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Predicting Functioning in Assisted Living: The Role of NAB Judgment Scores

This study investigates the predictive ability of NAB Judgment (NAB-JDG) scores in assessing functioning within an assisted living sample, including patients with cognitive impairment. Findings indicate that NAB-JDG scores demonstrated strong internal consistency and predicted basic and instrumental activities of daily living (ADLs), surpassing the predictive capacity of general cognitive measures like MMSE. Significant differences were observed between participants with and without informed consent decisional capacity. Results support the ecological validity of the NAB-JDG in evaluating judgment capabilities, particularly in dementia patients.

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Predicting Functioning in Assisted Living: The Role of NAB Judgment Scores

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  1. Can Judgment Predict Functioning in Assisted-Living? Elizabeth E. MacDougall, Ph.D. & William E .Mansbach, Ph.D. Hood College & MedOptions WHAT WE LEARNED • In a clinically-referred, assisted living sample: • NAB Judgment (NAB-JDG) scores displayed good internal consistency reliability. • NAB-JDG scores predicted basic and instrumental ADLs over and above a measure of general cognitive functioning (MMSE). • There were significant group differences on the NAB-JDG between participants with and without informed consent decisional capacity. RESULTS BACKGROUND • Neuropsychologists have called for better measures of judgment (Rabin et al., 2008). • The NAB-JDG (Stern & White, 2003) is an orally administered test that includes 10 practical judgment questions involving home safety and health/medical concerns. • There are no NAB-JDG data for dementia patients presented in the NAB manual. • Although the NAB-JDG is described in the manual as a test created with ecological validity in mind, there is no empirical evidence presented to support this claim. • Sample Demographics: • Median age – 84.5 • 71% female • 90% Caucasian • 65% widowed • 82% HS or more education • NAB-JDG scores ranged from 1 to 20 and were normally distributed: - Mean =13.48; standard deviation = 4.06. • Cronbach’s α based on standardized items =.82. 18 – 10 – 5 – 0 - Mean NAB Judgment Raw Score OBJECTIVES Yes No Did the participant have the capacity to consent? Error Bars: 95% CI Hierarchical multiple regression model with MMSE and NAB-JDG as predictors of PSMS To extend the initial work done by White and Stern (2003) on the reliability and validity of NAB-JDG scores and score inferences in an assisted-living sample with a high base rate of dementia. To contribute preliminary empirical evidence regarding the ecological validity of the NAB-JDG by examining the relation of the NAB-JDG with basic and instrumental ADLs. Hierarchical multiple regression model with MMSE and NAB-JDG as predictors of IADLs METHODS • 88 participants completed the NAB-JDG as part of a flexible battery of neuropsychological tests administered to assisted-living residents referred for evaluation of cognitive dysfunction. • Exclusion criteria: • <60 years old • <5 years of education • Any medical or psychiatric symptoms that would prevent the participant from completing the evaluation Note: R2 = .­11 for Step 1, ΔR2 = .08 for Step 2 (p < .01). *p < .01. Note: R2 = .­42 for Step 1, ΔR2 = .08 for Step 2 (p < .001). *p < .01, **p < .001. References: Rabin, L.A., Borgos, M.J., & Saykin, A.J. (2008). A survey of neuropsychologists’ practices and perspectives regarding the assessment of judgment ability. Applied Neuropsychology, 15, 264-273. Stern, R.A., & White, T. (2003). Neuropsychological assessment battery. Lutz, FL: Psychological Assessment Resources.

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