ADNeT Harmonised Neuropsychological Battery
Dementia is an enormous challenge for Australia yet it remains acutely underdiagnosed. Cognitive testing is vital for the accurate diagnosis of dementia but is not necessarily performed in primary care and hospital settings, even in the form of brief cognitive screening test that may prompt further investigations. Specialist dementia settings, including ADNeT Memory and Cognition Clinics, therefore perform a vital role in providing at least cognitive screening and in some cases comprehensive neuropsychological testing to better inform a possible dementia diagnosis. Please see the section on Neuropsychological Assessment within the ADNeT Memory and Cognition Clinic Guidelines for information on our proposed national standards for Specialised Dementia and Cognitive Decline Assessment Services in Australia.
Neuropsychological testing, that involves comprehensive assessment of multiple cognitive domains, is vital for accurate diagnosis, particularly in the context of early detection and differential diagnosis between multiple forms of dementia when the diagnosis is uncertain. It is also important for informing appropriate post-diagnostic care, such as cognitive interventions, to help alleviate cognitive decline and maintain quality of life.
However, aside from an overall lack of neuropsychological expertise in Australian specialist dementia settings, there is a lack of agreed upon minimum standards for neuropsychological testing in dementia, including the selection of specific neuropsychological tests or measures. The importance of harmonising neuropsychological measures includes increasing the reliability and consistency of diagnosis, permitting more valid interpretation of follow-up testing and change in performance, improve communication and collaboration between clinics, and increasing the scale and clinical relevance of research studies that could be based across ADNeT Memory and Cognition Clinics.
Our research survey of Australian Memory and Cognition Clinics (Mehrani et al., 2021) revealed the most commonly used neuropsychological tests for the assessment of older adults. These results, in combination with consideration of results from similar harmonisation efforts around the world (e.g., Boccardi et al., 2019; Rabin et al., 2016), and determination of the most important tests for assessing MCI and dementia based on consultation with neuropsychologists with expertise in older adults and dementia, were used to produce a list of harmonised measures, the ADNeT Neuropsychology Recommended Harmonised Battery (ANRHB).
The ANRHB is not intended to represent an exhaustive battery but as a set of core measures commonly used in assessment of older adults. It contains both a “Short” list of recommended tests that were considered absolutely essential as a starting point in neuropsychological testing, and a “Full” list comprising the minimum test list for a comprehensive neuropsychological assessment in an ADNeT Memory and Cognition Clinic.
To further facilitate the use of harmonised neuropsychological practices in ADNeT Memory and Cognition Clinics, we have also developed the ADNeT online Neuropsychology Norming Tool (ANNT), that allows automatic calculation of normative data from a selection of neuropsychological test scores within the ANRHB. (Please note that the ANNT contains only a subset of tools from the ANRHB, and that the ANRHB is not bound to the specific set of normative data used in the ANNT). Please click here if you wish to register your interest to use this tool.
(ANNT Short/Core Battery in Green)
TEST
|
DOMAIN(S)
|
MEASURE(S)
|
NORMS USED FOR ANNT
|
| Test of Premorbid Functioning |
General intellectual ability |
Total correct |
WAIS-IV ACS |
| Trail Making A |
Processing Speed |
Total time |
Tombaugh et al., 2004 |
| Trail Making B |
Executive Function |
Total time |
Tombaugh et al., 2004 |
| Logical Memory |
Learning and Memory |
LM I and LM II |
WMS-IV |
| Letter Fluency (FAS) |
Executive Function |
Total correct |
Tombaugh et al., 1999 |
| Category Fluency (Animals) |
Language |
Total correct |
Tombaugh et al., 1999 |
| Rey Auditory Verbal Learning Test |
Learning and Memory |
Eg: Total learning, Trial 6, Trial 7, Recognition |
MOANS: Ivnik et al., 1990, 1992; Harris et al., 2002 |
| Rey Complex Figure Test |
Visuospatial and Executive Function; Learning and Memory |
Copy, Immediate Recall, 30 minute delayed recall, Recognition |
Fastenau et al., 1999 |
| Similarities |
Executive Function |
Total correct |
WAIS-IV |
| Digit Span |
Attention and Working Memory |
Digit Span Forwards; Digit Span Backwards |
WAIS-IV |
| Boston Naming Test |
Language |
Total correct with stimuli cues |
MOANS: Ivnik et al., 1996 |
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