The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample

Aiello, Edoardo Nicolò; Esposito, Antonella; Gramegna, Chiara; Gazzaniga, Valentina; Zago, Stefano; Difonzo, Teresa; Appollonio, Ildebrando; Bolognini, Nadia

doi:10.1007/s10072-021-05392-y

Cited by 26 publications

(23 citation statements)

References 20 publications

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“…Consistently with the international literature [11], so far much attention has been paid in Italy to FAB normative psychometrics [13][14][15][16], by nonetheless neglecting its diagnostics.…”

Section: Introductionmentioning

confidence: 80%

Diagnostic properties of the Frontal Assessment Battery (FAB) in Italian healthy adults

et al. 2022

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Background Sub-clinical cognitive efficiency deficits of a dysexecutive nature are moderately prevalent in healthy older adults and negatively affect their functional outcomes. To screen for such dysfunctions, the Frontal Assessment Battery (FAB) provided promising evidence, although its diagnostic properties have not been tested to date. This study thus aimed at exploring the performance on the FAB of a large sample of Italian healthy adults and comparing it in individuals aged < 75 years vs. ≥ 75 years. Methods Four hundred and seventy-five healthy adults (169 males, 306 females, age: 61.1 ± 15.1; education 11.7 ± 4.6) were administered the FAB and the Montreal Cognitive Assessment (MoCA). Sensitivity, specificity, positive and negative predictive values and likelihood ratios were computed through receiver-operating characteristics analyses by addressing an above-vs. below-cutoff performance on the MoCA as the state variable (as including measures of executive functioning). ResultsThe FAB overall showed good accuracy (AUC = 0.71-0.76), although higher for healthy older adults. A trend towards higher specificity (64.4-80.3%) than sensitivity (61.1-77.8%) was found, despite these metrics being comparable in healthy older adults. Negative predictive values (0.98-0.99) were systematically higher than positive predictive values (0.05-0.24), whereas consistent post-test probabilities were detected (positive likelihood ratios: 2.19-3.35; negative likelihood ratios: 0.28-0.48). Discussion The FAB is an accurate test for the first-level assessment of dysexecutive-related global cognitive inefficiency in the general population, despite being moderately conservative as far as both its pre-and post-test features are concerned. Its diagnostic value is more informative for individuals aged ≥ 75 years.

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Section: Introductionmentioning

confidence: 80%

Diagnostic properties of the Frontal Assessment Battery (FAB) in Italian healthy adults

et al. 2022

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“…The t-FAB was adapted from Aiello et al's [24] version of the FAB. The in-person FAB total score ranges from 0 to 18 and it comprises 3 subtests (each ranging from 0 to 6), each including two tasks: Conceptualization, Mental flexibility (language-mediated executive functions, FAB-1), Motor programming and Sensitivity to interference (motor-mediated executive functions, FAB-2) and Inhibitory control and Environmental autonomy (inhibition; FAB-3) [24]. In the t-FAB, Conceptualization and Mental flexibility tasks were the same of the in-person version, whereas Programming and Environmental autonomy tasks were removed.…”

Section: Methodsmentioning

confidence: 99%

“…Among frontal-executive screeners, the in-person version of the Frontal Assessment Battery (FAB) [21] represent one of the most psychometrically and diagnostically sound tests worldwide [22]. In Italy, the FAB has been shown to come with optimal psychometrics, diagnostics and clinical usability evidence [18,19,23,24].…”

