Abstract

The accurate interpretation of serial neuropsychological testing is a fundamental activity of neuropsychologists in clinical and research settings. Although prior research supports the construct validity of several individual tests for the reliable measurement of cognitive change, neuropsychologists are often interested in detecting changes in cognitive functioning across a battery of tests. In the present study, we examined the specificity of a modified Reliable Change Index (RCI) methodology applied across a focused battery of commonly used neuropsychological tests. Fifty-seven healthy controls underwent neuropsychological assessment at two time points separated by approximately 1 year. Test–retest reliability coefficients and standard RCI confidence intervals for the individual tests were broadly comparable with prior research in healthy populations. Battery change scores were generated by calculating z-scores of change for each individual test, which were summed across the entire test battery. The RCI methodology was applied to the summed z-score to provide a 90% confidence interval as an indicator of overall cognitive stability. These battery RCI normative standards demonstrated adequate specificity when applied to 29 persons with HIV-1 infection who were classified as medically and neurologically stable. Findings from this study may be useful for both clinicians and researchers seeking normative standards for determining reliable changes in performance across a commonly used battery of neuropsychological tests.

Author notes

1
Steven Paul Woods, Stephanie Guaman, Igor Grant, and Robert K. Heaton, Department of Psychiatry and HIV Neurobehavioral Research Center (HNRC); Meredith Childers and Ronald J. Ellis, Department of Neuroscience and HNRC. The HNRC group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the San Diego Veterans Affairs Healthcare System, and includes: Director: Igor Grant, M.D.; Co-Directors: J. Hampton Atkinson, M.D. and J. Allen McCutchan, M.D.; Center Manager: Thomas D. Marcotte, Ph.D.; Naval Hospital San Diego: Mark R. Wallace, M.D. (P.I.); Neuromedical Component: J. Allen McCutchan, M.D. (P.I.), Ronald J. Ellis, M.D., Scott Letendre, M.D., Rachel Schrier, Ph.D.; Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), Mariana Cherner, Ph.D., Sharron Dawes, Ph.D., Lei Lu, Ph.D., Steven Paul Woods, Psy.D., and Corinna Young, Ph.D.; Imaging Component: Terry Jernigan, Ph.D. (P.I.), Michael J. Taylor, Ph.D., John Hesselink, M.D.; Neuropathology Component: Eliezer Masliah, M.D. (P.I.), Dianne Langford, Ph.D.; Clinical Trials Component: J. Allen McCutchan, M.D., J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., Scott Letendre, M.D.; Data Management Unit: Michelle Frybarger, B.A. (Data Systems Manager); Statistics Unit: Ian Abramson, Ph.D. (P.I.), Deborah Lazzaretto, M.S.