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Proefschrift Maastricht. Lit. opg. - Met een samenvatting in het Nederlands.
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La dimensión expresiva de lo artístico, la sensibilidad estética y la educación de los sentidos, poseen una importancia primor-dial en la socialización, inteligencia y juicio de los individuos, que hace posible una relación armoniosa y habitual con el mundo exterior , de particular relevancia para las personas con discapaci-dad.
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... Performance is interpreted by comparing individuals' scores with scores from a reference group [13]. As raw scores in cognitive tests are affected by demographic variables such as age, sex, or educational level [15][16][17], normative data are used to transform them into relative measures corrected for the influence of these variables [16,18] and to provide a framework in which theses scores can be located and interpreted. Thus, selecting appropriate normative datasets is necessary for accurately interpreting the results of the neuropsychological assessment, and for reducing the probability of false diagnoses of cognitive impairment [15,19]. ...
... Performance is interpreted by comparing individuals' scores with scores from a reference group [13]. As raw scores in cognitive tests are affected by demographic variables such as age, sex, or educational level [15][16][17], normative data are used to transform them into relative measures corrected for the influence of these variables [16,18] and to provide a framework in which theses scores can be located and interpreted. Thus, selecting appropriate normative datasets is necessary for accurately interpreting the results of the neuropsychological assessment, and for reducing the probability of false diagnoses of cognitive impairment [15,19]. ...
In this work, we developed normative data for the neuropsychological assessment of independent and cognitively active Spanish older adults over 55 years of age.
Method:
Regression-based normative data were calculated from a sample of 103 non-depressed independent community-dwelling adults aged 55 or older (67% women). Raw data for Digit Span (DS), Letters and Numbers (LN), the Trail Making Test (TMT), and the Symbol Digit Modalities Test (SDMT) were regressed on age, sex, and education. The model predicting TMT-B scores also included TMT-A scores. Z-scores for the discrepancy between observed and predicted scores were used to identify low scores. The base rate of low scores for SABIEX normative data was compared to the base rate of low scores using published normative data obtained from the general population.
Results:
The effects of age, sex, and education varied across neuropsychological measures. Although the proportion of low scores was similar between normative datasets, there was no agreement in the identification of cognitively impaired individuals.
Conclusions:
Normative data obtained from the general population might not be sensitive to identify low scores in cognitively active older adults, incorrectly classifying them as cognitively normal compared to the less-active population. We provide a friendly calculator for use in neuropsychological assessment in cognitively active Spanish people aged 55 or older.
... Individual test scores were combined in seven neurocognitive domain scores: verbal memory, visual memory, attention, executive functioning, working memory, information processing speed and visuoconstruction. Raw individual test scores were converted into standardized z-scores, by using means and standard deviations of individually matched healthy controls regarding age, gender, and education level, for four different domains (verbal memory, attention, executive functioning and information processing speed) [30][31][32]. Published norms were used, corrected for age and education, for the three other domains (visual memory, working memory and visuoconstruction) [33,34]. A change in z-score of ≥ 1.5 standard deviation (SD) was considered to be clinically meaningful, in line with previous research in the same population [21]. ...
Background:
Recently, it has been shown that at group level, patients with limited brain metastases treated with stereotactic radiotherapy (SRT) maintain their pre-treatment levels of neurocognitive functioning (NCF) and health-related quality of life (HRQoL). The aim of this study was to evaluate NCF and HRQoL changes over time at the individual patient level.
Methods:
NCF (seven domains assessed with a standardized test battery) and HRQoL (eight predetermined scales assessed with the EORTC QLQ-C30 and BN20 questionnaires) were measured prior to SRT and at 3 and/or 6 months follow-up. Changes in NCF and HRQoL were evaluated at (1) a domain/scale level and (2) patient level.
Results:
A total of 55 patients were examined, of which the majority showed stable NCF 3 months after SRT, on both the domain level (78-100% of patients) and patient level (67% of patients). This was different for HRQoL, where deterioration in the different scales was observed in 12-61% of patients, stable scores in 20-71%, and improvement in 16-40%, 3 months after SRT. At patient level, most patients (64%) showed both improvement and deterioration in different HRQoL scales. Results were similar between 3 and 6 months after SRT.
