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This study examined the relationship between neuropsychological functioning, activities of daily living, and social interaction in a biracial sample of 133 rural community-dwelling participants with fewer than 10 years of education, who were tested twice over 4 years as part of a normative study. Neuropsychological tests predicted self-reported IADL and social functioning at Time 1 after accounting for age, education, health, depression, and gender. Physical health and the Initiation and Perseveration subscale of the Mattis Dementia Rating Scale best predicted instrumental activities of daily living. Social functioning was best predicted by gender and delayed memory recall from the Fuld Object Memory Evaluation. Functional independence and social activities declined slightly over time for all participants, but those whose neuropsychological test scores declined significantly at Time 2 reported less independence and fewer social activities at Time 1 than those participants whose cognition remained stable. Ecological and concurrent validity of self-report measures of functional status and neuropsychological testing in predicting cognitive decline are discussed.

Several studies of head trauma utilizing the Wechsler Adult Intelligence Scale (WAIS) reported large sample differentials between verbal IQ (VIQ) and performance IQ (PIQ), leading some writers to claim that the VIQ is largely unaffected by traumatic brain injury (TBI), and that a superiority of VIQ over PIQ should be expected. In contrast, our review of Wechsler Adult Intelligence Scale-Revised (WAIS-R) studies indicates that although TBI sample PIQ means are often depressed relative to VIQ means, the differences are small and sometimes in the opposite direction. Possible reasons for the discrepancy between our WAIS-R review and those of an earlier review of WAIS studies are discussed. Clinically, the lack of a VIQ-PIQ difference should never be used to infer that a TBI has not occurred.

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