Basic and Applied Memory Research: Practical Applications - Vol. 2

By Douglas J. Herrmann; Cathy McEvoy et al. | Go to book overview

CHAPTER TWENTY-SEVEN Correlated Testing to Detect Cognitive Change

Herman Buschke
Martin Sliwinski
Gail Kuslansky
Albert Einstein College of Medicine

Cognitive change must be detected to infer acquired cognitive impairment in previously normal individuals. Cognitive change is detected by comparing individual test scores with some estimate of expected performance. The usual estimate of expected performance for all individuals is the mean of the distribution of normal scores. Although the mean and standard deviation are appropriate for describing the distribution of scores, for detecting group differences, and for characterizing individual performance relative to others, deviation from the mean is not appropriate for detecting cognitive change in individuals. A more sensitive and accurate estimate of expected performance can be obtained for each individual by correlated testing.


IMPAIRMENT AS DEVIATION FROM THE MEAN

Unless previous test scores or cutting scores are available, cognitive impairment is usually inferred by deviation from the mean. Individual test scores that are significantly different from (usually below) the mean of unimpaired normal subjects are taken to indicate acquired impairment (change) in previously normal individuals. Instead of estimating the expected performance for each individual, the mean is used to estimate expected performance for all individuals.

Using the mean score of unimpaired normal subjects as the single common estimate of expected performance by all individuals is self-contradictory. The mean is obtained by averaging scores that range from high to low,

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