Use of neuropsychological tests to predict adult patients' everyday functioning.

Heaton, Robert K.; Pendleton, Mark G.

doi:10.1037/0022-006x.49.6.807

Cited by 299 publications

(168 citation statements)

References 23 publications

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“…In general, if a person shows NP impairment on tests of a certain ability, he0she would be considered at risk for failure in everyday tasks that require the same ability (Heaton & Pendleton, 1981). Perhaps not surprisingly, we found that the NP deficits which best predicted failures on standardized tests of IADLs, were those that also are most commonly observed among cognitively impaired HIV1 participants.…”

Section: Discussionmentioning

confidence: 54%

The impact of HIV-associated neuropsychological impairment on everyday functioning

Heaton

Marcotte

Mindt

et al. 2004

J. Inter. Neuropsych. Soc.

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HIV-1 infection can be associated with neuropsychological (NP) deficits ranging from subtle to severe. The purpose of this study was to evaluate the functional, or "real-world" impact of HIV-associated NP impairment in a group of 267 HIV-infected participants. All participants received comprehensive NP, neuromedical, and standardized functional evaluations that included laboratory measures of shopping, cooking, financial management, medication management and vocational abilities. Compared to NP-normal participants, those with NP impairment performed significantly worse on all laboratory measures of everyday functioning. Multivariate analyses revealed that the NP ability domains of Abstraction0Executive Function, Learning, Attention0Working Memory and Verbal abilities most strongly and consistently predicted failures on the functional battery. Both NP impairment and impairment on the functional battery were significantly associated with subjective experiences of cognitive difficulties, as well as unemployment and increased dependence in activities of daily living; multivariate prediction models that also considered depressed mood and biological measures of disease progression revealed that impairment on the functional battery and depression were the only unique predictors of all three indicators of "real-world" functioning. The current results add to growing evidence concerning the clinical significance of HIV-associated NP impairment. Objective, laboratory based functional measures, such as those used here, may compliment NP testing in future studies directed at understanding the impact on life quality of central nervous system disorders and their treatments. Finally, there is a need for additional research investigating the apparently independent effect of depression on level of everyday functioning in HIV infected persons. (JINS, 2004, 10, 317-331.)

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Section: Discussionmentioning

confidence: 54%

The impact of HIV-associated neuropsychological impairment on everyday functioning

Heaton

Marcotte

Mindt

et al. 2004

J. Inter. Neuropsych. Soc.

Self Cite

678

689

View full text Add to dashboard Cite

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“…The total time to complete the test was taken as the test score. (2) The Wisconsin Card Sorting Test (WCST; Heaton and Pendleton, 1981). This assesses abstract thinking, cognitive flexibility, concept identification, hypothesis generation, and the ability to use response feedback information.…”

Section: Neuropsychological Testsmentioning

confidence: 99%

Brain Morphometry and Cognitive Performance in Detoxified Alcohol-Dependents with Preserved Psychosocial Functioning

Chanraud

Martelli

Delain

et al. 2006

Neuropsychopharmacol

370

295

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The extent of structural brain damage and related cognitive deficits has been little described in alcohol-dependent individuals with preserved social functioning. Thus, we investigated the relationship between regional alterations, executive performance, and drinking history. Volumes of gray and white matter were assessed using magnetic resonance imaging voxel-based morphometry in healthy men and in detoxified alcohol-dependent men with good psychosocial functioning. Their executive performance was assessed using neuropsychological tests. Regression analyses were carried out in the regions in which volume differences were detected. Decreases in gray matter were detected bilaterally in alcohol-dependents in the dorsolateral frontal cortex (up to 20% lower), and to a lesser extent in the temporal cortex, insula, thalamus, and cerebellum. Decreases in white matter volume were widespread, being up to 10% in corpus callosum. The degradation of neuropsychological performance correlated with gray matter volume decreases in the frontal lobe, insula, hippocampus, thalami and cerebellum, and with white matter decrease in the brainstem. An early age at first drinking was associated with decreased gray matter volumes in the cerebellum, brainstem (pons), and frontal regions. Regional alteration in gray and white matter volume was associated with impairment of executive function despite preserved social and somatic functioning in detoxified patients. Besides involving frontal regions, these findings are consistent with a cerebello-thalamo-cortical model of impaired executive functions in alcohol-dependent individuals.

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“…However, in a recent review of 15 studies, Bauer and colleagues (26) found that, except for ongoing depressive symptoms, few of these factors were consistently associated with poor functional outcomes across studies. Neurocognitive functioning, remarkably, was not examined in most of the preceding studies of BPD patients, despite having been explored extensively in relation to functional disability in patients with schizophrenia and other neuropsychiatric conditions (17)(18)(19)(20)(21)27).…”

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confidence: 99%

Neurocognitive impairment in bipolar disorder patients: functional implications

2009

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Growing evidence suggests that bipolar disorder (BPD) patients experience prominent neurocognitive impairment not only during acute mood episodes (1-3) but also during euthymia (1,(4)(5)(6)(7)(8)(9)(10)(11)(12). A recent meta-analytic review of 39 studies comparing neurocognitive functioning in 948 euthymic BPD patients and 1,128 normal controls, matched for age, sex, education, and estimated premorbid IQ, found medium-to-large effect sizes (ES, as group differences ⁄ variance) for impaired attention and processing speed (ES = 0.60-0.79), episodic memory (ES = 0.43-0.81), and executive functioning (ES = 0.47-0.71) in the BPD patients (11). Another meta-analytic review of 20 studies, also comparing neurocognitive performance in euthymic BPD patients to matched normal controls, found deficits of similar magnitude in measures of executive functions, verbal learning, immediate Background: Functional recovery among treated bipolar disorder (BPD) patients is far less likely than syndromal and even symptomatic recovery. We hypothesized that increasingly well-documented aspects of cognitive impairment may contribute to poor functional outcomes in BPD patients, and reviewed the available research on the topic.Methods: Computerized literature searching identified 12 studies with 13 comparisons that simultaneously evaluated cognitive and functional status in euthymic (n = 8) or non-euthymic (n = 5 comparisons) adult BPD patients versus otherwise similar healthy controls.Results: In 6 ⁄ 8 studies of euthymic BPD patients and 5 ⁄ 5 studies of non-euthymic BPD patients, neurocognitive impairment was significantly associated with impaired psychosocial functioning, even after adjusting for residual mood symptoms and relevant demographic and clinical variables. Cognitive status was consistently assessed with standardized, performance-based neuropsychological tests, but functional status usually was based on subjective self-appraisals. Approximately 55% of BPD patients were unemployed.Conclusions: Available studies are limited by subjective assessments of functional status rather than objective, performance-based measures. Nevertheless, they support the hypothesis that enduring aspects of cognitive impairment found even in euthymic BPD patients are associated with inferior functioning. These findings encourage further studies with better assessment methods and greater rehabilitative efforts in BPD patients.

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Use of neuropsychological tests to predict adult patients' everyday functioning.

Cited by 299 publications

References 23 publications

The impact of HIV-associated neuropsychological impairment on everyday functioning

The impact of HIV-associated neuropsychological impairment on everyday functioning

Brain Morphometry and Cognitive Performance in Detoxified Alcohol-Dependents with Preserved Psychosocial Functioning

Neurocognitive impairment in bipolar disorder patients: functional implications

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