A DESCRIPTIVE STUDY OF ATTENTIONAL SETSHIFTING IMPAIRMENT IN A MIXED CLINICAL SAMPLE OF 4,044 MIDDLE-AGED AND OLDER ADULTS REFERRED FOR NEUROPSYCHOLO GICAL ASSESSMENT.

PURPOSE: Attentional set shifting refers to the ability to alternate attention between simultaneous tasks or goals and plays an important role in managing everyday activities. We examined impaired attentional set-shifting in middle-aged and older adults referred for neuropsychological evaluation. MATERĠAL and METHODS: We included a mixed clinical group of 4,044 adults (age:30-95) referred for neuropsychological assessment. Attentional set-shifting ability was examined using the part B of the Trail Making Test (TMT-B). In order to minimize the motor effect on TMTB, the difference score [TMT part B minus part A, TMT-(BA)] instead of the traditional TMT-B score was used. The prevalence and degree of impairment was evaluated based on previous reference data for TMT-(B-A) in Greek population and according to the well- accepted cut-off score of -1.5 standard deviation (SD) for cognitive impairment. The total group was divided into three age groups (<50, 50- 69, >70 years) and two levels of education (≤12, >12 years). RESULTS: Mean performance was calculated for each age/education group. We further calculated the percentage of patients whose TMT-(B-A) performance fell within the next categories, (i)<-1.5SD, (ii)≥-1.5SD. The results were as follows: (30-49/≤12): (i)50%, (ii)50%; (30-49/>12): (i)63.2%, (ii)36.8%; (50-69/≤12): (i)36%, (ii)63.9%; (50-69/>12): (i)54.2%, (ii)45.8%; (70-95/≤12): (i)27.1%, (ii)72.9%; (70- 95/>12): (i)49.4%, (ii)50.6%. CONCLUSĠON: The evaluation of attentional set shifting should be primarily examined in clinical neuropsychological practice, since irrespective of the presence of underlying pathology, patients referred for neuropsychological evaluation present high percent of impairment, which is more evident in older and less educated groups. [ABSTRACT FROM AUTHOR]