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Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2022 Jan;29(1):139-157. doi: 10.1080/13825585.2020.1859081. Epub 2021 Feb 23.

Informant report of practical judgment ability in a clinical sample of older adults with subjective cognitive decline, mild cognitive impairment, and dementia.

Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition

Laura A Rabin, Crystal G Guayara-Quinn, Caroline O Nester, Liam Ellis, Nadia Paré

Affiliations

  1. Department of Psychology, Brooklyn College and the Graduate Center of CUNY, Brooklyn, NY, USA.
  2. Department of Psychology, Queens College and the Graduate Center of CUNY, New York, NY, USA.
  3. Neuropsychology Division, Department of Neurological Sciences, Nebraska Medicine, Omaha, NE, USA.
  4. Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA.

PMID: 33618617 PMCID: PMC8380745 DOI: 10.1080/13825585.2020.1859081

Abstract

Despite the importance of capturing problems with judgment and decision-making during neuropsychological evaluations of older adults, there are a limited number of validated measures and no informant rating scales. We developed an informant measure that captures compromised judgment related to safety, medical, financial, and social-ethical issues After item refinement and piloting in a memory disorders clinic, we utilized the Test of Practical Judgment-Informant (TOP-J-Informant) at two clinics in the Midwestern U.S., including 189 patient/informant dyads (mean age = 79.0, median years of education = 13, % female = 67.7) with various preclinical and clinical dementia conditions. We found psychometric support, including evidence for convergent, divergent, and criterion-related validity, and internal consistency. Importantly, we were able to discriminate between diagnostic groups in the expected direction. The TOP-J-Informant is brief (<5 minutes), easy to administer, and can reveal areas of concern related to poor judgment when administered in the context of a neuropsychological evaluation or clinic visit.

Keywords: Alzheimer’s disease; Judgment; Test of Practical Judgment; informant report; instrument validation; mild cognitive impairment; neuropsychological assessment; older adults; questionnaire

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