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93 Digitized Trail Making Test in the NKI-Rockland Sample Normative Lifespan Neuroimaging Study
- Anna MacKay-Brandt, Nadine Schwab, Irene Piryatinksy, Maxine Krengel, Malvina Pietrzykowski, Dave Gansler, Andrea Suazo Rivas, Alyssa DiFalco, Stan Colcombe
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 768-769
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Objective:
Digitized cognitive assessment captures rich behavioral information that remains unmeasured using conventional methods. Data capture tools recently accessible only in specialized laboratories are now feasible at scale using off-the-shelf tablet devices. This study aims to share data from a digitized cognitive assessment embedded in an open-science research program collecting extensive neuroimaging, health, behavioral, neuropsychological, and psychiatric characterizations to advance translational cognitive neuroscience. In this research we present normative performance metrics from a digital version of the Trail Making Test.
Participants and Methods:The NKI-Rockland Sample (NKI-RS) has provided a model for openly-shared lifespan normative neuroimaging resources contributed by a community-ascertained sample (n=1,500, aged 6-85) and generating over 400 publications across diverse research areas. The next generation NKI-RS study (recruitment target= 600, aged 9-75) aims to enrich these resources for brain-behavioral research, normative reference, and biomarker discovery. One focus of innovation is the inclusion of digitized cognitive assessments (DCAs) utilizing an open-resource task development and data collection platform (Mindlogger, Child Mind Institute). We present preliminary data from a digitized version of the Trail Making Tests and report early descriptive metrics. The TMTs was administered via an iPad Pro using an Apple pen as part of a laboratory-based EEG procedure. The TMTs follows standard administration instructions, including a practice sample before each test condition. Error feedback is included in the task implementation such that an incorrect connection is marked with an “x” and the participant is directed to the last correct circle to continue. Feedback is automated within the task. Pixel-level spatial resolution and millisecond timing is captured across all drawing tasks. Task design, implementation, and preliminary performance metrics including speed, accuracy, and variability are reported.
Results:Preliminary data include 12 participants from the NKI-RS2 study ranging in age from 11-75 years (M= 52.83, SD= 19.97); 67% female. Overall participants took longer to complete condition B (Mb = 51.71 secs) compared to condition A (Ma = 23.07 secs), p= 0.0005. Connections were made more slowly (Ma = 37.47 secs vs. Mb = 24.50 secs, p< 0.001) and connection speed was more variable (CVa = 0.90 vs. CVb = 1.22, p< 0.01) on condition B versus A. Connection speed decreased and speed variability increased with age (t[11 ]= -3.25, p= 0.05, t[11]= -3.63, p< 0.01, respectively). Time spent within circles (dwell time) was significantly greater in B versus A (t[11]= 6.81, p< 0.001). Number of errors were limited (MA = .89 and MB = 1.0, range 0-2 in both tests) with no difference between tests or effects of age (both ps >0.05).
Conclusions:These preliminary data from the NKI-RS2 normative neuroimaging study demonstrate that a digitized version of a classic neuropsychological test is feasible across a diverse range of community participants, and replicates known age effects. The advantages of growing access to these DCA tools and the shared data resources they will produce has the potential to revolutionize neuropsychological research and clinical practice.
Poster Symposium: Leveraging Digital Technology to Capture Highly Nuanced Neuropsychological Behavior: Realizing the Vision of the Boston Process Approach to Neuropsychological Assessment
- Anna MacKay, Rhoda Au
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 765-766
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Neuropsychological test scores tap a number of underlying cognitive abilities. Examining the means by which omnibus scores are achieved provides considerable information regarding brain - behavior relationships and a richer context for clinical interpretation. This examination is the core tenant of the Boston Process Approach. Nonetheless, quantification of errors and process can be time consuming. However, the development of digital assessment technology is able to meet this challenge. For example, using a digital clock drawing test, previously unappreciated behaviors are now easily quantified and can dissociate between dementia and MCI subtypes. Research presented in this paper session provides additional insight into how digital technology can be leveraged as a powerful tool to capture behavior that, until recently, was either impractical or impossible to measure.
