title: Atypical performance patterns on Delis-Kaplan Executive Functioning System Color-Word Interference Test: Cognitive switching and learning ability in older adults.
abstract: BACKGROUND
  Cognitive set shifting requires flexible application of lower level processes. The Delis-Kaplan Executive Functioning System (DKEFS) Color-Word Interference Test (CWIT) is commonly used to clinically assess cognitive set shifting. An atypical pattern of performance has been observed on the CWIT; a subset of individuals perform faster, with equal or fewer errors, on the more difficult inhibition/switching than the inhibition trial. This study seeks to explore the cognitive underpinnings of this atypical pattern. It is hypothesized that atypical patterns on CWIT will be associated with better performance on underlying cognitive measures of attention, working memory, and learning when compared to typical CWIT patterns.
  
  
  METHODS
  Records from 239 clinical referrals (age: M = 68.09 years, SD = 10.62; education: M = 14.87 years, SD = 2.73) seen for a neuropsychological evaluation as part of diagnostic work up in an outpatient dementia and movement disorders clinic were sampled. The standard battery of tests included measures of attention, learning, fluency, executive functioning, and working memory. Analyses of variance (ANOVAs) were conducted to compare the cognitive performance of those with typical versus atypical CWIT patterns.
  
  
  RESULTS
  An atypical pattern of performance was confirmed in 23% of our sample. Analyses revealed a significant group difference in acquisition of information on both nonverbal (Brief Visuospatial Memory Test-Revised, BVMT-R total recall), F(1, 213) = 16.61, p < .001, and verbal (Hopkins Verbal Learning Test-Revised, HVLT-R total recall) learning tasks, F(1, 181) = 6.43, p < .01, and semantic fluency (Animal Naming), F(1, 232) = 7.57, p = .006, with the atypical group performing better on each task. Effect sizes were larger for nonverbal (Cohen's d = 0.66) than verbal learning (Cohen's d = 0.47) and semantic fluency (Cohen's d = 0.43).
  
  
  CONCLUSIONS
  Individuals demonstrating an atypical pattern of performance on the CWIT inhibition/switching trial also demonstrated relative strengths in semantic fluency and learning.
authors.affiliation: a Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , NV , USA.
authors.forename: Jody-Lynn
authors.initials: JL
authors.lastname: Berg
authors.affiliation: a Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , NV , USA.
authors.forename: Natasha M
authors.initials: NM
authors.lastname: Swan
authors.affiliation: a Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , NV , USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Banks
authors.affiliation: a Cleveland Clinic Lou Ruvo Center for Brain Health , Las Vegas , NV , USA.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D007858:Learning / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011597:Psychomotor Performance / Q000502:physiology*; D012015:Reference Standards; D055815:Young Adult
keywords: Color–Word Interference Test; Executive functioning; cognitive switching; inhibition; learning ability