Age effects on Wechsler Memory Scale-Fourth Edition (WMS-IV) indexes and subtests.

This study examined age effects in the standardization samples of the Wechsler Memory Scale-Fourth Edition (WMS-IV) and compared these, where appropriate, to the norms of the Wechsler Memory Scale-Third Edition (WMS-III). On the Adult (16-69 years) and Older Adult (65-90 years) batteries of the WMS-IV, the most pronounced declines were on the Visual Memory Indexes starting in the 35-44 years cohort. The Auditory Memory Indexes showed the least deterioration, which did not commence until the 85-90 years age range. Subtest scores for the Adult Battery indicated that Logical Memory I was unchanged from 16 to 69 years. Likewise, only one scaled score point decline was evidenced on Logical Memory II. Conversely, WMS-III Logical Memory I performance showed a one scaled score point decline in the 18-19 years age band and progressed to moderate (i.e., 4 scaled score points) and large (i.e., ≥6 scaled score points) reductions by the 65-69 and ≥80 years cohorts. Logical Memory II showed even greater age-related deterioration. Age decline data at each age cohort are provided for all subtests and indexes from the Adult and Older Adult batteries as well as for the WMS-III subtests in common with the WMS-IV.

Efficacy of the nootropic supplement Mind Lab Pro on memory in adults: Double blind, placebo-controlled study.

OBJECTIVES: This study aimed to investigate the efficacy of taking Mind Lab Pro, a plant-based nootropic on memory in a group of healthy adults. Auditory, visual, visual working memory, immediate and delayed recall (DR) were assessed. METHODS: The study employed a pseudo randomised, double blinded, placebo-controlled design. A total of 49 healthy individuals completed the study with 36 in the experimental group and 13 in the control group. Participants ranged between 20 and 68 years with a mean age of 31.4 ± 14.4 years. Pre and post taking either the Mind Lab Pro supplement or placebo for 30 days. All participants completed the Wechsler Memory Scale Fourth UK Edition (WSM-IV UK). RESULTS: We found that the experimental group significantly improved in all memory subtests assessed (p < 0.05) whilst the control group only significantly improved in auditory memory and immediate recall (p = 0.004 and p = 0.014 respectively). A significant difference in immediate and DR was also found between the control and experimental group (p = 0.005 and 0.034 respectively). CONCLUSION: The use of Mind Lab Pro for 4 weeks improves memory with the experimental group significantly improving in all sub areas of memory as assessed by the WSM-IV UK.

Wechsler memory scale-fourth edition (WMS-IV) in the neuropsychological evaluation of patients diagnosed with probable Alzheimer's disease.

There is a scarcity of research concerning Wechsler Memory Scale-Fourth Edition (WMS-IV) findings in Alzheimer's disease (AD). We provide information, beyond that in the test manual, concerning the power of the scale to detect AD-associated memory deficits. Participants were 87 individuals with diagnoses made according to criteria specified in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): 31 probable neurocognitive disorders due to AD and 33 patients with depression. Twenty-three elderly controls were also studied. The depressed and control participants had similar demographics as well as test scores and therefore were blended into a single control group (n = 56). AD patients were significantly impaired on the four WMS-IV indexes relative to controls, and the index pattern of performance differed across groups. Delayed Memory Index was a significant weakness in AD, whereas the Visual Memory Index was the lowest mean for controls. Sensitivity, specificity, hit rate, positive predictive value, and negative predictive value were strong to excellent for each index when a cutoff of 1.5 SDs below the normative mean was used to separate ADs and controls. Receiver operating characteristics curve analyses yielded excellent area under the curve statistics that ranged from .970 for the Visual Memory Index to .999 for the Delayed Memory Index. A supplementary analysis yielded similar results when the AD group was divided into mild (n = 10) and major (n = 21) subgroups.

Does high scatter on the Wechsler Adult Intelligence Scale-Fourth Edition general ability index reduce validity in predicting Wechsler Memory Scale-Fourth Edition indexes?