The assessment of graphomotor behavior can be challenging. In the context of a large-scale normative neuroimaging study, Colcombe and colleagues have engineered a digital Archimedes Spiral Test that includes measures of speed variability, rotational smoothness, and goodness of fit to the model. The temporal and spatial precision of these metrics is impressive. This research shows that, age predicted greater variable drawing speed, greater tracing errors, reduced rotational smoothness, and increasing drawing speed variability.
MacKay-Brandt and colleagues present data using a digital version of the Trail Making Tests (TMT), one of the most commonly administered neuropsychological tests. This research provides a panel of new parameters to evaluate TMT performance, including detailed speed metrics with spatial segregation to parse circle connection time from dwell time within a circle. Interestingly, dwell time, rather than traditional total time to completion, was the strongest predictor of differences between conditions and across age. Baliga and colleagues present data on a protocol of novel cancellation tests. Memory clinic patients were classified into groups presenting with mild dementia, mild cognitive impairment, and those who were cognitively normal. Digital parameters of interest included correct responses, commissions, mean intra-response latency, and mean apple pencil touch. Using these parameters, significant between group differences were obtained. Moreover, logistic regression analyses were able to classify patients into their respective groups.
It is well understood that paragraph recall tests assess a variety of underlying cognitive abilities. Andersen and colleagues studied Logical Memory recall in the Long-Life Family Study and extracted linguistic parameters that included word count, grammatical features (e.g., prepositions), and content words related to specific categories (e.g., work). Participants were classified as cognitively normal or impaired. Analyses identified distinct linguistic features of free recall that predicted cognitive status.
Hershkovich and colleagues extract measured pauses and speech frequency behavior also from a paragraph recall test. A combination of paragraph recall pause duration, speech frequency parameters, and demographic variables were able to classify older adults with and without cognitive compromise. Collectively, the evidence provided in this series of papers demonstrates that digital platforms can capture and quantify highly nuanced neurocognitive behavior to enrich information available to researchers and clinicians for analysis and clinical formulations. Digital assessment technology holds promise to realize the vision of the Boston Process Approach and revolutionize neuropsychological assessment.
94 Digitized Archimedes Spiral Drawing in the NKI-Rockland Sample
- Stan Colcombe, Anna MacKay-Brandt, Ava Waters, Sarah Abdelaziz, Nora Liu
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 769-770
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Objective:
Digital cognitive assessments (DCAs) provide insight into cognition and behavior that remains inaccessible through standard assessment approaches. However, the availability of DCAs and the requisite toolkits to extract and analyze meaningful features from these datasets are largely constrained to technical specialists or through fee-for-service commercial entities. The NKI- Rockland Sample provides a large- scale lifespan data sample featuring DCAs, and also openly shares its DCA tasks through the open-source MindLogger platform along with pipelines for feature extraction and analyses. Here we present normative performance from a digital version of Archimedes Spiral Drawing.
Participants and Methods:NKI-RS2 participants were largely drawn from the existing NKI-RS participant pool (n= 1,500), aged 885. The NKI-RS2 is in year 1 of data collection; here, we report on a subset of participants (n= 9) who performed a digitized version of the Archimedes Spiral Drawing task. This graphomotor task with well-established research and clinical utility in movement disordered populations was adapted for use for off-the-shelf tablet devices. The NKI-RS2 implements these tasks on an Apple iPad Pro2, sampling participant drawing at 120Hz, and featuring pixel- and millisecond- level resolution for all tasks. On the Spiral Drawing and Recall Tests participants traced five Archimedes spirals from the center outward through four windings presented on the iPad. They were then asked to replicate the spiral freehand three times. From these spiral drawings, we extracted time to completion, distance covered, speed/ speed variability, rotational smoothness, number of crossings, mean absolute error, bias, and goodness of fit to the ideal Archimedes spiral.
Results:Comparing the tracing and recall conditions, participants showed significantly faster drawing speed (t[8]=5.32, p< .001), more variable drawing speed (t[8]=5.93, p< .001), reduced goodness of fit to the template t[8]=4.99, p< .002, and reduced rotational smoothness (t[8]=7.43, p< .0003) in the recall conditions. Collapsing across conditions, age predicted more variable drawing speed: t[8]= 2.77 p< .019, greater tracing error (t[8] = 2.69, p< .0227), and reduced rotational smoothness (t[8] = 2.67, p< .024). Between conditions, age predicts a greater increase in drawing speed variability (t[8] = 9.76, p< .0006).
