading,AMNART, STROOP,TMT, and JLO

Abstract

Age- (> 55 years) and education-based norms are presented for eight neuropsychological tests: COWAT, BNT, MAE Token, WRAT-R Reading, AMNART, STROOP, TMT, and JLO. These data were obtained via several research projects that are known collectively as Mayo's Older Americans Normative Studies (MOANS). While this normative information should prove useful for each test, the fact that these norms were simultaneously obtained from the same reference group should promote accuracy in the comparison of any person's performance on one test against his or her functioning on any other tests with MOANS norms. Finally, the unique features of this MOANS sample are reviewed. These features must be kept in mind when these norms are applied in any specific clinical or research setting.     

Free and cued selective reminding test: Moans norms

Abstract

Age-adjusted norms are presented for persons age 56–98 years on the Free and Cued Selective Reminding Test (FCSRT; Buschke, 1984; Grober & Buschke, 1987). These data were obtained via several research projects that are known collectively as Mayo's Older Americans Normative Studies (MOANS). These norms should be useful when the FCSRT is used as a “stand alone” test. They should also promote accuracy in the comparison of any person's FCSRT performance against his or her functioning on any other tests with MOANS norms. The unique features of the FCSRT are discussed. These norms will, hopefully, enhance the utility of the test when it is used in clinical and research investigations of various amnestic disorders.     

Mayo's Older Americans Normative Studies: Age- and IQ-Adjusted Norms for the Auditory Verbal Learning Test and the Visual Spatial Learning Test

Although normative data sets for standardized neuropsychometric instruments frequently feature adjustments for subject variables, there are reasons to believe that improvements in interpretive accuracy that result from such adjustments are less than optimal. In particular, years of education may be less closely associated with test performances than is overall intellectual functioning. In this last of four reanalyses of results from the Mayo Clinic's Older Americans Normative Studies (MOANS) databases, age-adjusted scores for the Rey Auditory Verbal Learning Test and the Visual Spatial Learning Test were found to be more strongly related to Mayo age-adjusted WAIS-R Full Scale IQ scores (rs=.150 to .395) than to education (rs=.060 to .236) for healthy older examinees between 56 and 99 years of age. Although AVLT-FSIQ correlations were greatest at moderate levels of intelligence, VSLT-FSIQ correlations consistently increased in strength as intelligence increased (cf. Dodrill, 19971999). Based on these results, we present tables of age- and IQ-adjusted percentile equivalents of Mayo age-adjusted AVLT index scores and MOANS age-adjusted AVLT and VSLT scaled scores for ten age ranges and either seven (AVLT) or five (VSLT) IQ ranges.     

Mayo's Older Americans Normative Studies: Age- and IQ-Adjusted Norms for the Trail-Making Test, the Stroop Test, and MAE Controlled Oral Word Association Test

Although normative data sets for standardized neuropsychometric instruments often include adjustments for subject variables, there are reasons to believe that improvements in interpretive accuracy that result from such adjustments are less than optimal. In particular, years of formal education may be less closely related to test performances than is general intellectual functioning. In this second of four reanalyses of results from the Mayo Clinic's Older Americans Normative Studies (MOANS) databases, age-adjusted scores for the Trail-Making Test, the Stroop Color-Word Test, and the MAE Controlled Oral Word Associations Test were found to be more strongly associated with Mayo age-adjusted WAIS-R Full Scale IQ scores (rs=.368 to .495) than with education (rs=.174 to .367) for healthy older examinees between 56 and 99 years of age. For the TMT and the COWAT, but not the Stroop, these associations became stronger as IQ increased (cf. Dodrill, 1997, 1999). Tables of age- and IQ-adjusted percentile equivalents of MOANS age-adjusted TMT, Stroop, and COWAT scores are presented for eleven age ranges and seven IQ ranges.     

Hopkins Verbal Learning Test-Revised: norms for elderly African Americans

The Hopkins Verbal Learning Test-Revised (HVLT-R) is a memory test commonly used in neuropsychological evaluations, but for which there are currently no normative data for elderly African Americans. The current study examined the influence of demographic characteristics on HVLT-R performance measures in a community-dwelling sample of 237 African American older adults (60-84 years). Age, gender, and education accounted for moderate amounts of variance in HVLT-R performance. Based on these results, normative tables for HVLT-R scores, stratified by age and with score adjustments for education and gender, are provided.     

