Stability of neuropsychological test performance in older adults serving as normative controls for a study on postoperative cognitive dysfunction

Abstract

Objective: Studies of postoperative cognitive dysfunction (POCD) rely on repeat neuropsychological testing. The stability of the applied instruments, which are affected by natural variability in performance and measurement imprecision, is often unclear. We determined the stability of a neuropsychological test battery using a sample of older adults from the general population. Forty-five participants aged 65 to 89 years performed six computerized and noncomputerized neuropsychological tests at baseline and again at 7 day and 3 months follow-up sessions. Mean scores on each test were compared across time points using repeated measures analyses of variance (ANOVA) with pairwise comparison. Two-way mixed effects, absolute agreement analyses of variance intra-class correlation coefficients (ICC) determined test-retest reliability.Results: All tests had moderate to excellent test-retest reliability during 7-day (ICC range 0.63 to 0.94; all p < 0.01) and 3-month intervals (ICC range 0.60 to 0.92; all p < 0.01) though confidence intervals of ICC estimates were large throughout. Practice effects apparent at 7 days eased off by 3 months. No substantial differences between computerized and non-computerized tests were observed. We conclude that the present six-test neuropsychological test battery is appropriate for use in POCD research though small sample size of our study needs to be recognized as a limitation.

Test-retest reliability on the Cambridge Neuropsychological Test Automated Battery: Comment on Karlsen et al. (2020)

“…The test-retest reliability coefficients documented by Karlsen et al (2020) are broadly in keeping with reliability levels previously reported for CANTAB (Barnett et al, 2010;Cacciamani et al, 2018;Feinkohl et al, 2020;Fowler et al, 1995;Gonçalves et al, 2016;Lowe & Rabbitt, 1998). As noted by Karlsen et al (2020) themselves, test-retest reliability below r ¼ .75 is not unique to CANTAB but is commonly reported for many traditional neuropsychological measures.…”

Reliability of P3 Event-Related Potential During Working Memory Across the Spectrum of Cognitive Aging

“…The ability to distinguish natural variability and measurement error from biologically relevant cognitive changes due to aging or early neurodegeneration is valuable to provide informed decisions on diagnosis, monitoring, and treatment of cognitive impairments (Feinkohl et al, 2020). However, older adults show more intraindividual variability in performance measures of working memory compared to younger adults.…”

Preoperative medication use and development of postoperative delirium and cognitive dysfunction

“…The composition and retest reliabilities of the test battery are described in an additional publication. 21 Trained doctoral students and study nurses performed the testing based on a standard operating procedure, which was approved by two neuropsychologists.…”