Conclusions:Using the open source MindLogger platform and off-the-shelf digital tablets, we were able to replicate classic paper and pen neuropsychological tests. By adapting these tasks to DCA, we were able to extract meaningful features that are not otherwise accessible (drawing speed, variability, etc.), or that would require additional hardware solutions (e.g., dwell time). By making these tasks and their processing pipelines available, the NKI-RS2 can facilitate the democratization of DCA and DCA analysis to a broader range of researchers and clinicians.
431 - Establishing a Canadian National ECHO Educational Program focused on Mental Health of Older Adults
- David Conn, Lisa Sokoloff, Claire Checkland, Jasmeen Guraya, Vivian Ewa, Sid Feldman, Cindy Grief, Andrea Hunter Navena Lingum, Ian MacKay, Kiran Rabheru, Anna Santiago, Dallas Seitz, Devin Sodums, Laurel Steed
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- Journal:
- International Psychogeriatrics / Volume 33 / Issue S1 / October 2021
- Published online by Cambridge University Press:
- 01 November 2021, pp. 50-51
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Background
Project ECHO is a virtual, case-based capacity-building education program for healthcare providers. It was developed in New Mexico, USA but, due to its effectiveness, the model has now spread to 40 countries around the globe. Baycrest, the Canadian Coalition for Seniors’ Mental Health and the Canadian Academy of Geriatric Psychiatry collaborated to launch a national ECHO for mental health and aging. This partnership, coordinated by a cross-Canadian Steering Group, allows for broad reach, including registration of learning partners from almost all Canadian provinces and territories. The program was funded by the RBC Foundation.
MethodsECHO COE: Mental Health pilot consisted of 2 cycles:
6 weekly sessions focused on broader mental health topics (e.g., delirium, mood disorders)
10 weeks with more specific topics (e.g., substance use disorders, sleep disorders)
Needs assessments of healthcare providers and older adults informed the program curricula. Evaluation included weekly satisfaction surveys, and pre and post evaluations.
ResultsParticipants:
154 healthcare providers participated in the 6-week session
39% of registrants were nurses or nurse practitioners, 35% allied health professionals, 14% physicians and 12% others
9 out of 10 provinces, 1 territory represented
Preliminary findings (based on the first 6 sessions):
High overall satisfaction (average of 4.5 out of 5).
99% would recommend the program to others
67% had already shared information with team members and colleagues.
ConclusionA national ECHO program is an effective way to bring together clinicians who work with and are interested in the mental health and wellbeing of older adults for education sessions, collaborative and mutual learning as well as for cross-jurisdictional knowledge transfer. Collaborative, cross-professional learning supports the exchange of best practice in mental health for older adults, supports the development of collegial national professional support and can address health system inequities. An international ECHO through IPA would be an exciting and valuable next step.
