Sex is an important factor to consider when evaluating memory with older adults. This present study aimed to examine sex differences in memory within a clinical sample of older adults (N = 1084). Raw learning and recall scores on the Hopkins Verbal Learning Test, Revised (HVLT-R) and Brief Visuospatial Memory Test, Revised (BVMT-R) were compared between sexes within the entire sample and cohorts stratified by age. Within the entire sample, women outperformed men in HVLT-R learning and recall, and there were no sex differences in BVMT-R performance. These sex differences, however, were absent or reversed for those with impaired HVLT-R performance and functional deficits, indicating that women retain an early advantage in verbal memory, which is lost with greater indication of disease severity. These findings indicate that women retain an advantage in verbal learning and memory, at least before significant levels of impairment, within a sample of older adults seen at an outpatient neurology clinic, which may have implications for diagnosing memory disorders.
It is the purpose of this report to give you, necessarily in sketchy form, an outline of the activities during .the last two years of organizations controlled largely by lawyers, in the field of criminal law reform. The report has been prepared from replies to letters sent out to attorneys general and presidents of bar associations in all of the states. The list was supplied by the Secretary of the American Bar Association.
for the training of lawyers have puzzled the sages for many years. Unlike the curriculum makers in some other fields, the law school executives have been faced with certain constants which have seemed to shape their objectives for them. The ever present bar examination, until only the most recent years, was so planned in practically all states that the candidate was better prepared by the coaching, cramming schools than by the thorough, intensive work of the standard schools. And even today the Quiz Course is as popular among graduates of Class A approved schools as among the less fortunate applicants. Another consideration, equally stifling to executive initiative is that the administration of
Women have an advantage in verbal memory compared to men and this difference persists into older age (McCarrey et al., 2016). The Hopkins Verbal Learning Test, Revised (HVLT-R; Benedict et al., 1998) is a widely used measure of memory, but the normative sample was predominantly female (75%) and the gender distribution was particularly unequal for older adults. The primary aim of this study was to examine sex differences in HVLT-R performance within a clinical sample of older adults from an outpatient neurology clinic. Participants were neurology outpatients 60-89 years old (n = 1078). HVLT-R measured verbal memory. Given mixed findings describing a male advantage in nonverbal memory (Kane & Yochim, 2016; Pauls et al., 2015), the Brief Visuospatial Memory Test, Revised (Benedict, 1997), was used to evaluate this effect and also rule out a generalized memory advantage in women. ANCOVA analyses evaluated sex differences in learning and delayed recall, controlling for education and depression severity, as these factors significantly differed between sexes. Within the entire sample, women exhibited better verbal learning (p < .001) and recall (p = .003). When stratifying by age cohort, the largest differences were in the 70-79 age group, where women outperformed men on both verbal learning (p < .001) and recall (p = .007). Within the 80-89 age group, there were significant differences in verbal learning, favoring women (p = .003), but no differences in recall. Within the 60-69 age group there were no sex differences in memory. There were no significant sex differences in nonverbal memory. The most striking sex differences occurred within the 70-79 year-old age group, with women recalling almost one more word on average than men (M = 4.96 versus M = 4.17). This raw score difference corresponds to almost six percentile points when converted to standardized scores. Interestingly, the HVLT-R 70-79 normative age group is the most skewed in gender distribution (90% female). Given the importance of verbal recall performance in the clinical diagnosis of Alzheimer's disease, HVLT-R sex differences could reduce detection of impairment in women or, alternatively, incorrectly classify men as impaired.
A number of performance validity tests (PVTs) are used to assess memory complaints associated with traumatic brain injury (TBI); however, few studies examine the concordance and predictive accuracy of multiple PVTs, specifically in the context of combined models in known-group designs. The present study compared five widely used PVTs: the Test of Memory Malingering (TOMM), Medical Symptom Validity Test (MSVT), Reliable Digit Span (RDS), Word Choice Test (WCT), and California Verbal Learning Test – Forced Choice (CVLT-FC). Participants were 51 adults with bona fide moderate to severe TBI and 58 demographically comparable healthy adults coached to simulate memory impairment. Classification accuracy of individual PVTs was evaluated using logistic regression and receiver operating characteristic (ROC) curves, examining both the dichotomous cutting scores as recommended by the test publishers and continuous scores for the measures. Results demonstrated nearly equivalent discrimination ability of the TOMM, MSVT, and CVLT-FC as individual predictors, all of which markedly outperformed the WCT and RDS. Models of combined PVTs were examined using Bayesian information criterion statistics, with results demonstrating that diagnostic accuracy showed only small to modest growth when the number of tests was increased beyond two. Considering the clinical and pragmatic issues in deriving a parsimonious assessment battery, these findings suggest that using the TOMM and CVLT in conjunction or the MSVT and CVLT in conjunction maximized predictive accuracy as compared to a single index or an assortment of these widely used measures.
Patients with frontotemporal dementia (FTD) typically have initial deficits in language or changes in personality, while the defining characteristic of Alzheimer's disease (AD) is memory impairment. Neuropsychological findings in the two diseases tend to differ, but can be confounded by verbal impairment in FTD impacting performance on memory tests in these patients.Twenty-seven patients with FTD and 102 patients with AD underwent a neuropsychological assessment before diagnosis. By utilizing analogous versions of a verbal and nonverbal memory test, we demonstrated differences in these two modalities between AD and FTD.Better differentiation between AD and FTD is found in a nonverbal memory test, possibly because it eliminates the confounding variable of language deficits found in patients with FTD. These results highlight the importance of nonverbal learning tests with multiple learning trials in diagnostic testing.
Introduction: Selection bias cannot be overemphasized when comparing endoscopic and open skull base series. However, skull base surgery is a rapidly changing field, and it remains imperative to describe the differences in complication rates as the endoscopic approach is utilized for increasingly complex disease and the open approach becomes reserved for the most extensive disease.
Evidence-based medicine (EBM) is a pillar of clinical medicine (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996 Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. BMJ, 312(7023), 71–72.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), but only recently has this been systematically discussed within the context of clinical neuropsychology (e.g., Chelune, 2010 Chelune, G. J. (2010). Evidence-based research and practice in clinical neuropsychology. The Clinical Neuropsychologist, 24(3), 454–467. doi:10.1080/13854040802360574[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]). Across the medical sciences, randomized controlled trials (RCTs) are often considered the most important source of evidence for treatment efficacy. To facilitate the conduct, dissemination, and evaluation of research findings, reporting standards have been implemented, including the Consolidated Standards of Reporting Trials (CONSORT) statement. This paper considers the implications of the CONSORT statement for the reporting of clinical trials that include neuropsychological endpoints. Adopting specific guidelines for trials involving neuropsychology endpoints will ultimately serve to strengthen the empirical evidence base by increasing uniformity within the literature, decrease ambiguity in reporting, improving trial design, and fostering methodological transparency. Implementing uniform reporting standards will also facilitate meta-analytic review of evidence from published trials, benefiting researchers, clinicians, educators and practitioners, as well as journal editors, reviewers, and ultimately, health care consumers.