Mayo's Older Americans Normative Studies: Age- and IQ-Adjusted Norms for the Boston Naming Test, the MAE Token Test, and the Judgment of Line Orientation Test

Although many extant normative data sets for standardized neuropsychometric instruments feature adjustments for subject variables, there are reasons to believe that improvements in interpretive accuracy that result from such adjustments are less than optimal. In particular, several theoretical considerations suggest that years of formal education may be less closely related to test performances than is general intellectual functioning. In this first of four reanalyses of results from the Mayo Clinic's Older Americans Normative Studies (MOANS) databases, age-adjusted scores on the Boston Naming Test, the MAE Token Test, and the Judgment of Line Orientation Test were indeed found to be more strongly associated with Mayo Age-adjusted WAIS-R Full Scale IQ scores (rs=.608, .473, and .502, respectively) than with education (rs=.310, .306, and .236, respectively) for healthy older examinees (56-99 years). Consistent with the remarks of Dodrill (19971999), these correlations generally decreased at higher levels of intelligence. The magnitude and pattern of such declines varied across the three tests, however, suggesting that IQ-test score associations must be empirically determined rather than assumed to be linear. Tables of Age- and IQ-Adjusted percentile equivalents of MOANS Age-adjusted BNT, Token Test, and JLO scaled scores are presented for eleven age ranges and seven IQ ranges. The article concludes with a discussion of factors that may underlie observed relations among age, intelligence, and neuropsychometric test performances.     

Intra-individual measures of association in neuropsychology: inferential methods for comparing a single case with a control or normative sample.

Performance on some neuropsychological tests is best expressed as an intra-individual measure of association (such as a parametric or non-parametric correlation coefficient or the slope of a regression line). Examples of the use of intra-individual measures of association (IIMAs) include the quantification of performance on tests designed to assess temporal order memory or the accuracy of time estimation. The present paper presents methods for comparing a patient's performance with a control or normative sample when performance is expressed as an IIMA. The methods test if there is a significant difference between a patient's IIMA and those obtained from controls, yield an estimate of the abnormality of the patient's IIMA, and provide confidence limits on the level of abnormality. The methods can be used with normative or control samples of any size and will therefore be of particular relevance to single-case researchers. A method for comparing the difference between a patient's scores on two measures with the differences observed in controls is also described (one or both measures can be IIMAs). All the methods require only summary statistics (rather than the raw data from the normative or control sample); it is hoped that this feature will encourage the development of norms for tasks that use IIMAs to quantify performance. Worked examples of the statistical methods are provided using data from a clinical case and controls. A computer program (for PCs) that implements the methods is described and made available.     

Expanded normative data for the Mattis Dementia Rating Scale for use with urban, elderly medical patients

Normative data for the Mattis Dementia Rating Scale (MDRS), stratified by age and education, are provided for use with older adults (ages 61-94) in urban medical settings. Age and education accounted for the greatest amount of variance in MDRS performance. Gender and race were also associated with total MDRS scores, though to a lesser extent. The present normative data are more appropriate for use with older patients seen in urban medical settings than normative data obtained from samples of better-educated, relatively healthy, Caucasian adults. This study provides additional evidence of the significant influence of age and education on MDRS total score (MDRS-T) performance, and highlights the importance of matching an examinee's demographic background to the normative sample with which his or her test score is being compared. Careful consideration of this match is likely to lead to more accurate diagnostic conclusions and potentially improved patient care.     

Expanded Normative Data for the Mattis Dementia Rating Scale for Use with Urban,Elderly Medical Patients

Normative data for the Mattis Dementia Rating Scale (MDRS), stratified by age and education, are provided for use with older adults (ages 61–94) in urban medical settings. Age and education accounted for the greatest amount of variance in MDRS performance. Gender and race were also associated with total MDRS scores, though to a lesser extent. The present normative data are more appropriate for use with older patients seen in urban medical settings than normative data obtained from samples of better-educated, relatively healthy, Caucasian adults. This study provides additional evidence of the significant influence of age and education on MDRS total score (MDRS-T) performance, and highlights the importance of matching an examinee's demographic background to the normative sample with which his or her test score is being compared. Careful consideration of this match is likely to lead to more accurate diagnostic conclusions and potentially improved patient care.     

Statistical methods for single-case studies in neuropsychology: comparing the slope of a patient's regression line with those of a control sample

Performance on some neuropsychological tests is best expressed as the slope of a regression line. Examples include the quantification of performance on tests designed to assess the accuracy of time estimation or distance estimation. The present paper presents methods for comparing a patient's performance with a control or normative sample when performance is expressed as slope. The methods test if there is a significant difference between a patient's slope and those obtained from controls, yield an estimate of the abnormality of the patient's slope, and provide confidence limits on the level of abnormality. The methods can be used with control samples of any size and will therefore be of particular relevance to single-case researchers. A method for comparing the difference between a patient's scores on two measures with the differences observed in controls is also described (one or both measures can be slopes). The methods require only summary statistics (rather than the raw data from the normative or control sample); it is hoped that this feature will encourage the development of norms for tasks that use slopes to quantify performance. Worked examples of the statistical methods are provided using neuropsychological data and a computer program (for PCs) that implements the methods is described and made available.     