We examined whether significant scatter in WAIS-IV GAI will reduce its validity to predict performance on WMS-IV indexes. Participants were 330 individuals with neurological, psychiatric, or neurodevelopmental disorders and 59 referrals who were found to be free of a diagnosable disorder. For VCI > PRI, 59.32% were significant at p < .05 and 12.29% were >22 points. For VCI < PRI, 48.37% were significant at p < .05 and 7.19% were >22 points. Inter-subtest scatter across GAI subtests indicated 82.26% of individuals had a significant scatter range and 13.88% had an unusually large range (≥8). For the VCI, 49.10% had significant scatter (≥3) and 12.08% had an unusually large scatter range (≥5). On the PRI, 43.19% had a significant scatter range (≥4) and 12.85% had an unusually large degree of scatter (≥6). Moderation analyses revealed GAI was a significant predictor of each WMS-IV index. The interaction term of GAI with GAI scatter was not significant for any indexes, indicating that regression equations for predicting WMS-IV scores from GAI did not vary significantly across levels of scatter. Estimation of WMS-IV indexes from the GAI is justified even when significant VCI-PRI discrepancies are present and there is unusual variability across the GAI subtests.

Effectiveness of neurobic exercise program on memory and depression among elderly residing at old age home.

Objectives This study finds out the effectiveness of neurobic exercise program on memory and depression among elderly residing in old age homes. Methods The non-probability purposive sampling technique was used for sample selection. Wechsler's memory scale (WMS-IV) and Geriatric depression scale (GDS) were the instruments used to assess the memory and depression among elderly during the pretest and posttest, respectively and the researcher had developed data sheet to collect information about the background variables using interview technique. Results The neurobic exercise program was found to be effective in reducing depression among elderly residing in old age homes. There was a significant difference (p<0.001) in the level of depression had been found during the pretest and posttest in the interventional group. There was a statistically significant difference (p<0.001) found between the study group and in the control group. There was significant correlation (r=0.417, p<0.05) found between the memory and depression during the pretest in the study group among the elderly. A statistically significant association (p<0.05) found in the mean scores of depression and marital status of the elderly during the pretest in the study group and there was a significant association (p<0.01) found in the mean scores of depression and the gender of the elderly during the pretest and posttest in the non interventional group were found. Conclusions The findings suggested that neurobic exercise program is an effective intervention in improving memory and reducing depression.

Normative Data for the Logical Memory Subtest of the Wechsler Memory Scale-IV in Middle-Aged and Elderly Korean People.

OBJECTIVE: The purpose of this study is to identify the demographic variables that are affecting performances on the Logical Memory (LM) subtest included in the Korean version of the Wechsler Memory Scale (WMS)-IV and to provide normative data on the LM subtest for the middle-age and elderly Korean people. METHODS: The participants were 435 non-demented adults aging from 50 to 90 and with the educational level ranging from 0 to 21 years. RESULTS: Age and education were found to be significantly associated with performance on the LM subtest, while gender effect was not statistically significant. Therefore, we stratified the norm blocks by age and education. Age was divided into three groups: 50-59, 60-74, and 75-90 years. Education was stratified into three groups: 0-8 years, 9-12 years, and 13 years or more. CONCLUSION: The normative data provided in the current study are expected to be useful in clinical and research settings to detect or define subtle changes in episodic memory in Korean adults and elderly, and can also be used for cross-cultural comparison of verbal episodic memory performance among elderly populations using different languages.

Evaluating the accuracy of the Wechsler Memory Scale-Fourth Edition (WMS-IV) logical memory embedded validity index for detecting invalid test performance.

Embedded performance validity tests (PVTs) allow for continuous assessment of invalid performance throughout neuropsychological test batteries. This study evaluated the utility of the Wechsler Memory Scale-Fourth Edition (WMS-IV) Logical Memory (LM) Recognition score as an embedded PVT using the Advanced Clinical Solutions (ACS) for WAIS-IV/WMS-IV Effort System. This mixed clinical sample was comprised of 97 total participants, 71 of whom were classified as valid and 26 as invalid based on three well-validated, freestanding criterion PVTs. Overall, the LM embedded PVT demonstrated poor concordance with the criterion PVTs and unacceptable psychometric properties using ACS validity base rates (42% sensitivity/79% specificity). Moreover, 15-39% of participants obtained an invalid ACS base rate despite having a normatively-intact age-corrected LM Recognition total score. Receiving operating characteristic curve analysis revealed a Recognition total score cutoff of < 61% correct improved specificity (92%) while sensitivity remained weak (31%). Thus, results indicated the LM Recognition embedded PVT is not appropriate for use from an evidence-based perspective, and that clinicians may be faced with reconciling how a normatively intact cognitive performance on the Recognition subtest could simultaneously reflect invalid performance validity.

