搜索结果：The Clinical neuropsychologist

Objective: To provide the Steering Committee's perspective on the challenges, controversies, and missteps that emerged during the development of the Minnesota Conference (MNC) Training Guidelines, with a focus on two primary areas of major discussion: Content and Process. This commentary also highlights emerging issues relevant to the future implementation and evolution of the guidelines. Methods: Meeting records, draft documents, stakeholder feedback, and public commentary were reviewed and synthesized to identify and categorize major areas of controversy and challenges during the development of the Minnesota Guidelines. Results: Process-related issues centered on concerns about the involvement of trainees and early-career neuropsychologists in the conference, perceived lack of transparency and communication throughout the process, unclear role expectations, and challenges surrounding the voting process. Emerging issues post-conference included how to effectively implement the guidelines amid current legal and political challenges. Content-related controversies and challenges included the inclusion of the two-year clinical fellowship requirement, the initial omission of a Brain and Behavior competency, and the broader shift toward a competency-based training model. Further discussions involved the proposed removal of the self-care competency, inclusion of a stand-alone forensic competency, clarification of expectations for scholarly activity, and the presentation of diversity-related language throughout the Guidelines. Conclusion: The development of the Minnesota Guidelines highlighted controversies and challenges related to both content and process, underscoring the complexity of reaching consensus among diverse, multi-level stakeholders. These challenges provide insights and concrete recommendations to prevent similar issues and guide future revisions of the Guidelines.

Objective: The Minnesota Conference (MNC) Guidelines for Education and Training in Clinical Neuropsychology reflect the specialty's effort to create competency-based training standards aligned with current and future needs. This article summarizes delegate perspectives on the MNC guideline revision process to inform future updates. Method: A feedback survey was distributed to all 55 delegates from June 12-22, 2025. Delegates rated their satisfaction with four aspects of the process: the in-person conference, post-conference writing process, Steering Committee communication, and the delegate role in the writing process. Open-ended feedback was collected and analyzed thematically. The authors (who are delegates) have also integrated reflections throughout the article. Results: The survey received 34 responses (62%). Satisfaction varied across the four domains queried, with the in-person conference receiving the highest satisfaction ratings (59% of respondents reported feeling "satisfied" or "very satisfied") and communication from the Steering Committee receiving the highest dissatisfaction ratings (50% of respondents reported feeling "dissatisfied" or "very dissatisfied"). In addition to several strengths, a recurring recommendation was a desire for increased transparency during the post-conference writing phase and improved communication throughout the entire process. Conclusions: The MNC revision process included years of planning and organization led by the Planning Commission and Steering Committee and was a herculean task that deserves tremendous praise. The present article highlights several strengths of the revision process, challenges regarding procedure and communication, and provides constructive feedback for future revisions. The authors believe these guidelines will advance the field and are optimistic that the recommendations provided can support future guidelines revision efforts.

To provide guidance for implementation of the Minnesota Conference Guidelines (MNC Guidelines) within doctoral, internship, post-doctoral fellowship, and continuing education programs. The development and maintenance of competencies in clinical neuropsychology is the goal of combined training at these four levels. In this paper, implementation guidance uses terminology consistent with the current Clinical Neuropsychology Taxonomy and current competency development concepts in the specialty. Delegates to the Minnesota 2022 Update Conference on Education and Training in Clinical Neuropsychology (MNC) were invited to participate in the drafting of this document. The MNC Steering Committee organized this process. Delegates were formed into four drafting teams (Doctoral, Internship, Fellowship, and Continuing Education), each with a Team Lead. Teams provided initial drafts that identified training opportunities at each level and provided example training activities to address the 13 MNC Guidelines competencies. The manuscript's lead authors (SC, AYS, RB) then edited and integrated these drafts and worked iteratively with Team Leads to produce the current document. The paper provides a conceptual framework for the MNC Guidelines, addresses supervision across training levels, discusses training activities that can be implemented to address the MNC Guidelines competencies, and discusses potential challenges to that implementation. The learning activities contained in these guidelines draw heavily upon existing training methods that are already in wide use across the specialty of clinical neuropsychology. These Implementation Guidelines are intended to provide training programs and individuals with non-prescriptive guidance on training activities designed to develop and maintain competency across all 13 of the MNC competencies.

