Some older adults cannot meaningfully participate in the testing portion of a neuropsychological evaluation due to significant cognitive impairments. There are limited empirical data on this topic. Thus, the current study sought to provide an operational definition for a futile testing profile and examine cognitive severity status and cognitive screening scores as predictors of testing futility at both baseline and first follow-up evaluations. We analysed data from 9,263 older adults from the National Alzheimer’s Coordinating Center Uniform Data Set. Futile testing profiles occurred rarely at baseline (7.40%). There was a strong relationship between cognitive severity status and the prevalence of futile testing profiles, χ²(4) = 3559.77, p < .001. Over 90% of individuals with severe dementia were unable to participate meaningfully in testing. Severity range on the Montreal Cognitive Assessment (MoCA) also demonstrated a strong relationship with testing futility, χ²(3) = 3962.35, p < .001. The rate of futile testing profiles was similar at follow-up (7.90%). There was a strong association between baseline dementia severity and likelihood of demonstrating a futile testing profile at follow-up, χ²(4) = 1513.40, p < .001. Over 90% of individuals with severe dementia, who were initially able to participate meaningfully testing, no longer could at follow-up. Similarly, there was a strong relationship between baseline MoCA score band and likelihood of demonstrating a futile testing profile at follow-up, χ²(3) = 1627.37, p < .001. Results can help to guide decisions about optimizing use of limited neuropsychological assessment resources.

中文翻译：

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受损程度有多受损？探索无用的神经心理学测试模式作为痴呆严重程度和认知筛查分数的函数

由于严重的认知障碍，一些老年人无法有意义地参与神经心理学评估的测试部分。关于这个主题的经验数据有限。因此，目前的研究试图为无效的测试配置文件提供操作定义，并检查认知严重程度状态和认知筛查分数作为基线和首次随访评估中测试无效的预测因子。我们分析了来自国家阿尔茨海默病协调中心统一数据集的 9,263 名老年人的数据。基线时很少发生无效的测试配置文件（7.40%）。认知严重程度状态与无效测试的流行率之间存在密切关系，χ ² (4) = 3559.77，p < .001。超过 90% 的重度痴呆患者无法有意义地参与测试。蒙特利尔认知评估 (MoCA) 的严重程度范围也显示出与测试无效性密切相关，χ ² (3) = 3962.35，p  < .001。随访时无效测试的比率相似（7.90%）。基线痴呆严重程度与随访时显示无效测试的可能性之间存在很强的关联，χ ² (4) = 1513.40，p < .001。超过 90% 的重度痴呆患者最初能够参与有意义的测试，但现在无法进行随访。同样，基线 MoCA 评分带与在随访中证明无效测试配置文件的可能性之间存在密切关系，χ ² (3) = 1627.37，p  < .001。结果可以帮助指导有关优化使用有限的神经心理学评估资源的决策。