Five-year change scores in old age for six neuropsychological tests and normative data for the Useful Field of View (UFOV) test: The influence of physical health

ABSTRACT

Introduction: Neuropsychological assessment of cognitive change over time is often conducted in clinical settings, but whether neuropsychological change scores are influenced by physical health has, as far as we know, not been examined previously.

Method: In a sample of 153 older Swedish adults (age range, 72–86 years), we evaluated the influence of common age-related diseases, terminal decline pathology, age, education, and gender, to provide (a) preliminary test-specific regression weights and 90% confidence intervals to assess significant change in performance after five years on tests of visual scanning, mental shifting, visual spatial ability, memory, reaction time, and selective attention, and (b) normative data for the Useful Field of View test (UFOV) from a single testing occasion.

Results: Multiple regression analyses showed that test–retest changes were affected by physical health for mental shifting, visual spatial ability, memory, and reaction time, by age for mental shifting and visual reaction time, by education for visual spatial ability, and by Age × Education for auditory reaction time. Gender did not affect any of the change scores. The overall average of variance explained was 2.5%: up to 8.1% for physical health, 4.4% for age, and 3.6% for education. The UFOV scores were mostly influenced by age, but also by physical health and education.

Conclusions: The findings indicate that considering the influence of health on normative change scores in old age in addition to demographic factors leads to more accurate predictions of whether true change has occurred.

KEYWORDS:

• Cognitive change
• neuropsychological change scores
• normal older Swedish adults
• physical health
• practice effects
• Useful Field of View test norms

Acknowledgments

We express our deep gratitude for the generous funding from the Research Foundation of Länsförsäkringar and to the participants for their time and effort over the years. The staff of the Traffic Medicine Centre involved in the examinations included the following administrative assistants, physicians, psychologists/psychology students, nurses and nursing assistants: Christina Bjertsjö, Mårten Eklöf, Niklas Eriksson, Monica Erlandsson, Henrik Hindmarsh, Thomas Karlsson, Hi-Young Kim, Anita Kvilhaug, Karolina Larsson, Anna-Karin Lidström, Frida Loménius, Lena Lundström, Margaret Maytan, Terttu Nyberg, Katarina Perlhagen, Thomas Pettersson, Maria Pihlsgård, Gunilla Rindström, Eva Skoglund, Birgitta Strandberg, Katrin Svensson, Pierre Wanger, and Maria Velenik. Valuable comments on a previous version of the manuscript were made by Björn Johansson.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. The highest score attained (0–5) of the subtraction task or the backward spelling tasks was included in the total MMSE score.

2. For easier calculation of z-scores for the tests, an Excel spreadsheet containing automatic formulas has been prepared and is available from the corresponding author.

Additional information

Funding

This research was supported by the Research Foundation of Länsförsäkringar.