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Revisiting reliable change with Iverson (2001).

Kevin Duff1

  • 1Layton Aging and Alzheimer's Disease Center, Department of Neurology, Oregon Health & Science University, Portland, OR, USA.

The Clinical Neuropsychologist
|April 21, 2023
PubMed
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Calculating reliable change in neuropsychological assessments is complex. Using cognitively intact individuals

Area of Science:

  • Neuropsychology
  • Gerontology

Background:

  • Reliable change methodology, expanded by Iverson (2001), accounts for score variability at Time 2.
  • Previous studies presented an incomplete picture of variables affecting change due to data limitations.
  • Assessing reliable change in neuropsychological testing requires robust methodology.

Purpose of the Study:

  • To address limitations in previous reliable change methodology.
  • To clarify the methodology for assessing reliable change in neuropsychological assessments.
  • To investigate the impact of cognitive status and practice effects on change scores.

Main Methods:

  • Utilized one-year test-retest data from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).
  • Included older adults with cognitively intact status or mild Alzheimer's disease (AD).
Keywords:
Reliable changepsychometricsstatistics

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  • Calculated change scores using various models, comparing those consistent with and divergent from Iverson's approach.

    • Main Results:

    • Cognitively intact individuals exhibited less variable scores and larger change scores than those with AD.
    • Models using intact data showed more cognitive change; those correcting for practice effects and using intact data indicated the most decline.
    • Models using intact data and discordant practice effect corrections best classified independent cases as decline/stable/improve.

    Conclusions:

    • Calculating reliable change in neuropsychological assessments is complex, warranting caution with existing methodologies.
    • Utilizing data from cognitively intact individuals appears beneficial for reliable change assessment.
    • Incorporating a correction for practice effects is recommended for more accurate reliable change calculations.