Performance and normative values of a concise neuropsychological test (CAMCOG) in an elderly population sample

BACKGROUND: CAMCOG is a widely used brief neuropsychological test. To date no normative values are available for English speaking individuals representative of the general population. OBJECTIVES: The aims of the study were to describe the population distribution of performance on CAMCOG, and to provide normative data derived from a representative population sample. METHODS: CAMCOG was administered at the assessment stage of the MRC Cognitive Function and Ageing Study. MRC CFAS is a multi-centre population-based study in England and Wales in respondents aged 65 years and older. Initial screening provided provisional identification of cognitive impairment. The subsequent assessment interview provided an algorithmic diagnosis of dementia, or other disorders, in a 20% sub-sample. RESULTS: There were large differences between demented and non-demented groups on the CAMCOG total score and on all CAMCOG subscales. Charts of normative values for CAMCOG are presented by age group, sex and education for the non-demented population (n = 1 914, representing 11 008 individuals screened). CONCLUSIONS: Population-derived normative data are valuable for comparing an individual's score to the score which would be expected of the general population, given the individual's specific demographic characteristics.     

Mayo's Older Americans Normative Studies: expanded AVLT Recognition Trial norms for ages 57 to 98

This paper expands upon previously published Mayo's Older Americans Normative Studies (MOANS) Auditory Verbal Learning Test (AVLT) norms by presenting age and gender specific data for Recognition Trial accuracy (recognition 'hits' corrected for false positive errors) in a total of 836 subjects (the original sample, augmented by an additional 311 subjects). Observations are offered concerning clinical implications of AVLT Recognition Trial performance. Gender differences in recognition memory are discussed.     

Hopkins Verbal Learning Test – Revised: Norms for Elderly African Americans

The Hopkins Verbal Learning Test – Revised (HVLT-R) is a memory test commonly used in neuropsychological evaluations, but for which there are currently no normative data for elderly African Americans. The current study examined the influence of demographic characteristics on HVLT-R performance measures in a community-dwelling sample of 237 African American older adults (60–84 years). Age, gender, and education accounted for moderate amounts of variance in HVLT-R performance. Based on these results, normative tables for HVLT-R scores, stratified by age and with score adjustments for education and gender, are provided.     

International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271

Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV? participants from Brazil (n?=?240), India (n?=?480), Malawi (n?=?481), Peru (n?=?239), South Africa (480), Thailand (n?=?240), and Zimbabwe (n?=?240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (<10 and ≥10 years), and age (<35 and ≥35 years). Of 2400 enrolled, 770 completed the 6-month follow-up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p?<?0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.     

Mayo's Older Americans Normative Studies: Expanded AVLT Recognition Trial Norms for Ages 57 to 98

This paper expands upon previously published Mayo's Older Americans Normative Studies (MOANS) Auditory Verbal Learning Test (AVLT) norms by presenting age and gender specific data for Recognition Trial accuracy (recognition ‘hits’ corrected for false positive errors) in a total of 836 subjects (the original sample, augmented by an additional 311 subjects). Observations are offered concerning clinical implications of AVLT Recognition Trial performance. Gender differences in recognition memory are discussed.     

Mayo's Older Americans Normative Studies: Age- and IQ-Adjusted Norms for the Wechsler Memory Scale--Revised

Normative data sets for standardized neuropsychometric instruments often include adjustments for subject variables. There are reasons to believe, however, that improvements in interpretive accuracy that result from such adjustments are less than optimal. In particular, "years of formal education" may be less closely related to test performances than is general intellectual functioning. In this third of four reanalyses of results from the Mayo Clinic's Older Americans Normative Studies (MOANS) databases, age-adjusted index and scaled scores for the Wechsler Memory Scale-Revised were found to be more strongly associated with Mayo age-adjusted WAIS-R Full Scale IQ scores (rs=.271 to .631) than with education (rs=.089 to .310) for healthy older examinees between 56 and 99 years of age. These associations were strongest for Attention/Concentration and General Memory Index scores and, in general, for individuals with average intelligence (cf. Dodrill, 19971999). Tables of age- and IQ-adjusted percentile equivalents of Mayo age-adjusted WMS-R index scores and MOANS age-adjusted WMS-R subtest scaled scores are presented for eleven age ranges and seven IQ ranges.     

Normative Data for Clustering and Switching on Verbal Fluency Tasks

Normative data for clustering and switching on verbal fluency tasks are provided. Four hundred and eleven healthy adults between the ages of 18 and 91 were given tests of phonemic fluency (FAS or CFL) and semantic fluency (Animals and Supermarket). Raw scores were corrected for demographic (i.e., age, education, and sex) and test (i.e., fluency form) variables that were determined to make sizable contributions to fluency performance. These normative data should be useful for clinicians and researchers in determining the nature of the fluency impairment in any given individual.     

Normative data for clustering and switching on verbal fluency tasks

Normative data for clustering and switching on verbal fluency tasks are provided. Four hundred and eleven healthy adults between the ages of 18 and 91 were given tests of phonemic fluency (FAS or CFL) and semantic fluency (Animals and Supermarket). Raw scores were corrected for demographic (i.e., age, education, and sex) and test (i.e., fluency form) variables that were determined to make sizable contributions to fluency performance. These normative data should be useful for clinicians and researchers in determining the nature of the fluency impairment in any given individual.