Regression-Based Norms for the Hopkins Verbal Learning Test-Revised and the Rey–Osterrieth Complex Figure in a Portuguese Adult Population

Objective The principal goal of this study was to produce adjusted normative data for European Portuguese native speakers from Portugal on 2 neuropsychological tests widely used to assess learning and memory: the Hopkins Verbal Learning Test-Revised (HVLT-R) and the Rey–Osterrieth Complex Figure Test (ROCF). Method The study included 300 individuals aged 18–92 years (M = 50.4, SD = 21.2), who had educational backgrounds ranging from 3 to 25 years (M = 10.4, SD = 5.2). Results Age, education, and sex were significantly associated with HVLT-R and ROCF performance. These demographic variables accounted for 61% of the variance in HVLT-R total recall, 54% in HVLT-R delayed recall, 18% in HVLT-R recognition, 55% in ROCF copy, and 39% in ROCF immediate recall. Conclusions The normative data are presented as regression-based algorithms to adjust direct and derived test scores for age, education, and sex. This study provides a calculator of normative data derived from the results of the regression models.

A-223 Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) Embedded Performance Validity Analyses in a Healthy Non-Clinical Sample

Objective The Hopkins Verbal Learning Test–Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) are memory tests with embedded measures of performance validity (Recognition Discrimination [RD] and Discrimination Index [DI], respectively). We evaluated whether cognitive ability and age influenced embedded measures of effort. Methods Participants included 30 young adults (YA) and 29 older adults (dichotomized into unimpaired [OAu] and impaired [OAi]). Participants completed a medication management ability assessment (MMAA), daily memory lapses survey (DM), digit span, and the Transverse Patterning (TP) and Reversal Learning (RL) computerized tests. Two Repeated-Measures MANOVAs were conducted to determine if Passing PVT and Age/Cognitive Ability influenced performance. An ROC analysis was conducted for HVLT-RD and BVMT-DI to determine pass/fail, and false positives/negatives on embedded measures. Results Those in the YA group who failed RDS (YA-fail), performed better than OAi-fail and OAi-pass groups on RT Errors (p < .0001). On TP Errors, the YA group differed from all four OA groups (p < .0001). On MMAA a significant difference was observed between OAi-fail and all other groups (p < .001). On RD, YA groups differed from both OAi groups (p = .0008). On DI, the YA groups differed from the OAi-fail group (p = .002). A logistic regression classified 43/57 participants successfully into the three cognitive groups using the six predictors (χ2 = 55.73, p < .0001, R2 = .468). RT Errors and TP were significant (Likelihood χ2 = 7.25, p = .027). Conclusion HVLT-RD failed to detect validity for OAi, as did BVMT-DI for YA and OAu. Instead, impairment effects are seen on HVLT-RD and BVMT-DI where YA groups differed from some combination of both/one of the OA groups.

PREDICTORS OF ATTRITION IN THE MULTI-ETHNIC 1FLORIDA ADRC CLINICAL CORE

Understanding predictors of attrition can position researchers to increase retention efforts and focus on preventing attrition. Attrition, or dropout of participants during a study prior to completion, can threaten the internal and external validity of a study’s findings. Data from the 1FloridaADRC Clinical Core was analyzed, and included 271 participants within a two-year follow-up window, of which 216 (79.7%) were retained. T-tests and chi-square analyses were used to determine if a number of demographic, clinical, acculturation, and neuroimaging predictors were associated with attrition. The participant cohort included: 85% with cognitive impairment; 60% Hispanic; 42% over the age of 75; and 62% female. Predictors of greater attrition included: age over 75 years (p< .003); cognitive diagnosis of MCI or dementia (p< .01); and lower scores on the Mini-Mental Status Exam (p<.04), the Hopkins Verbal Learning Test (HVLT) immediate (p< .02), and delayed (p<.002) Higher total score on the Neuropsychiatric Inventory Questionnaire (p<.06), endorsement of night time behaviors (p<.05) and greater hippocampal atrophy (p<.02) were also predictive of attrition. Hispanic ethnicity was not a predictor of attrition, as retention was 81% for Hispanics versus 79% for non-Hispanics. However, among Hispanic participants, English acculturation measured by the Bidimensional Acculturation Scale for Hispanics was lower for those who dropped out (t=2.8; p=.006).

Updated Demographically Adjusted Norms for the Brief Visuospatial Memory Test-Revised and Hopkins Verbal Learning Test-Revised in Monolingual Spanish Speakers from the United States – Mexico Border Region

Objective Culturally and linguistically appropriate neuropsychological assessments for the large number of primary Spanish speakers in the United States remain imperative to serve the needs of this underserved population. As part of a larger co-norming project, we generated demographically adjusted norms for the Brief Visuospatial Memory Test-revised (BVMT-R) and the Hopkins Verbal Learning Test-revised (HVLT-R) for use with native Spanish speakers from the U.S.-Mexico border regions. Participants and Method Participants were 202 healthy native Spanish speakers recruited in San Diego, CA and Tucson, AZ, ages 19 to 60, with education ranging from 0-20 years, and 59% women. Test stimuli for the HVLT-R and instructions for both tests were adapted into Spanish by a team of native Spanish speakers from multiple countries using standard procedures (Cherner et al., 2007). Raw scores for the various learning and delayed recall outcomes were converted to T-scores using fractional polynomial equations accounting for effects of education, age, and sex. We then computed the rates of impairment that would be obtained when applying the original published norms for these two tests, and compared these results to the expected rate of impairment of -1SD (around 16%) derived from the normal distribution of T-scores in our new, demographically corrected norms. Results Results showed significant overestimation of impairment when applying the original norms for non-Hispanic English speakers to our Spanish-speaking sample, ranging from 35-38% for HVLT-R and 25-26% for BVMTR. As expected, these overestimations of impairment were greater for individuals with lower education, but our demographically corrected norms reduced the rate of impairment for all levels of education. Conclusions These findings highlight the urgent need to account for demographic effects on neuropsychological performance in order to improve the diagnostic accuracy of our measures when applied to US-dwelling Spanish speakers. References Cherner, M., Suarez, P., Lazzaretto, D., Fortuny, L. A. I., Mindt, M. R., Dawes, S., ... & HNRC group. (2007). Demographically corrected norms for the Brief Visuospatial Memory Test-revised and Hopkins Verbal Learning Test-revised in monolingual Spanish speakers from the US–Mexico border region. Archives of Clinical Neuropsychology, 22(3), 343-353.