To further investigate the “other side of the bell curve” hypothesis, the current study examined the number of low and high scores on a neuropsychological battery: 1) in cognitively unimpaired or impaired older adults, 2) as they relate to biomarkers of Alzheimer’s disease (AD), and 3) as they relate to traditional scores on this battery.

In 68 cognitively unimpaired and 97 cognitively impaired participant, the number of low (i.e., ≤ 16th percentile) and high (i.e., ≥ 75th percentile) scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were calculated, compared between the two groups, and related to biomarkers of AD (i.e., amyloid deposition, hippocampal volumes, ε4 alleles of Apolipoprotein E (APOE)) and RBANS Total score.

In this cognitively diverse sample, low and high scores were common, with approximately 75% having at least one low score and 86% having at least one high score. Unimpaired participants had significantly more high scores and fewer low scores than their impaired counterparts. The number of low scores was significantly related to more amyloid deposition, smaller hippocampal volume, and having one or more copies of the ε4 allele of APOE. The number of high scores was similarly related with these biomarkers. Low/high scores were comparable to traditional scores on the RBANS in identifying cognitively impaired participants.

Support for the “other side of the bell curve” hypothesis was equivocal in these analyses, with both sides of the bell curve appearing to provide relevant information in a cognitively diverse sample.

No research has assessed Hamilton Rating Scale for Anxiety (HRSA) psychometric properties in Ethiopian university students, using item response theory (IRT) and classical theory.

This study aimed to assess psychometric properties of the English HRSA in Ethiopian students, using IRT and classical theory.

University students (N = 370, age 21.44 ± 2.30 years) in Ethiopia participated in a cross-sectional study. Participants completed a self-reported measure of anxiety, a sociodemographics tool and interviewer-administered HRSA.

Confirmatory factor analysis (CFA) favoured a one-factor structure because fit indices for the one-factor model; and two distinct two-factor models were similar, but high interfactor correlations violated discriminant validity criteria in two-factor models. This one-factor structure showed structural invariance as evidenced by multi-group CFA across gender groups. No ceiling/floor effects were seen for the HRSA total scores. Infit and outfit mean square values for all the items were within the acceptable range (0.6–1.4). Four threshold estimates (τi1, τi2, τi3 and τi4) for each item were ordered as expected. Differential item functions showed item-level measurement invariance for all the 14 HRSA items across gender for both uniform and non-uniform estimates. McDonald’s ω and Cronbach’s α for the HRSA tool were both 0.88. The convergent validity of the interviewer-administered HRSA with self-reported anxiety subscale of the 21-item Depression, Anxiety and Stress Scale was weak to moderate.

The findings favour the validity of a one-factor structure of the HRSA with adequate item properties (classical and rating scale model), convergent validity, reliability and measurement invariance (structural and item level) across gender groups in Ethiopian university students.

Impairments in social interaction are common symptoms of dementia and necessitate the use of validated neuropsychological instruments to measure social cognition. We aim to investigate the Hinting Task – Dutch version (HT-NL), which measures the ability to infer intentions behind indirect speech to assess Theory of Mind, in dementia.

Sixty-six patients with dementia, of whom 22 had behavioral variant frontotemporal dementia (bvFTD), 21 had primary progressive aphasia, and 23 had Alzheimer’s disease (AD), and 99 healthy control participants were included. We examined the HT-NL’s psychometric properties, including internal consistency, between-group differences using analyses of covariance with Bonferroni-adjusted post hoc comparisons, discriminative ability and concurrent validity using the area under the receiver operating characteristic curve (AUC), and construct validity using Spearman rank correlations with other cognitive tests.

Internal consistency was acceptable (Cronbach’s α = 0.74). All patient groups scored lower on the HT-NL than the control group. Patients with bvFTD scored lower than patients with AD dementia. The HT-NL showed excellent discriminative ability (AUC = 0.83), comparable to a test of emotion recognition (ΔAUC = 0.03, p = .67). The HT-NL correlated significantly with a test for emotion recognition (r = .45), and with measures of memory and language (r = [.31, .40]), but not with measures of information processing speed, executive functioning, or working memory (r = [.00, .17]). Preliminary normative data are provided.