Section: Introductionmentioning

confidence: 99%

Telephone-based Frontal Assessment Battery (t-FAB): standardization for the Italian population and clinical usability in neurological diseases

et al. 2022

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Background Despite the relevance of telephone-based cognitive screening tests in clinical practice and research, no specific test assessing executive functioning is available. The present study aimed at standardizing and providing evidence of clinical usability for the Italian telephone-based Frontal Assessment Battery (t-FAB). Methods The t-FAB (ranging 0–12), comprising two subtests, has two versions: one requiring motor responses (t-FAB-M) and the other verbal responses (t-FAB-V). Three hundred and forty-six Italian healthy adults (HPs; 143 males; age range = 18–96 years; education range = 4–23 years) and 40 participants with neurological diseases were recruited. To HPs, the t-FAB was administered along with a set of telephone-based tests: MMSE, verbal fluency (VF), backward digit span (BDS). The in-person version of the FAB was administered to both HPs and clinical groups. Factorial structure, construct validity, inter-rater and test–retest reliability, t-FAB-M vs. t-FAB-V equivalence and diagnostic accuracy were assessed. Norms were derived via Equivalent Scores. Results In HPs, t-FAB measures yielded high inter-rater/test–retest reliability (ICC = .78–.94), were internally related (p ≤ .005) and underpinned by a single component, converging with the telephone-based MMSE, VF, BDS (p ≤ .0013). The two t-FAB versions were statistically equivalent in clinical groups (ps of both equivalence bounds < .001). Education predicted all t-FAB scores (p < .001), whereas age only the t-FAB-M score (p ≤ .004). t-FAB scores converge with the in-person FAB in HPs and clinical groups (rs = .43–.78). Both t-FAB versions were accurate in discriminating HPs from the clinical cohort (AUC = .73-.76). Discussion The t-FAB is a normed, valid, reliable and clinically usable telephone-based cognitive screening test to adopt in both clinical and research practice.

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“…Similarly to Aiello et al [ 14 , 18 ], patients were sub-divided into either RCD + or RCD − . For a patient to be classified as RCD + , at least one neurological/psychiatric condition possibly affecting cognition had to be retrievable from either remote, recent, or COVID-19-related medical records.…”

Section: Methodsmentioning

confidence: 99%

Cognitive phenotyping of post-infectious SARS-CoV-2 patients

et al. 2022

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Background SARS-CoV-2 infection entails neuroinvasive, neuroinflammatory, and treatment-related features accounting for cognitive deficits in COVID-19-recovered patients. Although screening for such dysfunctions in this population is considered clinically relevant, contributions to cognitive phenotyping including premorbid and disease-related confounders are scarcely represented. This study thus aimed at describing the cognitive outcome at the function-/domain-level of post-infectious SARS-CoV-2 patients being already at risk (RCD +) or not (RCD −) for cognitive decline. Methods Fifty-four COVID-19-recovered individuals were classified as either RCD + or RCD − according to medical records. The Mini-Mental State Examination (MMSE), Addebrooke Cognitive Examination-Revised (ACE-R), Frontal Assessment Battery (FAB), and Attentive Matrices (AM) were administered (N = 54, 34, 28, and 28 patients, respectively). Results Prevalence of defective (cutoff = 24.89) MMSE scores was 24.3% in RCD + patients and 5.9% in the RCD − group. ACE-R-total below cutoff scores were less frequent (RCD + : 5.4%; RCD − : 5.9%). Abnormal performances at the FAB an AM were respectively detected in 18.9% and 8.1% of RCD + patients and 0% and 11.8% of the RCD − group. Within the ACE-R subtests, those assessing orientation, attention, and fluency were the most frequently impaired in both groups. Disease-related variables were mostly unassociated with cognitive measures. Discussion Both RCD + and RCD − COVID-19-recovered individuals might show cognitive deficits within the dysexecutive-inattentive and amnesic spectrum. Non-instrumental, executive/attentive dysfunctions are predominant in this population and can be detected by both screening and domain-specific psychometric tests—although the latter might be more sensitive in RCD − patients.

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The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample

Cited by 26 publications

References 20 publications

Diagnostic properties of the Frontal Assessment Battery (FAB) in Italian healthy adults

Diagnostic properties of the Frontal Assessment Battery (FAB) in Italian healthy adults

Telephone-based Frontal Assessment Battery (t-FAB): standardization for the Italian population and clinical usability in neurological diseases

Cognitive phenotyping of post-infectious SARS-CoV-2 patients

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