Base Rates of “Impaired” Neuropsychological Test Performance Among Healthy Older Adults
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Base rates of deficient neuropsychological test performance were evaluated among 132 neurologically healthy older normal adults using a variety of measures commonly employed in the "flexible-battery"approach to neuropsychological assessment. Subjects were divided into three age groups (50 to 59, 60 to 69, and 70 to 79 years). Despite the healthy status of our sample, most tests yielded at least some proportion of subjects earning scores in the borderline and impaired ranges (1.3 and 2.0 standard deviations below the age-group mean, respectively). Across the battery of measures, 73% of subjects earned a borderline score on at least one measure, and 20% of subjects earned at least two scores in the impaired range on separate tests. The proportion of subjects consistently earning borderline or impaired scores across multiple measures within specific cognitive domains was generally lower. Results illustrate the problems in interpreting isolated low scores, and the need to consider false-positive base rates in drawing inferences from poor test performance.
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Palmer et al. found that more than 20% of healthy older adults tested with a battery of tests containing multiple measures for each cognitive domain obtained one impaired score in two different cognitive domains, whereas less than 5% had two or more impaired scores in the same domain.
“More specific to aging, Palmer et al. [41] found that more than 20% of healthy older adults tested with a battery of tests containing multiple measures for each cognitive domain obtained one impaired score in two different cognitive domains, whereas less than 5% had two or more impaired scores in the same domain.”
From Neuropsychological Criteria for Mild Cognitive Impairment Improves Diagnostic Precision, Biomarker Associations, and Progression Rates (2014) · cites this paper as [41]
The Discussion reports that one fifth of healthy older adults had at least two impaired scores on separate tests, but it does not establish that those scores occurred in two different cognitive domains or that the proportion exceeded 20%. Table 4 (Consistency of “Abnormal” Scores Within Domains) shows low rates of multiple impaired scores in most domains, but the rate for memory was 6.1%, not less than 5%. Page numbers are unavailable in our copy. (LLM, conf=0.91)
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- Authors
- Palmer, B.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Palmer, B
- ORCID
- Palmer, B
- Venue
- Archives of Clinical Neuropsychology
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-08
- Volume
- 13
- Issue
- 6
- Pages
- 503-511
- ISSN
- 0887-6177 (ISSN-L)
- OpenAlex
- W2158198176
- Cited by
- 142
- References
- 25
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 8 · 2021: 16 · 2020: 6 · 2019: 9 · 2018: 8 · 2017: 10 · 2016: 3 · 2015: 7 · 2014: 10 · 2013: 7 · 2012: 6
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Clinical Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-43960)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- base rates, neuropsychological test performance, older adults, healthy aging, false positives, cognitive domain, age differences
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