The objective of the present study was to assess the inter-rater reliability of MoCA subtests with automated administration and retrospective manual scoring and to evaluate if advanced scoring instructions improved inter-rater reliability. MoCAs were administered through the MoCA Electronic Data Capture platform using a digital version of the MoCA, the MoCA Solo, and were independently scored manually after administration by three raters. Raters were blind to the scores from other raters, were trained in the administration and scoring of the MoCA and had several years of clinical experience. The study shows good to excellent inter-rater reliability for the total MoCA (0.91-0.96) and for most of the subtests and individual test items under both the original and advanced scoring instructions. Only for the Cube (0.58), Clock numbers (0.50) and Clock hands (0.58), the inter-rater reliabilities are fair under the original scoring instructions. Using the advanced scoring instructions increased the inter-rater reliabilities for these three tests from fair to good for the Cube (0.65) and Clock hands (0.66) and from fair to excellent for the Clock numbers (0.78), while slightly decreasing total MoCA scores (-0.32). Small modifications to the advanced scoring instructions reduced the difference in total MoCA scores (-0.22) while preserving good inter-rater reliability. Given the small difference in total MoCA score and weighting this difference against the increases in inter-rater reliability overall, we conclude that the advanced scoring instructions represent a meaningful improvement, providing greater consistency between raters with only a minimal impact on total scores.

Objective: Digit span tests are neurocognitive tests that measure attention and working memory. They depend on language-based auditory input and verbal responses. This study examined the effects of language of digit span administration in a linguistically diverse South African sample. Method: Data were drawn from four South African normative studies (N&#x2009;=&#x2009;512; ages 8-79) that included a digit span test as part of a broader neuropsychological battery. Data were stratified by age, education level and quality, and language. Forward and backward span scores were analyzed in relation to these variables. Results: For the forward span, amongst the educationally advantaged and disadvantaged children and the advantaged adults, the participants who heard and said the numbers in Afrikaans when it was their first language, scored significantly worse than those who heard and said the numbers in English when English was or was not their first language (t(23) = -4.48, p = <.001 for disadvantaged children; t(117) = -2.2, p = .03 for advantaged children; t(104) = -5.48, p < .001 for advantaged adults). Significant differences were not found for the educationally disadvantaged adults, although there was a trend toward lower scores when the numbers were said in Afrikaans. For the backward span, no significant differences were found when the numbers were or were not heard and said in the participants' first language. Findings suggest that digit span may be sensitive to auditory-linguistic interference in people who speak more than one language, complicated by language proficiency and complexity of number names. Conclusions: In multilingual settings, digit span test performance may be affected by both first language and language of administration. These findings support the need for neuropsychological norms that also stratify for examinees' language and the language of administration. Clinical neuropsychologists should consider factors such as language proficiency and complexity of number names when assessing working memory in linguistically diverse populations.

Objective: Teleneuropsychology (TeleNP) shows promise as an alternative visit type for patients in which face-to-face (FTF) neuropsychological evaluation is not a viable option. Undergoing FTF presurgical deep brain stimulation (DBS) neuropsychological evaluations may represent a hardship for some patients with movement disorders, yet comparison of performance for TeleNP and FTF for the commonly used Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has not been studied in this population. The current study aimed to examine RBANS performance of FTF and TeleNP administration in a cohort of movement disorders patients in a clinical setting, hypothesizing similar performance regardless of modality. Method: Four hundred six patients with Parkinson's disease or essential tremor completed the RBANS between two medical centers between 2020 and 2024 as part of standard clinical care within their presurgical assessment for candidacy for DBS or High-Intensity Focused Ultrasound thalamotomy. Results: The TeleNP sample was significantly older than the FTF sample (p = .02). There were no statistical differences in gender (p = .18) or education (p = .66) between the samples. After controlling for age and motor diagnosis differences between the two groups, 9 of the 11 RBANS subtests were comparable, with the TeleNP group performing significantly better on the Picture Naming subtest and the FTF group performing significantly better on the Figure Recall subtest. The effect size of these differences were small, indicating relatively low clinical meaningfulness. Conclusions: The findings of the current study suggest the two methods of administration were associated with broadly comparable performances in this movement disorder population, suggesting TeleNP may be a viable option for presurgical evaluation.