Conclusion:
In line with results at group level, most brain oligometastases patients with ≥ 6 months follow-up and treated with SRT maintained their pre-treatment level of NCF during this period. By contrast, changes in HRQoL scores differed considerably at domain and patient level, despite stable HRQoL scores at group level.
... Test scores were combined into 7 compound neurocognitive domain scores: verbal memory, visual memory, working memory, attention, information processing speed, executive functioning, and visuoconstructive abilities. Patients' performances on verbal memory, attention, information processing speed, and executive functioning were compared with healthy controls, 26,27 who were individually matched to the patients with respect to age, sex, and educational level. 28 For working memory, visuoconstruction, and visual memory, published norms were used, 29,30 correcting for age and education. ...
Background:
Stereotactic radiotherapy (SRT) is expected to have a less detrimental effect on neurocognitive functioning and health-related quality of life (HRQoL) than whole-brain radiotherapy. To evaluate the impact of brain metastases and SRT on neurocognitive functioning and HRQoL, we performed a prospective study.
Methods:
Neurocognitive functioning and HRQoL of 97 patients with brain metastases were measured before SRT and 1, 3, and 6 months after SRT. Seven cognitive domains were assessed. HRQoL was assessed with the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and BN20 questionnaires. Neurocognitive functioning and HRQoL over time were analyzed with linear mixed models and stratified for baseline Karnofsky performance status (KPS), total metastatic volume, and systemic disease.
Results:
Median overall survival of patients was 7.7 months. Before SRT, neurocognitive domain and HRQoL scores were lower in patients than in healthy controls. At group level, patients worsened in physical functioning and fatigue at 6 months, while other outcome parameters of HRQoL and cognition remained stable. KPS < 90 and tumor volume >12.6 cm(3) were both associated with worse information processing speed and lower HRQoL scores over 6 months time. Intracranial tumor progression was associated with worsening of executive functioning and motor function.
Conclusions:
Prior to SRT, neurocognitive functioning and HRQoL are moderately impaired in patients with brain metastases. Lower baseline KPS and larger tumor volume are associated with worse functioning. Over time, SRT does not have an additional detrimental effect on neurocognitive functioning and HRQoL, suggesting that SRT may be preferred over whole-brain radiotherapy.
... In diagnostic settings, the "raw" score of a person on a cognitive test (e.g., the number of items that were recalled in a memory test) is usually not of direct interest. The reason for this is that the raw scores on cognitive tests are strongly affected by demographic variables (such as age and educational level; Mitrushina et al., 2005;Strauss, Sherman, & Spreen, 2006;Van der Elst, 2006). For example, the same raw test score may be indicative of a severe memory problem in a 50-yearold person, while it is within the normal limits of test performance for an 80-year-old person (Van der Elst, Van Boxtel, Van Breukelen, & Jolles, 2005). ...
... Clinicians therefore use relative measures (rather than raw test scores) to evaluate a patient's test performance (e.g., what is the percentage of demographically matched "cognitively healthy" peers who obtain a test score that is equal to or worse than the test score of this patient?). So-called normative data are used to convert raw test scores into demographically corrected relative measures (Mitrushina et al., 2005;Van der Elst, 2006). ...
... Level of Education (LE) was categorized into three levels using a classification scheme that is often used in the Netherlands (De Bie, 1987), with low = at most primary education, average = at most junior vocational training, and high = senior vocational or academic training. More details regarding the SCWT and the sample frame, participant recruitment, stratification criteria, and other aspects of the MAAS can be found elsewhere (Jolles et al., 1995;Van der Elst, 2006). ...