Normative Data for the Logical Memory Subtest of the Wechsler Memory Scale-IV in Middle-Aged and Elderly Korean People

OBJECTIVE: The purpose of this study is to identify the demographic variables that are affecting performances on the Logical Memory (LM) subtest included in the Korean version of the Wechsler Memory Scale (WMS)-IV and to provide normative data on the LM subtest for the middle-age and elderly Korean people.METHODS: The participants were 435 non-demented adults aging from 50 to 90 and with the educational level ranging from 0 to 21 years.RESULTS: Age and education were found to be significantly associated with performance on the LM subtest, while gender effect was not statistically significant. Therefore, we stratified the norm blocks by age and education. Age was divided into three groups: 50–59, 60–74, and 75–90 years. Education was stratified into three groups: 0–8 years, 9–12 years, and 13 years or more.CONCLUSION: The normative data provided in the current study are expected to be useful in clinical and research settings to detect or define subtle changes in episodic memory in Korean adults and elderly, and can also be used for cross-cultural comparison of verbal episodic memory performance among elderly populations using different languages.

Neurocognitive changes in pituitary adenoma patients after Gamma Knife radiosurgery.

OBJECTIVEPituitary adenomas and the treatment required for the underlying neuropathology have frequently been associated with cognitive dysfunction. However, the mechanisms for these impairments remain the subject of much debate. The authors evaluated cognitive outcomes in patients treated with or without Gamma Knife radiosurgery (GKRS) for an underlying pituitary adenoma.METHODSThis was a retrospective, institutional review board-approved, single-institution study. A total of 51 patients (23 male, 28 female) treated for pituitary adenoma were included in this neurocognitive study. Twenty-one patients underwent GKRS following transsphenoidal surgery, 22 patients were treated with transsphenoidal surgery alone, and eight patients were conservatively managed or were treated with medical management alone. Comparisons using psychometric tests of general intellectual abilities, memory, and executive functions were made between the treatment groups, between male and female patients, and between patients with Cushing's disease and those with nonfunctioning adenoma (NFA).RESULTSThe entire patient sample, the NFA group, and the GKRS group scored significantly below expected on measures of both immediate and delayed memory, particularly for visually presented information (p ≤ 0.05); however, there were no significant differences between the patients with Cushing's disease and those with NFA (t ≤ 0.56, p ≥ 0.52). In those who underwent GKRS, memory scores were not significantly different from those in the patients who did not undergo GKRS (t ≤ 1.32, p ≥ 0.19). Male patients across the sample were more likely to demonstrate impairments in both immediate memory (t = -3.41, p = 0.003) and delayed memory (t = -3.80, p = 0.001) than were female patients (t ≤ 1.09, p ≥ 0.29). There were no impairments on measures of general intellectual functioning or executive functions in any patient group. The potential contributions of tumor size and hormone levels are discussed.CONCLUSIONSOverall, pituitary adenoma patients demonstrated relative impairment in anterograde memory. However, GKRS did not lead to adverse effects for immediate or delayed memory in pituitary adenoma patients. Cognitive assessment of pituitary adenoma patients is important in their longitudinal care.

Relationship of Working Memory, Processing Speed, and Fluid Reasoning in Psychiatric Patients.

OBJECTIVE: The present study aimed to investigate relationship among cognitive factors (working memory and processing speed) and fluid reasoning (Gf) in psychiatric patients using a standardized clinical tool. METHODS: We included the responses of 115 heterogeneous patients who were diagnosed with the MINI-Plus 5.0 and WAIS-IV/WMSIV was administered. For our analysis, structured equation modeling (SEM) was conducted to evaluate which cognitive variables are closely related to the Gf. RESULTS: The results showed that the visual working memory was the strongest predictor of the Gf compared to other cognitive factors. CONCLUSION: Processing speed was capable of predicting the Gf, when visual working memory was controlled. The inter-relationship among the Gf and other cognitive factors and its clinical implications were further discussed.

