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Abstract
Objective: To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment.
Methods: Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain.
Results: Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE.
Conclusions: We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment.
GLOSSARY
- AAN=
- American Academy of Neurology;
- AD=
- Alzheimer disease;
- BIT=
- Behavioral Inattention Test;
- BNS=
- Behavioral Neurology Section;
- BNT=
- Boston Naming Test;
- CERAD=
- Consortium to Establish a Registry in Alzheimer's Disease;
- FAB=
- Frontal Assessment Battery;
- FTLD=
- frontotemporal lobar degeneration;
- HVLT-R=
- Hopkins Verbal Learning Test–Revised;
- JLO=
- Judgment of Line Orientation;
- MMSE=
- Mini-Mental State Examination;
- MoCA=
- Montreal Cognitive Assessment;
- NBSE=
- Neurobehavioral Status Exam;
- ROCFT=
- Rey-Osterrieth Complex Figures Test;
- TBI=
- traumatic brain injury;
- TMT=
- Trail Making Test;
- UCNS=
- United Council for Neurologic Subspecialties;
- WAB-R=
- Western Aphasia Battery–Revised
Footnotes
↵* These authors contributed equally to this work.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received December 2, 2014.
- Accepted in final form May 7, 2015.
- © 2015 American Academy of Neurology
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