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. 2023 Jan 21;38(1):106-118.
doi: 10.1093/arclin/acac067.

The Benton Visual Form Discrimination Test as a Predictor of Neurocognitive Disorder in Older Veterans

Brian A Maruyama  1 , Valerie Z Alipio Jocson  2 , Julie Gretler  2   3 , Kelly Doudell  4 , Laura C Lazzeroni  5 , Beatriz Hernandez  5 , Art Noda  5 , Jerome A Yesavage  2   5 , Lisa M Kinoshita  2
Affiliations

The Benton Visual Form Discrimination Test as a Predictor of Neurocognitive Disorder in Older Veterans

Brian A Maruyama et al. Arch Clin Neuropsychol. .

Abstract

Objective: 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.

Method: 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.

Results: 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).

Conclusions: 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.

Keywords: Assessment; Dementia; Elderly/geriatrics/aging; Learning and memory; Mild cognitive impairment; Perception/spatial processing.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Predicted probabilities of achieving a diagnosis of No Neurocognitive Impairment, Mild Neurocognitive Disorder, and Major Neurocognitive Disorder by VFDT-Mat scores in subjects with No Neurocognitive Impairment. Predicted probabilities are presented as percentages and VFDT-Mat scores are represented by raw score values. Multiple bars per raw score value indicate variability in performance among individuals within a specific diagnostic category. VFDT-Mat = Visual Form Discrimination Test-Matching Subtest.
Fig. 2
Fig. 2
Predicted probabilities of achieving a diagnosis of No Neurocognitive Impairment, Mild Neurocognitive Disorder, and Major Neurocognitive Disorder by VFDT-Mat scores in subjects with Mild Neurocognitive Disorder. Predicted probabilities are presented as percentages and VFDT-Mat scores are represented by raw score values. Multiple bars per raw score value indicate variability in performance among individuals within a specific diagnostic category. VFDT-Mat, Visual Form Discrimination Test-Matching Subtest.
Fig. 3
Fig. 3
Predicted probabilities of achieving a diagnosis of No Neurocognitive Impairment, Mild Neurocognitive Disorder, and Major Neurocognitive Disorder by VFDT-Mat scores in subjects with Major Neurocognitive Disorder. Predicted probabilities are presented as percentages and VFDT-Mat scores are represented by raw score values. Multiple bars per raw score value indicate variability in performance among individuals within a specific diagnostic category. VFDT-Mat, Visual Form Discrimination Test-Matching Subtest.
Fig. 4
Fig. 4
Predicted probabilities of achieving a diagnosis of No Neurocognitive Impairment, Mild Neurocognitive Disorder, and Major Neurocognitive Disorder by VFDT-Rec scores in subjects with No Neurocognitive Impairment. Predicted probabilities are presented as percentages and VFDT-Rec scores are represented by raw score values. Multiple bars per raw score value indicate variability in performance among individuals within a specific diagnostic category. VFDT-Rec, Visual Form Discrimination Test-Recognition Subtest.
Fig. 5
Fig. 5
Predicted probabilities of achieving a diagnosis of No Neurocognitive Impairment, Mild Neurocognitive Disorder, and Major Neurocognitive Disorder by VFDT-Rec scores in subjects with Mild Neurocognitive Disorder. Predicted probabilities are presented as percentages and VFDT-Rec scores are represented by raw score values. Multiple bars per raw score value indicate variability in performance among individuals within a specific diagnostic category. VFDT-Rec, Visual Form Discrimination Test-Recognition Subtest.
Fig. 6
Fig. 6
Predicted probabilities of achieving a diagnosis of No Neurocognitive Impairment, Mild Neurocognitive Disorder, and Major Neurocognitive Disorder by VFDT-Rec scores in subjects with Major Neurocognitive Disorder. Predicted probabilities are presented as percentages and VFDT-Rec scores are represented by raw score values. Multiple bars per raw score value indicate variability in performance among individuals within a specific diagnostic category. VFDT-Rec, Visual Form Discrimination Test-Recognition Subtest.
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