Modality-Specific Working Memory Systems Verified by Clinical Working Memory Tests.

OBJECTIVE: This study was to identify whether working memory (WM) can be clearly subdivided according to auditory and visual modality. To do this, we administered the most recent and universal clinical WM measures in a mixed psychiatric sample. METHODS: A total of 115 patients were diagnosed on the basis of DSM-IV diagnostic criteria and with MINI-Plus 5.0, a structured diagnostic interview. WM subtests of Korean version of Wechsler Adult Intelligence Scale-IV and Korean version of Wechsler Memory Scale-IV were administered to assess WM. Confirmatory factor analysis (CFA) was used to observe whether WM measures fit better to a one-factor or two-factor model. RESULTS: CFA results demonstrated that a two factor model fits the data better than one-factor model as expected. CONCLUSION: Our study supports a modality model of WM, or the existence of modality-specific WM systems, and thus poses a clinical significance of assessing both auditory and visual WM tests.

Relationship of Working Memory, Processing Speed, and Fluid Reasoning in Psychiatric Patients

OBJECTIVE: The present study aimed to investigate relationship among cognitive factors (working memory and processing speed) and fluid reasoning (Gf) in psychiatric patients using a standardized clinical tool. METHODS: We included the responses of 115 heterogeneous patients who were diagnosed with the MINI-Plus 5.0 and WAIS-IV/WMS-IV was administered. For our analysis, structured equation modeling (SEM) was conducted to evaluate which cognitive variables are closely related to the Gf. RESULTS: The results showed that the visual working memory was the strongest predictor of the Gf compared to other cognitive factors. CONCLUSION: Processing speed was capable of predicting the Gf, when visual working memory was controlled. The inter-relationship among the Gf and other cognitive factors and its clinical implications were further discussed.

Modality-Specific Working Memory Systems Verified by Clinical Working Memory Tests

OBJECTIVE: This study was to identify whether working memory (WM) can be clearly subdivided according to auditory and visual modality. To do this, we administered the most recent and universal clinical WM measures in a mixed psychiatric sample. METHODS: A total of 115 patients were diagnosed on the basis of DSM-IV diagnostic criteria and with MINI-Plus 5.0, a structured diagnostic interview. WM subtests of Korean version of Wechsler Adult Intelligence Scale-IV and Korean version of Wechsler Memory Scale-IV were administered to assess WM. Confirmatory factor analysis (CFA) was used to observe whether WM measures fit better to a one-factor or two-factor model. RESULTS: CFA results demonstrated that a two factor model fits the data better than one-factor model as expected. CONCLUSION: Our study supports a modality model of WM, or the existence of modality-specific WM systems, and thus poses a clinical significance of assessing both auditory and visual WM tests.

Clinical validation of three short forms of the Dutch Wechsler Memory Scale-Fourth Edition (WMS-IV-NL) in a mixed clinical sample.

The reliability and validity of three short forms of the Dutch version of the Wechsler Memory Scale-Fourth Edition (WMS-IV-NL) were evaluated in a mixed clinical sample of 235 patients. The short forms were based on the WMS-IV Flexible Approach, that is, a 3-subtest combination (Older Adult Battery for Adults) and two 2-subtest combinations (Logical Memory and Visual Reproduction and Logical Memory and Designs), which can be used to estimate the Immediate, Delayed, Auditory and Visual Memory Indices. All short forms showed good reliability coefficients. As expected, for adults (16-69 years old) the 3-subtest short form was consistently more accurate (predictive accuracy ranged from 73% to 100%) than both 2-subtest short forms (range = 61%-80%). Furthermore, for older adults (65-90 years old), the predictive accuracy of the 2-subtest short form ranged from 75% to 100%. These results suggest that caution is warranted when using the WMS-IV-NL Flexible Approach short forms to estimate all four indices.