Serial cognitive assessment is conducted to monitor changes in the cognitive abilities of patients over time. At present, mainly the regression-based change and the ANCOVA approaches are used to establish normative data for serial cognitive assessment. These methods are straightforward, but they have some severe drawbacks. For example, they can only consider the data of two measurement occasions. In this article, we propose three alternative normative methods that are not hampered by these problems-that is, multivariate regression, the standard linear mixed model (LMM), and the linear mixed model combined with multiple imputation (LMM with MI) approaches. The multivariate regression method is primarily useful when a small number of repeated measurements are taken at fixed time points. When the data are more unbalanced, the standard LMM and the LMM with MI methods are more appropriate because they allow for a more adequate modeling of the covariance structure. The standard LMM has the advantage that it is easier to conduct and that it does not require a Monte Carlo component. The LMM with MI, on the other hand, has the advantage that it can flexibly deal with missing responses and missing covariate values at the same time. The different normative methods are illustrated on the basis of the data of a large longitudinal study in which a cognitive test (the Stroop Color Word Test) was administered at four measurement occasions (i.e., at baseline and 3, 6, and 12 years later). The results are discussed and suggestions for future research are provided.
... The main aims of the present study were (i) to evaluate the psychometric properties of the LGST, and (ii) to establish normative data for the LGST. Normative data are useful tools in both research and in clinical settings, because they allow for the quantification of the relative level of logical grammatical structures comprehension of a tested child (i.e., what is the level of logical grammatical structures comprehension of this child as compared to his or her demographically matched peers?; Capitani, 1997;Mitrushina, Boone, Razani, & D'Elia, 2005;Van der Elst, 2006). ...
Logical grammatical structures comprehension is the ability to understand the relations between objects, actions, and qualities in spoken and written sentences. The Logical Grammatical Structures Test (LGST) was especially devised to assess these abilities in children and adolescents. In the present study the LGST was administered to 405 healthy Dutch children and adolescents. The aims of the present study were (i) to evaluate the psychometric properties of the LGST (using an Item Response Theory framework), and (ii) to establish demographically corrected normative data. The results showed that there was a strong curvilinear relationship between age and LGST performance, i.e., the relative improvement in ability level was much more pronounced for younger children (aged below 14 years) than for older children (aged above 14 years). Level of parental education was positively associated with the LGST performance. Normative data that took the relevant demographic variables into account were established, and it was shown that the LGST had sound psychometric properties.
... In the present study, the psychometric properties of the AEFI were evaluated as based on the data of a large sample (N = 6,730) of adolescents (aged between 15.0 and 18.0 years). Normative data were also established, because it is difficult to interpret raw test scores in a meaningful way without an empirical frame of reference (Capitani, 1997;Van der Elst, 2006). Norms are indeed useful tools, which allow clinicians and researchers to address questions such as: "Are the Attention, Self-Control and Self-Monitoring, and Planning and Initiative AEFI scale scores of this child "normal" as compared to the scores of his or her demographically matched peers, or are these scores deviant (i.e., exceptionally low or high)?" ...
... The AEFI scale scores were normed by means of a four-step procedure (Van Breukelen & Vlaeyen, 2005;Van der Elst, 2006;Van der Elst, Van Boxtel, Van Breukelen, & Jolles, 2006a, 2006b. In this procedure, the user of the normative data calculates first the testee's predicted AEFI scale scores by means of the final regression models: predicted AEFI scale score = B 0 + B 1 X 1 + . . . ...
The Amsterdam Executive Function Inventory (AEFI) is a newly developed brief self-report questionnaire to assess three important components of the executive aspects of daily-life behavior--that is, Attention, Self-Control and Self-Monitoring, and Planning and Initiative. In a population-based study, the AEFI was administered to N = 6,730 Dutch adolescents aged between 15 and 18 years. Psychometric analyses showed that the construct validity and the reliability of the AEFI were adequate. Educational level and gender affected the different AEFI scale scores. Regression-based normative data that took these demographic influences into account were established, so that the AEFI can be used by clinicians and researchers who need to assess executive aspects of daily-life behavior.
... The aim of the present study was to establish the normal range of performance on the Animal Verbal Fluency (AVF) and the Design Fluency (DF) tests, using a sample of N = 294 healthy native Dutch-speaking children who were aged between 6.56 and 15.85 years. Normative data are an essential tool in both clinical and research settings, because they provide an empirical frame of reference to evaluate the test performance of an individual (Capitani, 1997;Mitrushina et al., 2005;Van der Elst, 2006). The first step in a normative analysis is to identify the demographic variables that are associated with test performance (e.g., age, sex, and parental education), so that the normative data can be appropriately corrected for the relevant demographic influences. ...
