Qualitative Neuropsychological Measures: Normative Data on Executive Functioning Tests from the Framingham Offspring Study

Abstract

Background/Study Context: Studies have found that executive functioning is affected early in the pathophysiological processes associated with Alzheimer's disease and vascular dementia. There also exists a range of functioning on executive tasks during normal aging. Although qualitative data are commonly utilized in clinical practice for evaluating subtle changes in cognitive functioning and diagnostic discernment, it is not clear whether error responses used in clinical practice are also evident as normative behavior.

Methods: As part of an extensive battery of neuropsychological tests, executive functioning measures (i.e., Trail Making Test Part B, Similarities and Verbal Fluency tests) were administered via standardized administration prescript. Regression analyses were used to determine associations between vascular aging indices and qualitative performance measures. Descriptive statistics are included for 1907 cognitively normal individuals.

Results: Results suggest that although qualitative errors do occur, they are relatively infrequent within a presumably cognitively normal sample. Error commission rates on executive functioning tests are significantly associated with both age and education.

Conclusion: Provided is a baseline profile of errors committed on tests of executive function across a range of age and educational levels. The normative data sets are included, stratified by age and educational achievement, for which to compare qualitative test performance of clinical and research populations.

Acknowledgments

This work was supported by the Framingham Heart Study's National Heart, Lung, and Blood Institute contract (N01-HC-25195), by grants (R01-AG16495, R01-AG08122, R01-AG033040) from the National Institute on Aging, and by grant (R01-NS17950) from the National Institute of Neurological Disorders and Stroke.

The authors thank the extraordinary participants and families of the Framingham Heart Study who made this work possible. The authors also acknowledge the great work of all the research assistants and study staff.

Notes

Note. Log WMH-L = volume large white matter hyperintensities, log-transformed.

*N = 1503 for subset with MRI measures.

Note. WAIS = Wechsler Adult Intelligence Scale.

*3 degrees of freedom.

*3 degrees of freedom.

Note. %Psv errors = perseverations/total responses; %Total errors = total errors/total responses.

*3 degrees of freedom.

Note. %Psv errors = perseverations/total responses; %Total errors = total errors/total responses.

*3 degrees of freedom.

*3 degrees of freedom.

*3 degrees of freedom.

Note. All models are adjusted for age, sex, and education group. All statistical tests use 1 degree of freedom. WMH-L = large white matter hyperintensities. Psv = perseveration.

*p < .05; **p < .01; ***p < .001.

Note. WMS = Wechsler Memory Scale; WAIS = Wechsler Adult Intelligence Scale.

Note. LM = WMS Logical Memory; VR = WMS Visual Reproduction; VPA = WMS Verbal Paired Associates; HVOT = Hooper Visual Organization Test.

Note. % Error responses = errors/tests administered; % Sequencing errors = sequencing errors/tests administered.