Failed Performance on the Test of Memory Malingering and Misdiagnosis in Individuals with Early-Onset Dysexecutive Alzheimer's Disease

Nick Corriveau-Lecavalier, Eva C. Alden, Nikki H. Stricker, Mary M. Machulda, David T. Jones

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Individuals with early-onset dysexecutive Alzheimer's disease (dAD) have high rates of failed performance validity testing (PVT), which can lead to symptom misinterpretation and misdiagnosis. METHOD: The aim of this retrospective study is to evaluate rates of failure on a common PVT, the test of memory malingering (TOMM), in a sample of clinical patients with biomarker-confirmed early-onset dAD who completed neuropsychological testing. RESULTS: We identified seventeen patients with an average age of symptom onset at 52.25 years old. Nearly fifty percent of patients performed below recommended cut-offs on Trials 1 and 2 of the TOMM. Four of six patients who completed outside neuropsychological testing were misdiagnosed with alternative etiologies to explain their symptomatology, with two of these patients' performances deemed unreliable based on the TOMM. CONCLUSIONS: Low scores on the TOMM should be interpreted in light of contextual and optimally biological information and do not necessarily rule out a neurodegenerative etiology.

Original languageEnglish (US)
Pages (from-to)1199-1207
Number of pages9
JournalArchives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists
Volume37
Issue number6
DOIs
StatePublished - Aug 23 2022

Keywords

  • Alzheimer’s disease
  • Assessment
  • Dementia
  • Executive functions
  • Malingering/symptom validity testing

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Clinical Psychology
  • Psychiatry and Mental health

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