Age-related differences and reliability on computerized and paper-and-pencil neurocognitive assessment batteries.
BACKGROUND
Neurocognitive testing is a recommended component in a concussion assessment. Clinicians should be aware of age and practice effects on these measures to ensure appropriate understanding of results.


OBJECTIVE
To assess age and practice effects  on computerized and paper-and-pencil neurocognitive testing batteries in collegiate and high school athletes.


METHODS
Cohort study.


METHODS
Classroom and laboratory.


METHODS
Participants consisted of 20 collegiate  student-athletes (age = 20.00 ± 0.79 years) and 20 high school student-athletes (age = 16.00 ± 0.86 years).


METHODS
Hopkins Verbal Learning Test scores, Brief Visual-Spatial Memory Test scores, Trail Making Test B total time, Symbol Digit Modalities  Test score, Stroop Test total score, and 5 composite scores from the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) served as outcome measures. Mixed-model analyses of variance were used to examine each measure.


RESULTS
Collegiate student-athletes performed  better than high school student-athletes on ImPACT processing speed composite score (F(1,38) = 5.03, P = .031) at all time points. No other age effects were observed. The Trail Making Test B total time (F(2,66) = 73.432, P < .001), Stroop Test  total score (F(2,76) = 96.85, P = < .001) and ImPACT processing speed composite score (F(2,76) = 5.81, P = .005) improved in test sessions 2 and 3 compared with test session 1. Intraclass correlation coefficient calculations demonstrated values  ranging from 0.12 to 0.72.


CONCLUSIONS
An athlete's neurocognitive performance may vary across sessions. It is important for clinicians to know the reliability and precision of these tests in order to properly interpret test scores.
Clinical Research Unit, Emergency Services Institute, WakeMed Health & Hospitals, Raleigh, NC 27610, USA. jmihalik@wakemed.org
Johna K
JK
Register-Mihalik
Daniel L
DL
Kontos
Kevin M
KM
Guskiewicz
Jason P
JP
Mihalik
Robert
R
Conder
Edgar W
EW
Shields
D000293:Adolescent; D000367:Age Factors; D056352:Athletes; D001265:Athletic Injuries / Q000175:diagnosis; D001924:Brain Concussion / Q000175:diagnosis; D001930:Brain Injuries / Q000175:diagnosis; D003071:Cognition; D015331:Cohort Studies; D003201:Computers; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012984:Software; D013334:Students; D014495:Universities; D055815:Young Adult