Effort testing in dementia assessment: a systematic review

McGuire, C., Crawford, S. and Evans, J. J. (2019) Effort testing in dementia assessment: a systematic review. Archives of Clinical Neuropsychology, 34(1), pp. 114-131. (doi: 10.1093/arclin/acy012) (PMID:29579143)

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Objective: Interpretation of neuropsychological test data is only valid when appropriate effort has been exerted. Research, however, suggests that neuropsychologists do not always formally test for effort and that this may especially be the case in the context of dementia assessment. This review systematically examined the literature that has investigated the use of both purpose-built and embedded effort-sensitive indices in dementia, mild cognitive impairment (MCI), and healthy control samples. The aim was to determine which tests of effort are most sensitive to suboptimal effort and least sensitive to the type of cognitive impairment seen in dementia. Methods: A systematic search of databases was conducted to October 2017. There was no start date. Results: Twenty-five studies were included for review. The studies were divided into two categories according to methodology. One category of studies (n = 5) was reviewed using a tailored methodological quality rating checklist whilst the remaining studies (n = 20) were reviewed using the Crowe Critical Appraisal Tool (CCAT). Conclusions: The results of this review suggest that PVTs which take a hierarchical approach to effort testing such as the WMT, MSVT, and NV-MSVT are preferable for use with older adults who are under investigation for possible dementia. These tests go above and beyond the traditional pass/fail approach of more traditional tests of effort because they allow the examiner to analyze the examinee’s profile of scores. The methodological limitations and challenges involved in this field of research are discussed.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Evans, Professor Jonathan
Authors: McGuire, C., Crawford, S., and Evans, J. J.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Journal Name:Archives of Clinical Neuropsychology
Publisher:Oxford University Press
ISSN (Online):1873-5843
Published Online:22 March 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Archives of Clinical Neuropsychology 34(1): 114-131
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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