The RAPID Neuropsychological Test Battery for Subjects Aged 50–89: From Norms to Cognitive Profile

Abstract

Background/Aims: It is well established that healthy adults obtain low performances when simultaneously interpreting the results of multiple tests. The aim of this study was to estimate the proportion of French-speaking healthy older adults with low scores for the RAPID (Réseau d’Aide au diagnostic et à la PrIse en charge des Détériorations cognitives et de maladies neurologiques chroniques en Franche-Comté et au niveau national) battery test and consider different combinations of test scores within a specific domain and across different domains. Methods: The prevalence of low scores (i.e., ≤5th percentile) on the 14 RAPID primary measures was calculated from the RAPID normative sample (n = 476), based on 4 ages (50–89 years) and 3 levels of education. Results: A high percentage (40.1%) of the normative sample obtained at least one or more low scores (i.e., false positives). In contrast, the risk of having low scores was much less important (<2%) when considering the combinations of 2 test-scores. Conclusion: Low scores are very common in healthy older subjects and are thus not necessarily pathological or indicative of truly impaired functioning. The information derived from a cognitive profile may provide a greater clinical relevance in an individual, since very few of the healthy older adults obtained low scores on combinations of 2 test-scores.

Cognitive Impairment in Late-Life Depression: A Comparative Study of Healthy Older People, Late-Life Depression, and Mild Alzheimer's Disease Using Multivariate Base Rates of Low Scores

“…The 5th percentile cut-off values for the 13 primary measures of the RAPID test battery were calculated in a previous study (Sylvestre et al, 2017 ) from the normative sample of older adults (Ferreira et al, 2010 ) based on three age categories (ranges 60–69, 70–79, and 80–89 years) and three educational levels: high level (i.e., >11 years of education), middle level (i.e., 8–11 years of education), or the lowest educational level (i.e., <8 years of education).…”

“…They are consistent with previously reported studies on other neuropsychological test batteries (Heaton, 1991 ; Palmer et al, 1998 ; Brooks et al, 2009a , 2011 ; Karr et al, 2017 ) and confirmed that low scores are common in healthy older people when multiple test scores are simultaneously analyzed across a battery. This implies that isolated low scores obtained by an individual across multiple tests are not necessarily pathological or indicative of truly impaired functioning (Schretlen et al, 2008 ; Binder et al, 2009 ; Sylvestre et al, 2017 ). Thus, our data showed that from 9.4 to 17.6% of healthy older people obtained at least one low score on either measure in each cognitive domain.…”

“…However, this study has the advantage of showing results from a large sample (742 participants), thereby making it possible to present the data in terms of frequency of low scores (Gualtieri and Morgan, 2008 ). Furthermore, the 5th percentile cut-off values used in this study to define a low score were determined from age-and education-adjusted normative data (Sylvestre et al, 2017 ) that help to minimize over-or underestimation of impairment due to these two potential confounding variables (Potter and Steffens, 2007 ).…”

“…For example, when considering performance across all subtests from the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) neuropsychological assessment battery, 60.6% of the healthy older participants (aged 49–92 years) obtained one or more score at or below the 10 th percentile (Mistridis et al, 2015 ). Using the RAPID (Regional Network for Diagnostic Aid and Management of Patients with Cognitive Impairment) neuropsychological battery, we previously found that 40.1% of the normative sample (individuals aged 50–89 years) obtained one or more test scores at or below the 5th percentile (Sylvestre et al, 2017 ). These findings suggest that isolated low scores may be erroneously considered impaired performances and lead to a false positive interpretation (Schretlen et al, 2008 ).…”