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It is common practice for Neuropsychologists to administer the same tests on more than one occasion to document the progression of a patient’s cognitive.

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Presentation on theme: "It is common practice for Neuropsychologists to administer the same tests on more than one occasion to document the progression of a patient’s cognitive."— Presentation transcript:

1 It is common practice for Neuropsychologists to administer the same tests on more than one occasion to document the progression of a patient’s cognitive status. When interpreting changes, one should take into consideration the stability of the measure as well as practice effects. The Rey-Osterrieth Complex Figure Test (ROCFT) is a frequently administered test that assesses cognitive functions such as visuospatial organization and memory. Previous test-retest studies on the ROCFT have been mixed, with reliability coefficients ranging from poor to adequate (Knight & Kaplan, 2003). To enhance the generalizability of prior investigations, we examined the test-retest reliability of the ROCFT in a sample of participants with Parkinson’s disease (PD) and normal controls. While reliable test-retest differences were not expected, we predicted that normal controls, compared to PD patients, will demonstrate higher scores at retest across the ROCFT Copy, Immediate Recall, and Delayed Recall tasks. 33 non-demented PD (7 women, 26 men) and 26 non-demented controls (5 women, 21 men). Means for age and education are (SD = 5.58) and (SD = 2.99) for PD, and (SD = 4.64) and (SD = 2.60) for Controls. Participants were matched by age and education Exclusion criteria: having another medical disease likely to limit lifespan or confound outcome analysis PD patients could not have undergone Deep Brain Stimulation and could not have evidence of secondary or atypical Parkinsonism as suggested by the presence of any of the following: 1) history of major stroke(s), 2) exposure to toxins or neuroleptics, 3) history of encephalitis, 4) neurological signs of upper motor neuron disease, cerebellar involvement, supranuclear palsy, or significant orthostatic hypertension. Test-Retest Reliability on the Rey-Osterrieth Complex Figure Test in a Sample of Parkinson’s Disease Patients Compared to Normal Controls Affiliations: 1 Department of Clinical and Health Psychology, University of Florida; 2 Department of Neurology, University of Florida 1 Freedland, A., 1 Glass Umfleet, L., 1 Schwab, N., 1 Ward, J., 1 Leninger, S., 1 Coronado, N., 1 Tanner, J., 1 Nguyen, P., 2 Okun, M., 1 Bowers, D., 1 Price, C. Rey –Osterrieth Complex Figure Test (ROCFT): Participants were administered the ROCFT presented in landscape version. They were required to copy the figure on a landscape white piece of paper, immediately recall the figure, and then recall the figure after a 30 minutes delay. To achieve inter-rater reliability 10 figures in the three conditions were scored twice according to Denman criteria (72 total points for each condition ; Denman, 1984), by two different trained research assistants, to reduce examiner scoring errors (r=.944). The testing intervals was one year ± 1.2 months for both PD and control groups. Figure 1. Copy time 1 for PDFigure 2. Copy time 2 for PD Figure 3. Copy time 1 for control Figure 4. Copy time 2 for control Cognitive/ Neuropsychological Tests Administered: In addition to the ROCFT, participants were administered the Wechsler Test of Adult Reading (Wechsler, 2001), the Dementia Rating Scale-2 (Jurica, Leitten, & Mattis, 2001), and the Wechsler Test of Adult Reading Wechsler, 2001) to screen for dementia and match for estimated premorbid intelligence. No significant differences emerged between PDs and Controls on the WTAR, DRS-2, and WTAR scores (ps >.05). Supported by: K23NS60660 (CP) Objectives Methods and Procedures Participants Test-retest reliability was relatively larger for PD’s Copy score (r=.68) compared to controls (r=.11). Stability coefficients for PDs and controls ranged from small to medium on immediate (r=.631,.735) and delayed trials (r=.734,.708). Coefficients were small for the unit scores (rs <.60) for both groups. Compared to the PDs, controls were more susceptible to practice effects. Test-retest reliability was relatively larger for PD’s Copy score (r=.70) compared to controls (r=.29). Stability coefficients for PDs and controls were adequate on immediate and delayed trials Illustrated in Figure 5 are ROCFT Copy, Immediate Recall, and Delayed Recall mean raw scores at both testing periods for PDs and Controls. Independent samples t-tests revealed statistically significant differences between the PD and control group on all ROCFT variables at retest (ps <.05). However, the controls and PDs did not differ on ROCFT means at time 1. These findings may suggest that groups were relatively comparable on initial testing, but Controls improved at 1 year thereby suggesting a practice effect. Our findings were similar to previous studies with testing intervals ≥ 1 year (Bartels, Wegrzyn, Wiedl, Ackerman, & Ehrenreich, 2010). Clinicians should cautiously proceed with interpreting changes on the ROCFT over one year test-retest intervals, especially when examining less impaired subjects. For non-disease individuals (e.g., controls) a reliable change metric appears appropriate. Using the ROCFT for individuals with Parkinson’s disease appears reasonable, but clinicians are encouraged to consider symptom variability between patients. Test-retest reliability was relatively larger for PD’s Copy score (r=.68) compared to controls (r=.11). Stability coefficients for PDs and controls ranged from small to medium on immediate (r=.631,.735) and delayed trials (r=.734,.708). Coefficients were small for the unit scores (rs <.60) for both groups. Compared to the PDs, controls were more susceptible to practice effects. Conclusions/Implications Results


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