Presidents Test performance in varieties of diffuse and unilateral cerebral disease

Two studies addressed issues concerning the validity of the Presidents Test. The results of Study 1 substantiated that generalized impairment for recent presidents occurs frequently in the context of multifocal and diffuse cerebral disease. Performances of normal elderly (n = 31) on all four Presidents subtests were superior to those of patients with confusional states (n = 7), uncomplicated dementia (n = 24), and dementia with confusion (n = 20). Overall, 88% of the combined sample was correctly classified (control v. diffuse cerebral disease). In Study 2, generalized memory impairment for recent presidents was found to be rare among samples of patients with unilateral right- and left-hemisphere lesions (n = 40 each). A selective impairment in temporal sequencing was preferentially associated with right-hemisphere disease, whereas verbal deficit patterns were more common in patients with left-sided lesions. These findings further document the validity of the Presidents Test as an efficient, objective method for assessing recent memory impairment due to widespread cerebral disease and suggest that qualitative analysis of performance patterns may be useful for detecting certain nonmnemonic cognitive defects in patients with focal brain disease.