Objective: systematically explore the available literature about unexplored neuropsychological domains in the characterization of the CNS involvement in DMD that could be relevant based on the recent findings about dystrophin expression in human CNS. Method: a scoping review was performed to comprehensively overview the neuropsychological scales/tests adopted on DMD patients. A systematic approach was applied to select pertinent papers among those published between 2000 and 2023. A labeling algorithm, based on Korkman and Luria's framework of neuropsychological sub-domains, was applied to classify the tools. Results: The data extraction process resulted in a landscape of 96 adopted different tools. The Wechsler scales were the most recurring tests. The use of the other tools was more scattered, and most of them recurred only once. The least assessed function was social cognition (n&#x2009;=&#x2009;18 references). Moreover, almost all adopted tests and scales referring to this domain were not specifically designed to assess social cognition. Conclusions: dystrophin is highly expressed in structures involved in the brain networks underlying some social cognition skills. Our results, which provide evidence of a gap in the study of social cognition in DMD, underscore the importance of assessing this domain as a possible feature of the CNS phenotype of the disease, consistent with a few other previous reports.

Objective Inconsistency, or intra-individual variability in performance across time (IIV-I), is a possible marker of subtle cognitive weakness. Little neuropsychological research on IIV-I has occurred, and its neurocognitive underpinnings remain unclear. Some hypothesize IIV-I is a unique construct that taps into specific neuroanatomic/cognitive processes, regardless of the task from which IIV-I was derived. However, IIV-I could also be a novel approach to measuring the same constructs being measured by the tasks from which IIV-I was derived. The present study sought to investigate IIV-I's (a) construct validity (i.e., its relationships with standard clinical measures of cognition) and (b) incremental utility beyond mean performance on the same task to help elucidate the clinical utility of IIV-I variables. Method A sample of 72 community-dwelling older adults completed clinical measures and computerized tasks used to derive IIV-I that tapped into processing speed, inhibition, and working memory (i.e., domains that have demonstrated associations with IIV-I). Results In multiple linear regressions, IIV-I variables demonstrated associations with clinical measures with shared neurocognitive underpinnings as the task from which the IIV-I variable was derived. Additionally, in hierarchical regressions, one IIV-I variable demonstrated potential for incremental utility beyond mean performance. Conclusions The present findings suggest that IIV-I may not be an independent construct that shows consistent associations with particular cognitive processes, regardless of how it is measured. Rather, IIV-I variables may tap into the cognitive constructs being measured by the task from which they are derived. Additionally, the incremental utility of IIV-I must continue to be established.

Objective: The clock drawing test (CDT) assesses multiple cognitive functions, including visuospatial construction and executive planning, and it is a core feature of many cognitive screens. Recent evidence indicates that young adults may experience difficulties producing an accurate response and we present a closer examination of generational differences in CDT performance in the context of the Montreal Cognitive Assessment (MoCA), where a notable failure rate was observed in our young adult respondents. Method: A total of 165 younger adults (18-35&#x2009;years) and 53 healthy older adults (65-93&#x2009;years) completed the MoCA as part of a larger study. CDT performance was scored using MoCA criteria (contour, numbers, hands), and errors were further codified. Contour size was measured to assess constructional differences. Results: About 29.7% of young adults scored below MoCA cutoff (<26), compared to 45.3% of older adults, with only 63.6% of young adults achieving maximum CDT score. Young adults drew significantly smaller clocks, but there were no between-group differences in component scores. Hand placement accounted for the largest proportion of errors. Young adults outperformed older adults on some components of the screen, including executive function, yet still produced equivalent errors on the CDT. Conclusions: Although generally considered robust to demographic factors, the CDT revealed substantial inaccuracies among young adults, likely reflecting reduced familiarity with analogue clocks. These findings reveal the impact that these differences can have on a widely used cognitive screen. Accordingly, they also raise concerns about the long-term validity of the CDT, as expectations may lead to future misclassification in clinical settings.

