Regression-based normative data for the D-KEFS Color-Word Interference Test in Norwegian adults ages 20-85

Clin Neuropsychol. 2024 Jul;38(5):1227-1255. doi: 10.1080/13854046.2023.2276967. Epub 2023 Nov 16.

Abstract

Objective: The Delis-Kaplan Executive Function System (D-KEFS) Color-Word-Interference Test (CWIT; AKA Stroop test) is a widely used measure of processing speed and executive function. While test materials and instructions have been translated to Norwegian, only American age-adjusted norms from D-KEFS are available in Norway. We here develop norms in a sample of 1011 Norwegians between 20 and 85 years. We provide indexes for stability over time and assess demographic adjustments applying the D-KEFS norms. Method: Participants were healthy Norwegian adults from Center for Lifespan Changes in Brain and Cognition (LCBC) (n = 899), the Dementia Disease Initiation (n = 77), and Oslo MCI (n = 35). Using regression-based norming, we estimated linear and non-linear effects of age, education, and sex on the CWIT 1-4 subtests. Stability over time was assessed with intraclass correlation coefficients (ICC). The normative adjustment of the D-KEFS norms was assessed with linear regression models. Results: Increasing age was associated with slower completion on all CWIT subtests in a non-linear fashion (accelerated lowering of performance with older age). Women performed better on CWIT-1&3. Higher education predicted faster completion time on CWIT-3&4. The original age-adjusted norms from D-KEFS did not adjust for sex or education. Furthermore, we observed significant, albeit small effects of age on all CWIT subtests. ICC analyses indicated moderate to good stability over time. Conclusion: We present demographically adjusted regression-based norms and stability indexes for the D-KEFS CWIT subtests. US D-KEFS norms may be inaccurate for Norwegians with high or low educational attainment, especially women.

Keywords: Color-Word interference test; D-kefs; Neuropsychological tests; cWIT; cross-cultural neuropsychology; executive function; norms; norway; stroop test.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging / physiology
  • Executive Function* / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests / standards
  • Neuropsychological Tests / statistics & numerical data
  • Norway
  • Reference Values
  • Stroop Test*
  • Young Adult

Grants and funding

This work was supported by the University of Tromsø - the Arctic University of Norway; the university of Oslo; the Norwegian Research Council, Helse Nord under grant number HNF1540-20. Additional support was received from ERC grants (283634 and 725025 to AMF), Research Council of Norway grants to KBW and AMF, and European Commission (EC) EU Horizon 2020 Grant agreement number 732592 (Lifebrain project). The funding sources were not involved in the drafting of this manuscript.