The Animal Verbal Fluency (AVF) and Design Fluency (DF) structured and unstructured test versions were administered to N = 294 healthy native Dutch-speaking children who were aged between 6.56 and 15.85 years. The AVF and DF structured test scores increased linearly as a function of age, whilst the relation between age and the DF unstructured test score was curvilinear (i.e., the improvement in test scores was much more pronounced for younger children than for older children). A higher mean level of parental education was associated with significantly higher AVF and DF structured test scores. Sex was not associated with any of the outcomes. Demographically corrected norms for the AVF and DF tests were established, and an automatic scoring program was provided.
Psychological tests and questionnaires are often used to assess a person’s cognitive, emotional, and behavioral functioning. The large majority of psychological tests are norm-referenced. This means that normative data are needed to allow for a meaningful interpretation of the test scores. For example, knowing that a person answered 20 out of 50 items correctly on a test of abstract reasoning is not informative by itself. To give this test score a meaningful interpretation, the relative position of the score in a broader reference group (i.e., a normative sample) should be known.
Traditional normative data consist of subgroup-specific summary statistics of the test scores in a normative sample. This normative approach is straightforward, but it has some fundamental limitations. For example, it is difficult to derive fine-grained norms that account for the impact of several independent variables (such as Age, Gender, and Level of Education). Indeed, the subgroups become small when multiple independent variables have to be accounted for, which results in imprecise norms. The regression-based normative approach provides a statistically principled alternative to the traditional normative method that is substantially less hampered by such issues.
This study explores which aspects of cognitive functioning may influence the self-care and independence of older patients with a bipolar disorder and whether there is a correlation between characteristics of the disease and self-care. Patients completed a comprehensive neuropsychological battery and filled in a questionnaire on activities of daily living and instrumental activities of daily living. Results indicate that (compared with age-matched norm scores) this group of euthymic patients performed worse on tests of attention, verbal memory, and executive functioning. Tests of attention and executive functioning were related to self-care. Attention and aspects of verbal memory were related to characteristics of the disease. The findings suggest that aspects of attention, memory, and executive functioning are associated with activities of daily living and instrumental activities of daily living.
BACKGROUND: The present study aims to design and standardize the verbal fluency test (VFT) among bilingual (Turkish-Persian) adolescents in Tabriz, Iran. METHODS: In the designing stage, 190 adolescents who were already selected randomly from among the guidance and high school students in Tabriz were classified into three age groups (11-12, 13-15, 16-18). The screening test including 33 Persian letters and three ‘animal’, ‘fruit’, and ‘supermarket stuff’ categories, and SDQ was administered to them. The results were the three letters ‘M’, ‘D’, and ‘B’ for phonological fluency, and two ‘animal’ and ‘supermarket stuff’ categories for semantic fluency in the Persian language. In the standardization stage, the letters and categories specified in the designing stage were administered in the same order to 302 adolescents. Moreover, 28 adolescents diagnosed with ADHD were selected to estimate the discriminant validity of VFT. RESULTS: Pearson correlation coefficient between test-retest of the three letters ‘M’, ‘D’, and ‘B’ for phonological fluency were estimated at 0.67, 0.66, and 0.75, respectively. Furthermore, for the two categories of ‘animal’ and ‘supermarket stuff’ it was estimated to be 0.80 and 0.65, respectively. All these amounts were significant (P < 0.01). The discriminant validity, which was estimated through comparison between the scores of normal and ADHD adolescents, showed that the obtained t value for all indices except for the letter ‘B’ was meaningful. The results of MANOVA between two gender groups were significant at P < 0.05 for three ‘M’, ‘D’, and ‘B’ variables of verbal fluency and ‘animal’ semantic fluency. In both verbal and semantic fluency the mean of subjects’ performance scores showed that females outperformed males. CONCLUSIONS: The findings of the current study indicated that VFT is reliable in the studied sample group, and has a valid psychometric property in discrimination between ADHD adolescents and normal adolescents. Furthermore, ageand sex could affect VFT performance