Mood and Personality Characteristics are Associated with Metamemory Knowledge Accuracy in a Community-Based Cohort of Older Adults
- Leigh E. Colvin, Matteo Malgaroli, Silvia Chapman, Anna MacKay-Brandt, Stephanie Cosentino
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- Journal:
- Journal of the International Neuropsychological Society / Volume 24 / Issue 5 / May 2018
- Published online by Cambridge University Press:
- 05 February 2018, pp. 498-510
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Objectives: Emerging work reveals the neuroanatomic changes that compromise metacognition; however, little is known about the impact of premorbid factors. Research suggests that psychological variables influence the perception of cognition, but whether they influence the accuracy of those perceptions (i.e., metacognition) has not been directly examined. Participants and Methods: Using Latent Class Analysis (LCA), we tested for discrete personality (NEOFFI) and mood (STAI, BDI-II, and GDS) classes among a community-based cohort of 151 older adults, enrolled in the NKI-Rockland study. Metamemory was calculated by comparing subjective memory ratings (modified Cognitive Failures Questionnaire) to objective memory (Rey Auditory Verbal Learning Test) to determine the degree to which individuals were overconfident, underconfident, or accurate in their self-assessment. A generalized linear model was used to examine whether metamemory differed across the emergent classes. A one sample t test was used to determine whether the metamemory scores of the emergent classes were statistically significantly different from zero, that is, over or under confident. Results: Two discrete classes emerged in the LCA: Class 1 was characterized predominantly by high extraversion and conscientiousness and low neuroticism and anxiety; Class 2 was characterized predominantly by low extraversion and conscientiousness and high neuroticism and anxiety. Metamemory differed significantly as a function of Class Membership (F(4,151)=5.42; p<.001), with Class 1 demonstrating accurate metamemory (M=0.21; SD=1.31) and Class 2 demonstrating under-confidence (M=−0.59; SD=1.39) in their memory. Conclusions: The significant association between psychological factors and metamemory knowledge accuracy suggests that such characteristics may be important to consider in the conceptualization, assessment, and treatment of metacognitive disturbances. (JINS, 2018, 24, 498–510)
Contributor affiliations
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- By Frank Andrasik, Melissa R. Andrews, Ana Inés Ansaldo, Evangelos G. Antzoulatos, Lianhua Bai, Ellen Barrett, Linamara Battistella, Nicolas Bayle, Michael S. Beattie, Peter J. Beek, Serafin Beer, Heinrich Binder, Claire Bindschaedler, Sarah Blanton, Tasia Bobish, Michael L. Boninger, Joseph F. Bonner, Chadwick B. Boulay, Vanessa S. Boyce, Anna-Katharine Brem, Jacqueline C. Bresnahan, Floor E. Buma, Mary Bartlett Bunge, John H. Byrne, Jeffrey R. Capadona, Stefano F. Cappa, Diana D. Cardenas, Leeanne M. Carey, S. Thomas Carmichael, Glauco A. P. Caurin, Pablo Celnik, Kimberly M. Christian, Stephanie Clarke, Leonardo G. Cohen, Adriana B. Conforto, Rory A. Cooper, Rosemarie Cooper, Steven C. Cramer, Armin Curt, Mark D’Esposito, Matthew B. Dalva, Gavriel David, Brandon Delia, Wenbin Deng, Volker Dietz, Bruce H. Dobkin, Marco Domeniconi, Edith Durand, Tracey Vause Earland, Georg Ebersbach, Jonathan J. Evans, James W. Fawcett, Uri Feintuch, Toby A. Ferguson, Marie T. Filbin, Diasinou Fioravante, Itzhak Fischer, Agnes Floel, Herta Flor, Karim Fouad, Richard S. J. Frackowiak, Peter H. Gorman, Thomas W. Gould, Jean-Michel Gracies, Amparo Gutierrez, Kurt Haas, C.D. Hall, Hans-Peter Hartung, Zhigang He, Jordan Hecker, Susan