The HT-NL is a psychometrically sound and valid instrument and is useful for identifying Theory of Mind impairments in patients with dementia.

The aims of this study were to field and pilot test the Korean version of the Household Emergency Preparedness Instrument (K-HEPI) and perform psychometric testing of the instrument’s reliability and validity.

The English to Korean translation followed a symmetrical translation approach utilizing a decentered process (i.e., both the source and target languages were considered equally important) focusing on the instruments remaining loyal to the content. After translation, the K-HEPI was field tested with 30 bilingual participants who all reported that the instructions were easy to understand and the items aligned closely with the original English version. The K-HEPI was then pilot tested with 399 Korean-speaking participants in a controlled, before-after study utilizing a disaster preparedness educational intervention.

Confirmatory factor analyses supported the K-HEPI retaining the factor structure of the original English version. The K-HEPI was also found to be psychometrically comparable to the original instrument.

The K-HEPI can validly and reliably assess the disaster preparedness of Korean-speaking populations, enabling clinicians, researchers, emergency management professionals, and policymakers to gather accurate data on disaster preparedness levels in Korean communities, identify gaps in preparedness, develop targeted interventions, and evaluate the effectiveness of disaster preparedness interventions over time.

We compare the Emory 10-item, 4-choice Rey Complex Figure (CF) Recognition task with the Meyers and Lange (M&L) 24-item yes/no CF Recognition task in a large cohort of healthy research participants and in patients with heterogeneous movement disorder diagnoses. While both tasks assess CF recognition, they differ in key aspects including the saliency of target and distractor responses, self-selection versus forced-choice formats, and the length of the item sets.

There were 1056 participants from the Emory Healthy Brain Study (EHBS; average MoCA = 26.8, SD = 2.4) and 223 movement disorder patients undergoing neuropsychological evaluation (average MoCA = 24.3, SD = 4.0).

Both recognition tasks differentiated between healthy and clinical groups; however, the Emory task demonstrated a larger effect size (Cohen’s d = 1.02) compared to the M&L task (Cohen’s d = 0.79). d-prime scoring of M&L recognition showed comparable group discrimination (Cohen’s d = 0.81). Unidimensional two-parameter logistic item response theory analysis revealed that many M&L items had low discrimination values and extreme difficulty parameters, which contributed to the task’s reduced sensitivity, particularly at lower cognitive proficiency levels relevant to clinical diagnosis. Dimensionality analyses indicated the influence of response sets as a potential contributor to poor item performance.

Emory CF Recognition task demonstrates superior psychometric properties and greater sensitivity to cognitive impairment compared to the M&L task. Its ability to more precisely measure lower levels of cognitive functioning, along with its brevity, suggests it may be more effective for diagnostic use, especially in clinical populations with cognitive decline.

To describe motor, respiratory and quality of life changes in a mixed cohort of adults with spinal muscular atrophy (SMA) from a single tertiary rehabilitation center in Canada and to report preliminary psychometric evidence of a nationally recommended core outcome set over 12 months.

This real-world, mixed-treatment cohort, exploratory, single-site, prospective observational study followed fifteen adults with SMA over 12 months. Participants completed the Spinal Muscular Atrophy Recommended Toolkit (SMART), which consists of eight outcome measures (OM) assessed at baseline and 12 months. Concurrent and predictive validity were assessed using Spearman’s Correlation Coefficient (SCC). Longitudinal change and sensitivity to change were evaluated using the Wilcoxon signed-rank test and standardized response mean.

Ten participants were receiving disease-modifying treatments. None of the OMs demonstrated statistically significant changes over 12 months. Respiratory and motor function measures are independently clustered into two clusters. Only the Children’s Hospital of Philadelphia – Adult Test of Neuromuscular Disorders (CHOP-ATEND) exhibited high sensitivity to change. Forced vital capacity (FVC) >2 L or peak cough flow (PCF) >200 L/min corresponds with ceiling effects of the Revised Upper Limb Module (RULM) and SMA Functional Rating Scale (SMAFRS).

