Judgment in older adults: development and psychometric evaluation of the Test of Practical Judgment (TOP-J).
This article reports on the development and validation of a novel, objective test of judgment for use with older adults. The Test of Practical Judgment (TOP-J) is an open-ended measure that evaluates judgment related to safety, medical, social/ethical, and financial issues. Psychometric features were examined in a sample of 134 euthymic individuals with mild Alzheimer's disease (AD), amnestic mild cognitive impairment (MCI), or cognitive complaints but intact neuropsychological performance (CC), and demographically-matched healthy controls (HC). Measures of reliability were adequate to high, and TOP-J scores correlated with select measures of executive functioning, language, and memory. AD participants obtained impaired TOP-J scores relative to HCs, while MCI and CC participants showed an intermediate level of performance. Confirmatory factor analyses were consistent with a unidimensional structure. Results encourage further development of the TOP-J as an indicator of practical judgment skills in clinical and research settings. Longitudinal assessments are being performed to examine predictive validity of the TOP-J for cognitive progression in our clinical groups.
Rabin
L A
LA
Dartmouth Medical School, Lebanon, NH, USA. lrabin@brooklyn.cuny.edu
Borgos
M J
MJ
Saykin
A J
AJ
Wishart
H A
HA
Crane
P K
PK
Nutter-Upham
K E
KE
Flashman
L A
LA
D000368:Aged; D000369:Aged, 80 and over; D005069:Evaluation Studies as Topic; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007600:Judgment / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results