Dementia and effort test performance

Abstract

Research on the performance of patients with dementia on tests of effort is particularly limited. We examined archival data from 214 non-litigating patients with dementia on 18 effort indices derived from 12 tests (WAIS-III/WAIS-R Digit Span and Vocabulary, Dot Counting Test, Warrington Recognition Memory Test-Words, WMS-III Logical Memory, Rey Word Recognition Memory Test, Finger Tapping, b-Test, Rey 15-Item, Test of Memory Malingering, Rey Auditory Verbal Learning Test, and Rey Complex Figure Test). Results indicated that recommended cut-offs for Digit Span indicators (Vocabulary Minus Digit Span and four-digit forward span time score) provided > or =90% specificity across participants, while the majority of other effort tests displayed specificities in the 30-70% range. Analyses of test specificity as a function of Mini Mental Status Examination (MMSE) score and specific dementia diagnosis are provided, as well as adjustments to cut-offs to maintain specificity where feasible.

Poststroke Apathy

“…Incapability of goal-oriented thinking and behavior may lead to loss of interest and lack of effort in cognitive testing. 56,57 Also, both apathy and cognitive impairment could be a consequence of the same underlying brain damage. Lesions in distant areas related to memory and learning and their projections may influence anterior cingulate circuit function, which is associated with motivation.…”

Performance on Standard Indexes of Effort Among Patients with Dementia

“…In a recent study, Dean, Victor, Boone, Philpott, and Hess (2009) investigated the efficacy of 18 effort indexes in a group of patients with mixed dementia. Most of the effort tests that were investigated had significantly high false-positive error rates, and several of the established cutoffs were inaccurate in assessing for effort in the dementia sample.…”

Avaliação da simulação ou esforço insuficiente com o Rey 15-Item Memory Test (15-IMT): Estudos de validação em grupos de adultos idosos

“…Tendo em consideração os comentários formulados relativamente às percentagens de sujeitos incorrectamente classificados como "simuladores", em casos provenientes de populações clínicas, e reportando aos valores de especificidade calculados, os dados obtidos convergem com os estudos que documentam uma baixa especificidade da prova em populações com Demência (Dean, Victor, Boone, Philpott, & Hess, 2009;Hays, Emmons, Stallings, 2000;Philpott, 1992;Schretlen et al, 1991) ou outro tipo de défices cognitivos, como é o caso da Deficiência Mental (Dean, Victor, Boone, & Arnold, 2008;Goldberg & Miller, 1986;Hurley & Deal, 2006;Marshall & Happe, 2007).…”