J. Herdman, Seth Herman, Leigh R. Hochberg, Ahmet Höke, Fay B. Horak, Jared C. Horvath, Richard L. Huganir, Friedhelm C. Hummel, Beata Jarosiewicz, Frances E. Jensen, Michael Jöbges, Larry M. Jordan, Jon H. Kaas, Andres M. Kanner, Noomi Katz, Matthew S. Kayser, Annmarie Kelleher, Gerd Kempermann, Timothy E. Kennedy, Jürg Kesselring, Fary Khan, Rachel Kizony, Jeffery D. Kocsis, Boudewijn J. Kollen, Hubertus Köller, John W. Krakauer, Hermano I. Krebs, Gert Kwakkel, Bradley Lang, Catherine E. Lang, Helmar C. Lehmann, Angelo C. Lepore, Glenn S. Le Prell, Mindy F. Levin, Joel M. Levine, David A. Low, Marilyn MacKay-Lyons, Jeffrey D. Macklis, Margaret Mak, Francine Malouin, William C. Mann, Paul D. Marasco, Christopher J. Mathias, Laura McClure, Jan Mehrholz, Lorne M. Mendell, Robert H. Miller, Carol Milligan, Beth Mineo, Simon W. Moore, Jennifer Morgan, Charbel E-H. Moussa, Martin Munz, Randolph J. Nudo, Joseph J. Pancrazio, Theresa Pape, Alvaro Pascual-Leone, Kristin M. Pearson-Fuhrhop, P. Hunter Peckham, Tamara L. Pelleshi, Catherine Verrier Piersol, Thomas Platz, Marcus Pohl, Dejan B. Popović, Andrew M. Poulos, Maulik Purohit, Hui-Xin Qi, Debbie Rand, Mahendra S. Rao, Josef P. Rauschecker, Aimee Reiss, Carol L. Richards, Keith M. Robinson, Melvyn Roerdink, John C. Rosenbek, Serge Rossignol, Edward S. Ruthazer, Arash Sahraie, Krishnankutty Sathian, Marc H. Schieber, Brian J. Schmidt, Michael E. Selzer, Mijail D. Serruya, Himanshu Sharma, Michael Shifman, Jerry Silver, Thomas Sinkjær, George M. Smith, Young-Jin Son, Tim Spencer, John D. Steeves, Oswald Steward, Sheela Stuart, Austin J. Sumner, Chin Lik Tan, Robert W. Teasell, Gareth Thomas, Aiko K. Thompson, Richard F. Thompson, Wesley J. Thompson, Erika Timar, Ceri T. Trevethan, Christopher Trimby, Gary R. Turner, Mark H. Tuszynski, Erna A. van Niekerk, Ricardo Viana, Difei Wang, Anthony B. Ward, Nick S. Ward, Stephen G. Waxman, Patrice L. Weiss, Jörg Wissel, Steven L. Wolf, Jonathan R. Wolpaw, Sharon Wood-Dauphinee, Ross D. Zafonte, Binhai Zheng, Richard D. Zorowitz
- Edited by Michael Selzer, Stephanie Clarke, Leonardo Cohen, Gert Kwakkel, Robert Miller, Case Western Reserve University, Ohio
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- Book:
- Textbook of Neural Repair and Rehabilitation
- Published online:
- 05 May 2014
- Print publication:
- 24 April 2014, pp ix-xvi
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Contributor affiliations
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- By Frank Andrasik, Melissa R. Andrews, Ana Inés Ansaldo, Evangelos G. Antzoulatos, Lianhua Bai, Ellen Barrett, Linamara Battistella, Nicolas Bayle, Michael S. Beattie, Peter J. Beek, Serafin Beer, Heinrich Binder, Claire Bindschaedler, Sarah Blanton, Tasia Bobish, Michael L. Boninger, Joseph F. Bonner, Chadwick B. Boulay, Vanessa S. Boyce, Anna-Katharine Brem, Jacqueline C. Bresnahan, Floor E. Buma, Mary Bartlett Bunge, John H. Byrne, Jeffrey R. Capadona, Stefano F. Cappa, Diana D. Cardenas, Leeanne M. Carey, S. Thomas Carmichael, Glauco A. P. Caurin, Pablo Celnik, Kimberly M. Christian, Stephanie Clarke, Leonardo G. Cohen, Adriana B. Conforto, Rory A. Cooper, Rosemarie Cooper, Steven C. Cramer, Armin Curt, Mark D’Esposito, Matthew B. Dalva, Gavriel David, Brandon Delia, Wenbin Deng, Volker Dietz, Bruce H. Dobkin, Marco Domeniconi, Edith Durand, Tracey Vause Earland, Georg Ebersbach, Jonathan J. Evans, James W. Fawcett, Uri Feintuch, Toby A. Ferguson, Marie T. Filbin, Diasinou Fioravante, Itzhak Fischer, Agnes Floel, Herta Flor, Karim Fouad, Richard S. J. Frackowiak, Peter H. Gorman, Thomas W. Gould, Jean-Michel Gracies, Amparo Gutierrez, Kurt Haas, C.D. Hall, Hans-Peter Hartung, Zhigang He, Jordan Hecker, Susan J. Herdman, Seth Herman, Leigh R. Hochberg, Ahmet