Southwestern Assessment of Processing Speed (SWAPS): A new brief test with demographically-corrected norms in an ethnically and educationally diverse population

Abstract

Objective. Neuropsychological measures of processing speed have long been used as sensitive indices of cognitive functioning. Most of these commonly used tests are proprietary, and there is a need for brief, freely available tools that can be used in diverse clinical and research settings. The Southwestern Assessment of Processing Speed (SWAPS) is a 60-second digit-symbol transcription task developed as a brief alternative to commercially available coding tests. Demographically-corrected normative data are presented along with reliability and sensitivity/specificity values in older adults with and without cognitive impairment.

Method. SWAPS data from 915 healthy aging individuals (NC) and 858 subjects with clinical diagnoses of mild cognitive impairment (MCI; n = 430) and Alzheimer’s disease clinical syndrome (ADCS; n = 428) were obtained from the Texas Alzheimer’s Research and Care Consortium (TARCC). TARCC participants represent ethnically and educationally diverse community-dwelling individuals age 50+.

Results. SWAPS scores showed the expected associations with age, sex, and education, and the interaction between age and education were significant predictors of SWAPS scores. Test-retest reliability in NC was good, and the SWAPS distinguished impaired and non-impaired groups with adequate to excellent sensitivity and specificity for the primary analyses, with optimal cut-off points provided. Raw score- to uncorrected normalized T-scores and demographically-corrected SWAPS T-scores using regression-based norms are presented along with scoring programs for the calculation of each.

Conclusions. The SWAPS is a brief, free, easily administered test with demographically-corrected regression-based norms and promising utility for detection of cognitive impairment and efficient assessment of processing speed.

Keywords:

• Processing speed
• neuropsychological testing
• normal aging
• dementia
• T-score norms
• demographically-corrected norms
• norms calculator

Acknowledgements

We wish to thank Sarah Sprinkle, MA, for her assistance in the preparation of this manuscript and Maria Grosh Rothaar, PhD for her early work on SWAPS stimuli and forms. We also wish to thank TARCC participants for their time and dedication to assisting in the study of Alzheimer’s Disease. TARCC is a state-funded multi-institutional research program directed and funded by the Texas Council on Alzheimer’s Disease and Related Disorders, as part of the Darryl K. Royall Alzheimer’s Initiative that currently includes the University of Texas Southwestern Medical Center, Baylor University Medical Center, The University of North Texas Health Science Center, Texas Tech University Health Science Center, Texas A&M Health Science Center, The University of Texas at Austin Dell Medical School, The University of Texas Health Science Center at San Antonio, The University of Texas Medical Branch at Galveston, University of Texas Health Science Center at Houston, and The University of Texas Rio Grande Valley.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available upon reasonable request from the corresponding author, C. Munro Cullum, PhD.

Additional information

Funding

This study was made possible by the Texas Alzheimer’s Research and Care Consortium (TARCC) funded by the state of Texas through the Texas Council on Alzheimer’s Disease and Related Disorders. Support for the use of REDCap came from the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001105.