Attention-deficit/hyperactivity disorder (ADHD) often persists into adult=hood, but its association with Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) profiles in clinical settings remains unclear. We examined whether ADHD diagnosis and dimensional symptom severity were associated with WAIS-IV indices and subtests in adults undergoing psychiatric evaluation. This retrospective study included 429 adults assessed at a tertiary university hospital between January 2023 and December 2025; 47 (11.0%) had ADHD. Separate linear regression models tested associations of ADHD diagnosis and standardized Adult ADHD Self-Report Scale (ASRS) scores with cognitive outcomes, adjusting for age, sex, education, depressive symptoms, and anxiety symptoms. Inference used HC3 heteroskedasticity-consistent standard errors and Holm correction within four outcome families. No index-level association was significant. At the subtest level, Digit Span Backward showed the largest and nominally significant difference (B = -1.30, 95% CI [-2.32, -0.27], unadjusted p = 0.014), although it did not remain significant after Holm correction (p = 0.095). ASRS scores were not significantly associated with outcomes. Conclusions were unchanged after excluding the 28 comparison participants with a rule-out ADHD notation. These findings do not establish an ADHD-specific WAIS-IV profile, but the Digit Span pattern, particularly the Backward difference, warrants evaluation in larger samples with performance validity assessment.
Commonly applied cutoff scores of the Montreal Cognitive Assessment (MoCA) perform poorly among US Latinos. Prior studies relied on small samples, combining persons with mild cognitive impairment (MCI) and dementia into a single group, or failing to account for multiple intersecting demographic factors. We identified optimal MoCA cutoffs for MCI and dementia while addressing these limitations, cross-sectionally, among 1,780 English- and Spanish-speaking Latinos. Research diagnostic groups consisted of cognitively unimpaired (CU), MCI, and dementia. Area under the curve (AUC) values for CU vs. MCI were 0.70 for Spanish-tested participants and 0.75 for English-tested participants, while values for MCI vs. dementia were 0.83 and 0.84 for the Spanish and English tested participants, respectively. Generally, there was a pattern of lower cutoffs for both MCI and dementia among Spanish speakers at older ages and lower educational attainment, with some optimal cutoffs shown to be substantially lower than the traditionally used standard cutoff. These findings provide cutoffs that better reflect differences amongst language and demographic groups.
We examined whether regional lesion burden adds information beyond clinical variables and total lesion volume regarding chronic aphasia severity. This secondary analysis of the Aphasia Recovery Cohort included 195 participants with left-hemisphere stroke, Western Aphasia Battery Aphasia Quotient (AQ) ≤93.8, and assessment ≥180 days after stroke. Lesion burden was quantified in five atlas-defined groups. Partial Spearman correlations were adjusted for age at stroke, sex, time to assessment, and lesion volume, and four ridge-regression models were compared using 30 repetitions of five-fold cross-validation. A sensitivity analysis included participants whose imaging and Western Aphasia Battery assessments were ≤90 days apart (n = 128). Dorsal white-matter burden remained associated with lower AQ after adjustment (partial ρ = -0.261; false-discovery-rate q = 0.002). Adding regional burdens to the clinical-plus-volume model increased mean cross-validated R2 from 0.306 to 0.384 (ΔR2 = 0.078) and reduced mean absolute error from 18.76 to 17.31 AQ points. In the time-restricted sample, R2 increased from 0.312 to 0.442 (ΔR2 = 0.130), with the dorsal association persisting (partial ρ = -0.307). Regional lesion burden adds information beyond lesion volume and supports anatomical characterization of chronic aphasia severity.
Objective The Denver Attention Test (DAT) is a novel free-standing performance validity test (PVT) with limited research. This study was designed to replicate the initial validation study and explore the utility of alternate metrics.Method The DAT was administered to 71 adults. Classification accuracy was calculated using the Word Memory Test as the criterion PVT.Results A total accuracy <= 41 had .53 sensitivity at .92 specificity; total completion time >= 157" had .27 sensitivity at .92 specificity. Accuracy cutoffs across individual trials (<= 12, <= 13 and <= 14) produced similar classification accuracy (.47-.60 sensitivity at .92 specificity). Failing any of these cutoffs correctly classified 85% of the sample (.67 sensitivity at .90 specificity). Finally, increasing reaction times across trials and forgetting curves were associated with invalid performance (.07-.40 sensitivity at .90-.98 specificity). Chance level responding on individual trials was associated with multiple at or even below chance scores on other PVTs in a case study.Conclusions The DAT is a cost-effective and psychometrically robust free-standing PVT. Incorporating data from its individual components can enhance its clinical utility. More research is needed to consolidate the evidence base on its classification accuracy across samples with different demographics and clinical characteristics and using multiple criterion PVTs.
