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Arch Clin Neuropsychol. 2017 Aug 1;32(5):574-584. doi: 10.1093/arclin/acx032.

Interpreting Patterns of Low Scores on the NIH Toolbox Cognition Battery.

Author information

1
Center on Assessment Research and Translation, University of Delaware, USA.
2
Center on Assessment Research and Translation & and Departments of Physical Therapy, Psychological and Brain Sciences, University of Delaware, USA.
3
Neurosciences Program (Brain Injury and Rehabilitation), Alberta Children's Hospital, Alberta, Canada.
4
Departments of Paediatrics, Clinical Neurosciences, and Psychology, University of Calgary, Alberta, Canada.
5
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
6
Department of Medical Social Sciences.
7
Division of Biomedical Informatics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, USA.
8
Northwestern University Feinberg School of Medicine, Rehabilitation Institute of Chicago, USA.
9
Department of Physical Medicine and Rehabilitation, Harvard Medical School, USA.
10
Spaulding Rehabilitation Hospital, USA.
11
MassGeneral Hospital for Children™ Sports Concussion Program, USA.
12
Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, USA.

Abstract

Introduction:

The National Institutes of Health Toolbox for Assessment of Neurological and Behavioral Function Cognition Battery is comprised of seven cognitive tests, including two tests measuring crystallized cognitive ability (i.e., vocabulary and reading) and five tests measuring fluid cognitive functioning (i.e., working memory, memory, speed of processing, and executive functioning). This study presents comprehensive base rate tables for the frequency of low scores in adults and older adults from the normative sample.

Methods:

Participants were 843 adults, ages 20-85, from the NIH Toolbox standardization sample who completed all seven cognition tests. Rates of low scores were derived for standard age-adjusted and fully-demographically-adjusted scores at multiple cut-scores. Base rates were stratified by education, crystallized intellectual ability, and cognitive domain.

Results:

Using the five demographically-adjusted fluid cognitive test scores, 45.9% of adults obtained one or more scores at or below the 16th percentile, and 16.8% obtained one or more score at or below the 5th percentile, which is consistent with findings from other neurocognitive test batteries.

Discussion:

Based on the study findings, nearly 50% of adults in the general population would meet psychometric criteria for a diagnosis of the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) Mild Neurocognitive Disorder (MND). We developed new psychometric criteria for identifying MND using the NIH Toolbox Cognition Battery that reduce the false positive rate. Knowing these multivariate normative base rates will help researchers and clinicians interpret NIH Toolbox scores in people with neurodevelopmental, psychiatric, medical, neurological, and neurodegenerative disorders that affect cognitive functioning.

KEYWORDS:

Cognition; Cognitive impairment; Multivariate base rates; NIH Toolbox; Traumatic brain injury

PMID:
28419177
PMCID:
PMC5860176
DOI:
10.1093/arclin/acx032
[Indexed for MEDLINE]
Free PMC Article

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