Kaiser Permanente Redwood City, Integrated Behavioral Health Services-Mental Health, Redwood City, CA, USA.
Department of Veterans Affairs, VA Palo Alto Health Care System, Palo Alto, CA, USA.
Arch Clin Neuropsychol. 2023 Jan 21;38(1):106-118. doi: 10.1093/arclin/acac067.
The Benton Visual Form Discrimination Test (VFDT) is a commonly used measure of visual discrimination and visual recognition memory and has shown promise in distinguishing between different levels of cognitive impairment. We assess the predictive diagnostic utility of the VFDT in a sample of older Veterans with cognitive concerns.
Subjects included a total of 172 mostly male Veterans over the age of 64 (mean = 76.0; SD = 7.6) recruited from a VA clinic specializing in neuropsychological assessment of older Veterans. The clinical sample included 56 subjects diagnosed with Major Neurocognitive Disorder, 74 diagnosed with Mild Neurocognitive Disorder, and 42 with No Neurocognitive Impairment. Impairment categories were modeled in separate multinomial logistic regressions with two versions of the VFDT as predictors: the Visual Form Discrimination Test-Recognition Subtest (VFDT-Rec) test (visual recognition memory) and the Visual Form Discrimination Test-Matching Subtest VFDT-Mat test (visual form discrimination). Years of education were included as a covariate.
After adjusting for education, higher VFDT-Rec total scores were associated with lower odds of being categorized with a greater degree of cognitive/functional impairment (OR 0.66-0.83, p < .001). VFDT-Mat scores showed a similar pattern, but only reached statistical significance for the Major versus No Neurocognitive Impairment (OR = 0.77, p = .0010) and Major versus Mild comparisons (OR = 0.89, p = .0233).
The VFDT may enhance the confidence of differential diagnosis of dementia in older adult Veterans. Formal education-adjusted norms need to be established for clinical use.
本研究旨在探讨 Benton 视觉形式辨别测验（VFDT）在认知障碍鉴别诊断中的预测诊断价值。
本研究共纳入 172 名年龄大于 64 岁的退伍军人，他们均来自一家退伍军人事务部的认知评估专科门诊。临床样本包括 56 名被诊断为重度认知障碍、74 名被诊断为轻度认知障碍、42 名认知正常的患者。将两个版本的 VFDT （VFDT-Rec 和 VFDT-Mat）作为预测因子，分别采用二项逻辑回归对以上三个认知损伤组别进行建模，同时校正教育年限的影响。
校正教育年限后，VFDT-Rec 总评分越高，认知/功能损伤程度越轻（OR 0.66-0.83，p<.001）。VFDT-Mat 评分也呈现出相似的模式，但仅在重度与非认知障碍（OR=0.77，p=.0010）和重度与轻度认知障碍（OR=0.89，p=.0233）之间具有统计学意义。
VFDT 可能有助于提高老年退伍军人痴呆症鉴别诊断的准确性。为了临床应用，需要建立正式的教育调整后的常模。
