A Comparative Study of Tower of London Scoring Systems and Normative Data

作者：Michalec Jiri; Bezdicek Ondrej^*; Nikolai Tomas; Harsa Pavel; Jech Robert; Silhan Petr; Hyza Martin; Ruzicka Evzen; Shallice Tim

来源：Archives of Clinical Neuropsychology, 2017, 32(3): 328-338.

DOI：10.1093/arclin/acw111

• Tower of London
• Planning
• Scoring
• Parkinson's disease mild cognitive impairment
• Schizophrenia

Objective: Tower of London (ToL) is a planning ability task that includes multiple versions. The original ToL was developed by Shallice together with two scoring systems (ToL-SS). Another two ToL-SS were proposed by Anderson et al. and Krikorian et al. The purpose of this study is to provide normative data for four ToL-SS and explore the effects of demographic variables on ToL performance. Furthermore, we aimed to determine the discriminative validity of these ToL-SS in clinical samples.
Method: Four groups were included in the study: a normative sample of healthy adults (HC; n = 298); patients with Parkinson's disease with mild cognitive impairment (PD-MCI; n = 52) and without cognitive impairment (PD-ND; n = 57); and patients with schizophrenia (SCH; n = 28). The effects of demographic variables on ToL-SS were examined in the HC group. Between-groups comparisons of ToL-SS were conducted using regression analysis with dummy codes.
Results: All four ToL-SS were not significantly affected by age, whereas the effect of gender and education is not consistent. ToL-SS significantly (p < .05) differentiate HC from PD-MCI and SCH. Cohen's effect size coefficients d range from 0.68 to 1.29. Internal consistency coefficients (Cronbach's a) of ToL-SS range from 0.33 to 0.60.
Conclusions: Despite poor to questionable internal consistency of ToL-SS, the discriminative validity and clinical utility for assessing planning deficits in PD-MCI and SCH are high. This study provides normative standards for all four ToL-SS on an adult population for use in clinical practice.

• 出版日期2017-5