Brazilian preliminary norms and investigation of age and education effects on the Modified Wisconsin Card Sorting Test, Stroop Color and Word test and Digit Span test in adults

Abstract

Executive functions are involved in a series of human neurological and psychiatric disorders. For this reason, appropriate assessment tools with age and education adjusted norms for symptom diagnosis are necessary.ObjectiveTo present normative data for adults (19-75 year-olds; with five years of education or more) on the Modified Wisconsin Card Sorting Test (MWCST), Stroop color and word test and Digit Span test. Age and education effects were investigated.MethodsThree samples were formed after inclusion criteria and data analysis: MWCST (n=124); Digit Span (n=123), and Stroop test (n=158). Groups were divided into young (19-39), middle-aged (40-59) and older (60-75) participants with five to eight years of education and nine years of education or more. Two-way ANOVA and ANCOVA analyses were used.ResultsEducation effects were found in most variables of the three tasks. An age effect was only found on color naming and color-word naming speed from the Stroop test. No interactions were detected.ConclusionIn countries with heterogeneous educational backgrounds, the use of stratified norms by education to assess at least some components of executive functions is essential for an ethical and accurate cognitive diagnosis.

The Stroop Color and Word Test

“…This condition represents an intermediate inhibition condition, as the interference effect between the written word and the color name is not present. In this SCWT form (Strauss et al, 2006b), for each condition, the completion time and the number of errors (corrected, non-corrected, and total errors) are recorded and two interference scores are computed: $\begin{array}{c}eqnarrayright\; center\; left\text{I}1=\text{ Word}/\text{Dot for time}\end{array}$ $\begin{array}{c}eqnarrayright\; center\; left\text{I}2=\text{ Interference}/\text{Dot for time}\end{array}$ Five studies (Strickland et al, 1997; Van der Elst et al, 2006; Zalonis et al, 2009; Kang et al, 2013; Zimmermann et al, 2015) adopted different SCWT versions. Three of them (Strickland et al, 1997; Van der Elst et al, 2006; Kang et al, 2013) computed, independently, the completion time and the number of errors for each condition.…”

Influence of age and education on the Rivermead Behavioral Memory Test (RBMT) among healthy elderly

“…Studies have shown that educational level has a significant impact on cognitive performance, which may confound the interpretation of test results, even those with ecological validity. 7 - 9 In Brazil, there is significant heterogeneity in relation to cultural and socioeconomic status, making it especially important to develop, adapt and standardize cognitive tests that take into account at least educational level in the interpretation of their results. 7 , 10 - 12 …”

Stroop Color and Word Test

“…Five studies (Strickland et al, 1997;Van der Elst et al, 2006;Zalonis et al, 2009;Kang et al, 2013;Zimmermann et al, 2015) adopted different SCWT versions. Three of them (Strickland et al, 1997;Van der Elst et al, 2006;Kang et al, 2013) computed, independently, the completion time and the number of errors for each condition.…”

“…Moreover, they computed an interference score subtracting the number of errors in the CW conditions from the number of items properly named in 120 s in the same table. Lastly, Zimmermann et al (2015) computed the number of errors and the number of correct answers given in 45 s in each conditions. Additionally, they calculated an interference score derived by the original scoring method provided by Stroop (1935).…”