Apparently abnormal Wechsler Memory Scale index score patterns in the normal population.

Interpretation of the Wechsler Memory Scale-Fourth Edition may involve examination of multiple memory index score contrasts and similar comparisons with Wechsler Adult Intelligence Scale-Fourth Edition ability indexes. Standardization sample data suggest that 15-point differences between any specific pair of index scores are relatively uncommon in normal individuals, but these base rates refer to a comparison between a single pair of indexes rather than multiple simultaneous comparisons among indexes. This study provides normative data for the occurrence of multiple index score differences calculated by using Monte Carlo simulations and validated against standardization data. Differences of 15 points between any two memory indexes or between memory and ability indexes occurred in 60% and 48% of the normative sample, respectively. Wechsler index score discrepancies are normally common and therefore not clinically meaningful when numerous such comparisons are made. Explicit prior interpretive hypotheses are necessary to reduce the number of index comparisons and associated false-positive conclusions. Monte Carlo simulation accurately predicts these false-positive rates.

Executive functioning and visual working memory.

The matter of modality is controversially discussed in the context of working memory (WM). There is evidence that modality-specific processes are accompanied by amodal processes to some extent. We investigated the relationship between executive-functioning tasks and visual WM (VWM) and were especially interested in the issue of amodal processes. Our correlational analyses suggest modality-independent relations of the tasks. We also aimed to quantify to what extent executive functioning is meaningful for VWM performances. We therefore estimated the relationship between executive tasks and VWM performances in a healthy (n = 710) and a clinical traumatic brain injury sample (n = 151) as well as in the combined total sample. The results indicate a substantial relevance of the verbal task for VWM performances in the total and the clinical sample but a low relevance in the healthy sample. These results could support assumptions of resource-depending differences in the relations of executive functioning and VWM but need further validation due to limitations of our study.

Clinical utility of the Wechsler Memory Scale--Fourth Edition (WMS-IV) in predicting laterality of temporal lobe epilepsy among surgical candidates.

This study evaluated the accuracy of the Wechsler Memory Scale--Fourth Edition (WMS-IV) in identifying functional cognitive deficits associated with seizure laterality in localization-related temporal lobe epilepsy (TLE) relative to a previously established measure, the Rey Auditory Verbal Learning Test (RAVLT). Emerging WMS-IV studies have highlighted psychometric improvements that may enhance its ability to identify lateralized memory deficits. Data from 57 patients with video-EEG-confirmed unilateral TLE who were administered the WMS-IV and RAVLT as part of a comprehensive presurgical neuropsychological evaluation for temporal resection were retrospectively reviewed. We examined the predictive accuracy of the WMS-IV not only in terms of verbal versus visual composite scores but also using individual subtests. A series of hierarchal logistic regression models were developed, including the RAVLT, WMS-IV delayed subtests (Logical Memory, Verbal Paired Associates, Designs, Visual Reproduction), and a WMS-IV verbal-visual memory difference score. Analyses showed that the RAVLT significantly predicted laterality with overall classification rates of 69.6% to 70.2%, whereas neither the individual WMS-IV subtests nor the verbal-visual memory difference score accounted for additional significant variance. Similar to previous versions of the WMS, findings cast doubt as to whether the WMS-IV offers significant incremental validity in discriminating seizure laterality in TLE beyond what can be obtained from the RAVLT.

Chance performance and floor effects: threats to the validity of the Wechsler Memory Scale--fourth edition designs subtest.

The Designs subtest allows for accumulation of raw score points by chance alone, creating the potential for artificially inflated performances, especially in older patients. A random number generator was used to simulate the random selection and placement of cards by 100 test naive participants, resulting in a mean raw score of 36.26 (SD = 3.86). This resulted in relatively high-scaled scores in the 45-54, 55-64, and 65-69 age groups on Designs II. In the latter age group, in particular, the mean simulated performance resulted in a scaled score of 7, with scores 1 SD below and above the performance mean translating to scaled scores of 5 and 8, respectively. The findings indicate that clinicians should use caution when interpreting Designs II performance in these age groups, as our simulations demonstrated that low average to average range scores occur frequently when patients are relying solely on chance performance.