INS NYC 2024 Program

Poster	Poster Session 10 Program Schedule 02/17/2024 09:00 am - 10:15 am Room: Majestic Complex (Posters 61-120) Poster Session 10: Neurodevelopmental \| Congenital Conditions Final Abstract #63 Informant Report Judgment and its Correlates in a Mixed Clinical Sample of Older Adults Ammara Malik, Dartmouth Hitchcock Medical Center, Lebanon, United States Hannah Darwazah, Dartmouth Hitchcock Medical Center, Lebanon, United States Grant Moncrief, Dartmouth Hitchcock Medical Center, Lebanon, United States Anna Graefe, Dartmouth Hitchcock Medical Center, Lebanon, United States Laura Rabin, Brooklyn College, Brooklyn, United States Robert Roth, Dartmouth Hitchcock Medical Center, Lebanon, United States Category: Genetics/Genetic Disorders Keyword 1: genetic neuropsychology Keyword 2: activities of daily living Keyword 3: cognitive functioning Objective: Judgment ability in older adults has important implications for everyday functioning such as financial management, medical decision making, and susceptibility to scams. There are few published measures of practical judgment used regularly in clinical assessments with older adults. Recently, Rabin et al. (2022) developed an informant report measure, the Test of Practical Judgment – Informant (TOP-J-Informant), following a wealth of research demonstrating the utility of informant reports in understanding older adults’ cognition and risk for dementia. Here, we examined the TOP-J-Informant in a mixed clinical sample of older adults, including its association with demographics, mood, objective and subjective cognition, as well as IADLs. Participants and Methods: Participants included 91 older adults referred for comprehensive neuropsychological evaluation at a large Northeastern academic medical center (39.1% female; mean age=71.7 years, SD=5.26, range= 60-86; mean years of education=14.8 years, SD=3.0, range=7-20). Patients completed a battery of neuropsychological tests including the CVLT-3, Trail Making Test (TMT), D-KEFS Color-Words Interference Test (CWIT), and Test of Premorbid Functioning (TOPF), as well as the Geriatric Depression Scale and Geriatric Anxiety Inventory, though not all patients completed all measures. A knowledgeable informant completed the TOP-J-Informant, with scores ranging from 0-35 (higher score reflect poorer judgment) and the Functional Activities Questionnaires (FAQ) to assess IADLs. Both the patient and informant completed the BRIEF-A to assess executive functions as manifested in everyday life. Data were gathered retrospectively from archival datasets. Results: Mean TOP-J-Informant score was 10.26 (SD=9.30), with only 2.2% of patients (n=2) scoring in what could be considered the impaired range (i.e., z < 2.0). TOP-J score was unrelated to age, education, or sex. Poorer judgment was associated (spearman’s rho) with worse CVLT-3 delayed free recall (r_s =-.25, p=.03), TMT-B (r_s =.22, p=.05), and inhibition on the CWIT (r_s=-.27, p=.013). Furthermore, higher TOP-J score was related to worse IADLs (r_s=.57, p<.001), as well as both self (r_s =.33, p=007) and informant (r_s=.78, p<.001) reported difficulties with executive functioning. There was a trend towards association with greater depressive symptoms (r_s=.054) but not anxiety. Conclusions: The present findings revealed that informant report of judgment ability varies widely within a mixed clinical older adult sample. In addition, worse judgment is related to poorer memory as well as both objective and subjective executive functions. Importantly, poorer judgment was strongly associated with greater difficulty with IADLs, consistent with the importance of judgment ability for everyday functioning in older adults. These findings highlight the utility of seeking informant report of judgment ability in older adults presenting for neuropsychological evaluation. Future research examining the association of the TOP-J-Informant report with specific clinical diagnoses, IADLs, and quality of life in older adults would be informative, including whether scores are predictive of cognitive and functional decline.

Poster

02/17/2024
09:00 am - 10:15 am
Room: Majestic Complex (Posters 61-120)

Poster Session 10: Neurodevelopmental | Congenital Conditions

Final Abstract #63

Informant Report Judgment and its Correlates in a Mixed Clinical Sample of Older Adults

Ammara Malik, Dartmouth Hitchcock Medical Center, Lebanon, United States
Hannah Darwazah, Dartmouth Hitchcock Medical Center, Lebanon, United States
Grant Moncrief, Dartmouth Hitchcock Medical Center, Lebanon, United States
Anna Graefe, Dartmouth Hitchcock Medical Center, Lebanon, United States
Laura Rabin, Brooklyn College, Brooklyn, United States
Robert Roth, Dartmouth Hitchcock Medical Center, Lebanon, United States

Category: Genetics/Genetic Disorders

Keyword 1: genetic neuropsychology
Keyword 2: activities of daily living
Keyword 3: cognitive functioning

Objective:

Judgment ability in older adults has important implications for everyday functioning such as financial management, medical decision making, and susceptibility to scams. There are few published measures of practical judgment used regularly in clinical assessments with older adults. Recently, Rabin et al. (2022) developed an informant report measure, the Test of Practical Judgment – Informant (TOP-J-Informant), following a wealth of research demonstrating the utility of informant reports in understanding older adults’ cognition and risk for dementia. Here, we examined the TOP-J-Informant in a mixed clinical sample of older adults, including its association with demographics, mood, objective and subjective cognition, as well as IADLs.

Participants and Methods:

Participants included 91 older adults referred for comprehensive neuropsychological evaluation at a large Northeastern academic medical center (39.1% female; mean age=71.7 years, SD=5.26, range= 60-86; mean years of education=14.8 years, SD=3.0, range=7-20). Patients completed a battery of neuropsychological tests including the CVLT-3, Trail Making Test (TMT), D-KEFS Color-Words Interference Test (CWIT), and Test of Premorbid Functioning (TOPF), as well as the Geriatric Depression Scale and Geriatric Anxiety Inventory, though not all patients completed all measures. A knowledgeable informant completed the TOP-J-Informant, with scores ranging from 0-35 (higher score reflect poorer judgment) and the Functional Activities Questionnaires (FAQ) to assess IADLs. Both the patient and informant completed the BRIEF-A to assess executive functions as manifested in everyday life. Data were gathered retrospectively from archival datasets.

Results:

Mean TOP-J-Informant score was 10.26 (SD=9.30), with only 2.2% of patients (n=2) scoring in what could be considered the impaired range (i.e., z < 2.0). TOP-J score was unrelated to age, education, or sex. Poorer judgment was associated (spearman’s rho) with worse CVLT-3 delayed free recall (r_s =-.25, p=.03), TMT-B (r_s =.22, p=.05), and inhibition on the CWIT (r_s=-.27, p=.013). Furthermore, higher TOP-J score was related to worse IADLs (r_s=.57, p<.001), as well as both self (r_s =.33, p=007) and informant (r_s=.78, p<.001) reported difficulties with executive functioning. There was a trend towards association with greater depressive symptoms (r_s=.054) but not anxiety.

Conclusions:

The present findings revealed that informant report of judgment ability varies widely within a mixed clinical older adult sample. In addition, worse judgment is related to poorer memory as well as both objective and subjective executive functions. Importantly, poorer judgment was strongly associated with greater difficulty with IADLs, consistent with the importance of judgment ability for everyday functioning in older adults. These findings highlight the utility of seeking informant report of judgment ability in older adults presenting for neuropsychological evaluation. Future research examining the association of the TOP-J-Informant report with specific clinical diagnoses, IADLs, and quality of life in older adults would be informative, including whether scores are predictive of cognitive and functional decline.