This exploratory study identified two collinear clusters between SMART OMs, suggesting measurement redundancy. SMART OMs did not demonstrate significant changes over 12 months in this small mixed-treatment cohort. Developing new OMs that are valid, reliable and responsive, and optimizing OM selection will reduce clinic and patient burden, and improve clinical utility in a real-world setting.

To assess for differences in low score frequency on cognitive testing amongst older adults with and without a self-reported history of traumatic brain injury (TBI) in the National Alzheimer’s Coordinating Center (NACC) dataset.

The sample included adults aged 65 or older who completed the Uniform Data Set 3.0 neuropsychological test battery (N = 7,363) and was divided by individuals with and without a history of TBI, as well as cognitive status as measured by the CDR. We compared TBI- and TBI + groups by the prevalence of low scores obtained across testing. Three scores falling at or below the 2nd percentile or four scores at or below the 5th percentile were criteria for an atypical number of low scores. Nonparametric tests assessed associations among low score prevalence and demographics, symptoms of depression, and TBI history.

Among cognitively normal participants (CDR = 0), older age, male sex and greater levels of depression were associated with low score frequency; among participants with mild cognitive impairment (CDR = 0.5-1), greater levels of depression, shorter duration of time since most recent TBI, and no prior history of TBI were associated with low score frequency.

Participants with and without a history of TBI largely produced low scores on cognitive testing at similar frequencies. Cognitive status, sex, education, depression, and TBI recency showed variable associations with the number of low scores within subsamples. Future research that includes more comprehensive TBI history is indicated to characterize factors that may modify the association between low scores and TBI history.

People with an intellectual disability are vulnerable to additional disorders such as dementia. Psychometrically sound and specific instruments are needed for assessment of cognitive functioning in cases of suspected dementia.

To evaluate the construct and item validity, internal consistency and test–retest reliability of a new neuropsychological test battery, the Dementia Test for People with Intellectual Disability (DTIM).

The DTIM was applied to 107 individuals with intellectual disability with (n = 16) and without (n = 91) dementia. The psychometric properties of the DTIM were assessed in a prospective study. The assessors were blinded to the diagnostic assignment.

Confirmatory factor analysis at the scale level showed that a one-factor model fitted the data well (root mean square error of approximation < 0.06, standardised root mean square residual < 0.08, comparative fit index > 0.9). At the domain level, one-factor models showed reasonable-to-good fit index for five of seven domains. Internal consistency indicated excellent reliability of the overall scale (Cronbach’s α: 0.94 for dementia and 0.95 for controls). Item analysis revealed a wide range of difficulties (0.19–0.75 for dementia, 0.31–0.87 for controls), with minimal floor and ceiling effects. Eleven items (26%) had discrimination value ≤ 0.50. Test–retest reliability (n = 82) was high, with intraclass correlations of 0.95 (total score) and 0.69–0.96 (domains).

The DTIM fits a one-factor model and demonstrates internal and test–retest reliability; thus, it is suitable for use in cases of suspected dementia in people with various intellectual disabilities.

This methodological study aimed to adapt the DLS, introduced for individuals aged 18-60 years, to those aged 60 years and older and to determine its psychometric properties.

We collected the data between December 15, 2021 and April 18, 2022. We carried out the study with a sample of 60 years and older living in the city center of Burdur, Turkey. The sample was selected using snowball sampling, a non-probability sampling technique. We collected the data using a questionnaire booklet covering an 11-item demographic information form and the DLS. We utilized reliability and validity analyses in the data analysis. The analyses were performed on SPSS 23.0, and a P value < 0.05 was considered statistically significant.

The mean age of the participants was found to be 68.29 (SD = 6.36). The 61-item measurement tool was reduced to 57 items by removing a total of 4 items from the scale. We also calculated Cronbach’s α values to be 0.936 for the mitigation/prevention subscale, 0.935 for the preparedness subscale, 0.939 for the response subscale, and 0.945 for the recovery/rehabilitation subscale.

As adapted in this study, the DLS-S can be validly and reliably used for individuals aged 60 years and older.