Development and Validation of Norm-Referenced Measures of Reaction Time Inconsistency
Date
2015-04-28
Authors
Brewster, Paul W. H.
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Abstract
Objective: The purpose of this dissertation was to determine whether measures of reaction time inconsistency (RTI) can be applied clinically to detect cognitive impairment in older adults.
Methods: Data were obtained from the Victoria Longitudinal Study (VLS), a longitudinal study of healthy aging, and PREVENT, a multivariate study of risk factors for Alzheimer’s disease. Study 1 examined effects of task complexity and computational approach on the association between RTI and physical and cognitive functioning in participants of the VLS. Study 2 assembled normative data from the VLS and standardized RTI data from an independent VLS cohort against these normative data. Significant Study 1 findings were replicated in Study 2 using the obtained RTI T-Scores, and the clinical utility of results were evaluated using stratum specific likelihood ratios (SSLRs). Study 3 replicated Study 2 analyses in data from PREVENT.
Results: Results of Study 1 identified four operationalizations of RTI from a choice reaction task that yielded consistent significant associations with cross-sectional cognitive performance. Consistent associations were not observed between these scores and cognitive change or performance on measures of physical functioning. Study 2 replicated Study 1 findings in an independent sample using RTI T-Scores. SSLRs supported the clinical utility of measures of RTI for detecting prevalent cognitive impairment. Study 3 replicated findings from Study 2, but SSLRs indicated that only low RTI scores yielded associations of sufficient reliability for clinical interpretation. Consistent with Study 1 and Study 2, associations between RTI T-Scores and measures of physical function were nonsignificant.
Conclusions: Low RTI T-Scores were shown across two samples to be associated with a clinically meaningful reduction in the odds of cognitive impairment. Further research is needed in order to clarify the utility of high RTI scores for positive prediction of cognitive impairment.
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Keywords
Aging, Reaction time, Intraindividual variability, Psychometrics, Cognitive impairment