Höke, Fay B. Horak, Jared C. Horvath, Richard L. Huganir, Friedhelm C. Hummel, Beata Jarosiewicz, Frances E. Jensen, Michael Jöbges, Larry M. Jordan, Jon H. Kaas, Andres M. Kanner, Noomi Katz, Matthew S. Kayser, Annmarie Kelleher, Gerd Kempermann, Timothy E. Kennedy, Jürg Kesselring, Fary Khan, Rachel Kizony, Jeffery D. Kocsis, Boudewijn J. Kollen, Hubertus Köller, John W. Krakauer, Hermano I. Krebs, Gert Kwakkel, Bradley Lang, Catherine E. Lang, Helmar C. Lehmann, Angelo C. Lepore, Glenn S. Le Prell, Mindy F. Levin, Joel M. Levine, David A. Low, Marilyn MacKay-Lyons, Jeffrey D. Macklis, Margaret Mak, Francine Malouin, William C. Mann, Paul D. Marasco, Christopher J. Mathias, Laura McClure, Jan Mehrholz, Lorne M. Mendell, Robert H. Miller, Carol Milligan, Beth Mineo, Simon W. Moore, Jennifer Morgan, Charbel E-H. Moussa, Martin Munz, Randolph J. Nudo, Joseph J. Pancrazio, Theresa Pape, Alvaro Pascual-Leone, Kristin M. Pearson-Fuhrhop, P. Hunter Peckham, Tamara L. Pelleshi, Catherine Verrier Piersol, Thomas Platz, Marcus Pohl, Dejan B. Popović, Andrew M. Poulos, Maulik Purohit, Hui-Xin Qi, Debbie Rand, Mahendra S. Rao, Josef P. Rauschecker, Aimee Reiss, Carol L. Richards, Keith M. Robinson, Melvyn Roerdink, John C. Rosenbek, Serge Rossignol, Edward S. Ruthazer, Arash Sahraie, Krishnankutty Sathian, Marc H. Schieber, Brian J. Schmidt, Michael E. Selzer, Mijail D. Serruya, Himanshu Sharma, Michael Shifman, Jerry Silver, Thomas Sinkjær, George M. Smith, Young-Jin Son, Tim Spencer, John D. Steeves, Oswald Steward, Sheela Stuart, Austin J. Sumner, Chin Lik Tan, Robert W. Teasell, Gareth Thomas, Aiko K. Thompson, Richard F. Thompson, Wesley J. Thompson, Erika Timar, Ceri T. Trevethan, Christopher Trimby, Gary R. Turner, Mark H. Tuszynski, Erna A. van Niekerk, Ricardo Viana, Difei Wang, Anthony B. Ward, Nick S. Ward, Stephen G. Waxman, Patrice L. Weiss, Jörg Wissel, Steven L. Wolf, Jonathan R. Wolpaw, Sharon Wood-Dauphinee, Ross D. Zafonte, Binhai Zheng, Richard D. Zorowitz
- Edited by Michael E. Selzer, Stephanie Clarke, Leonardo G. Cohen, Gert Kwakkel, Robert H. Miller, Case Western Reserve University, Ohio
-
- Book:
- Textbook of Neural Repair and Rehabilitation
- Published online:
- 05 June 2014
- Print publication:
- 24 April 2014, pp ix-xvi
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- Chapter
- Export citation
Noun and verb retrieval in healthy aging
- ANNA J. MACKAY, LISA TABOR CONNOR, MARTIN L. ALBERT, LORAINE K. OBLER
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- Journal:
- Journal of the International Neuropsychological Society / Volume 8 / Issue 6 / September 2002
- Published online by Cambridge University Press:
- 12 November 2002, pp. 764-770
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This study tests the hypothesis that retrieval of object and action names declines at different rates with age. Uncued and cued performance on the Boston Naming Test (BNT) and the Action Naming Test (ANT) were examined for 171 individuals from 50 to 88 years old. To control for differences in item difficulty, a subset of items from each of the two tests was selected for which uncued performance was equivalent in individuals in their 50s. With this matched set of items, differences in action and object naming were tested in the 60s and 70+ age groups. Although age-related decline in name retrieval was observed for both the BNT and the ANT subsets, no differences between object and action retrieval were found. Our results, thus, do not confirm previous studies reporting that object names and action names are differentially retrieved with aging. We discuss these new findings in relation to evidence of dissociations in object and action naming in brain-damaged individuals. (JINS, 2002, 8, 764–770.)