The influence of age, gender and education on neuropsychological test scores: Updated clinical norms for five widely used cognitive assessments

JF Scheffels, I Ballasch, N Scheichel… - Journal of Clinical …, 2023 - mdpi.com
JF Scheffels, I Ballasch, N Scheichel, M Voracek, E Kalbe, J Kessler
Journal of Clinical Medicine, 2023mdpi.com
Background: Sociodemographic effects (ie, age, gender, education) have been shown to
influence neuropsychological test scores. The current retrospective, quasi-epidemiological
work provides age-, gender-and education-corrected clinical norms for five common
cognitive assessments. Methods: In total, test scores of 4968 patients from the University
Hospital of Cologne (Department of Neurology), recruited between 2009 and 2020, were
analyzed retrospectively. Conducted tests were the Mini-Mental State Examination (MMSE) …
Background
Sociodemographic effects (i.e., age, gender, education) have been shown to influence neuropsychological test scores. The current retrospective, quasi-epidemiological work provides age-, gender- and education-corrected clinical norms for five common cognitive assessments.
Methods
In total, test scores of 4968 patients from the University Hospital of Cologne (Department of Neurology), recruited between 2009 and 2020, were analyzed retrospectively. Conducted tests were the Mini-Mental State Examination (MMSE), F-A-S Test (FAS), Rey–Osterrieth Complex Figure Test (ROCFT) and Trail Making Test, Part A and B (TMT-A/-B). Using multiple linear regression analyses, test scores were analyzed for sociodemographic influences (age, gender, education). Based on these analyses, norms were generated by first separating patients into different age groups stratified by educational level and (if necessary) gender. Subsequently, percentile ranks and z-scores for a subsample including only individuals without dementia were calculated.
Results
Lower age and higher educational level predicted better test scores (MMSE, FAS, ROCFT) and completion times (TMT-A/-B). Additionally, produced words on the FAS and remembered drawings from the ROCFT were influenced by gender, with females having better FAS but lower ROCFT (delayed recall) scores than males. Considering these effects, clinical norms were provided for the five cognitive assessments.
Conclusions
We found influences of age, gender and education on test scores, although they are frequently not or only partially considered for test score interpretation. With the provided norms, neuropsychologists can make more profound evaluations of cognitive performance. A user-friendly Microsoft Excel file is offered to assist this process.
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