The importance of demographic adjustments on neuropsychological test performance: A response to reitan and wolf son (1995)

Abstract

Recently, Reitan and Wolfson (1995) questioned the validity of using age and education adjustments in the clinical practice of neuropsychology based on a study of the effects of age and education on the General Neuropsychological Deficit Scale (GNDS) score. We critique their findings and conclusions on both theoretical and methodological grounds. We then present the results of a similar investigation on the effects of age and education on three different neuropsychological summary scores. In contrast to Reitan and Wolf-son's findings, in the present study age and education had similar effects on neuropsychological summary scores (GNDS, HII, and AIR) whether or not subjects were brain-damaged. Younger or more educated subjects consistently performed better than did older or less educated subjects. This was true even though correlations between age and education with neuropsychological summary scores were low and often statistically nonsignificant in both brain-damaged and pseudoneurologic samples. In addition, the present study demonstrated that the use of demographically adjusted neuropsychological summary scores results in consistently higher diagnostic classification accuracy than the use of nonadjusted scores.