Incremental validity of the test of practical judgment (TOP-J) in the prediction of diagnosis in preclinical dementia

The Test of Practical Judgment (TOP-J) has not been thoroughly investigated in terms of its incremental validity. In the current study, we explored whether the TOP-J adds unique and meaningful information to the neuropsychological assessment beyond other executive functioning tests that are often used as proxies for practical judgment. Ninety-seven older adults who were classified as cognitively unimpaired, with subjective cognitive decline, or with mild cognitive impairment completed a comprehensive neuropsychological evaluation. Incremental validity was assessed through hierarchical ordinal regression analysis by modeling the TOP-J (Forms A and B, 15-item and 9-item versions), in addition to widely used tests of executive function, with participant classification/diagnosis as the outcome. The addition of the TOP-J (both 15-item versions) added incremental validity beyond traditional executive functioning measures to predict diagnosis. Including the TOP-J within neuropsychological evaluations of older adults may enhance differentiation of preclinical dementia diagnoses and provide clinically valuable information to the exam.