Objective: Delusional syndromes of misidentification and/or reduplication (DSMRs) are based on the misidentification or duplication of people, places, objects, or events. A qualitative and comprehensive investigation was conducted to shed light on the core neurological and neuropsychological features and, neural correlates of all DSMRs, particularly Reduplicative Paramnesia for Place (RPP). Method: A detailed and systematic approach based on clinical, experimental, and neuroimaging data was carried out in a single case. We investigated the role played by the co-presence of an alteration of the sense of familiarity and damage to the critical belief evaluation system as a necessary condition for the generation of all DSMRs, and in particular for RPP. Results: Unlike most of previously described cases, RPP syndrome persists during the chronic phase in the context of a well-preserved global cognitive status whereas other forms of DSMRs tend to recover over time. In addition, there is a persistent alteration in the sense of familiarity and absence of critical evaluation of delusional beliefs. A structural disconnection analysis relates cortical-subcortical damaged areas and the corresponding white matter fasciculi with the clinical manifestation of DSMRs syndromes. Conclusions: The striato-capsular stroke coupled with subcortical damages and bifrontal cortical atrophy may explain the clinical manifestations and experimental data obtained and are in agreement with the bicomponential model hypothesis highlighting the role played by altered sense of familiarity in generating all DSMRs.

Objective: Preclinical research and cognitive neuroscience implicate the hippocampus as a critical node in the neurobiology of drug addiction, as is vividly illustrated in this clinical case study. Method: The patient, JD, was a 52-year-old male with a long history of severe cocaine use disorder who sustained a bilateral ischemic stroke to the hippocampus due to a cocaine-related overdose. He was evaluated at the initial injury and at 12-month follow-up. Results: While hospitalized, neuropsychological assessment revealed both severe 2-year retrograde amnesia and anterograde amnesia with preserved global cognitive functioning. At 12-month follow-up, JD exhibited a similar neuropsychological profile. Most significantly, JD reported full sustained remission of cocaine use disorder at follow-up, without cravings or effort to achieve this outcome and despite intact declarative and autobiographical memory of his past cocaine use. His remission was confirmed by his son with whom he lived. A 12-month follow-up 3T MRI confirmed bilateral total hippocampus volumes in <1st%ile compared to normative nomograms. In addition, high-resolution segmentation of the hippocampus comparing JD to a healthy community sample revealed that the largest differences were in the hippocampal tail , CA1 subfield, CA4 subfield, dentate gyrus, molecular layer, and fimbria of the hippocampal body. Conclusions: JD's case reveals the essential role of memory systems subserved by the hippocampus in maintaining addiction, even in the presence of declarative historical memories. Moreover, although no longer relevant for JD, this case underscores the importance addressing the memory systems in addiction treatment.

There is strong support for the use of performance validity tests (PVTs) in all neuropsychological evaluations, however, research examining racial, ethnic, and linguistic differences in failure rates remains scarce, particularly in younger populations. The current investigation sought to determine whether race/ethnicity, primary household language, and participant's first language predicts failure rates on the Test of Memory Malingering (TOMM), Memory Validity Profile (MVP), and Medical Symptom Validity (MSVT) in a large clinical sample. This sample included N&#x2009;=&#x2009;2,266 neurologically, racially, and linguistically diverse children, adolescents, and young adults (Mean age = 11.78 [SD = 3.98], range = 5-25; Female sex = 45.9%; mean FSIQ = 80.31 [SD = 18.57]) who completed one or more stand-alone PVTs as part of their neuropsychological assessment. PVT failure rates across groups were calculated and regression analyses assessed predictors of failure. Although those with a non-English household and child's first language had higher failure rates on TOMM and MVP (Chi-square), logistic regression analyses showed that race/ethnicity, primary household language, and child's first language did not predict PVT failures rates across measures above age of assessment and FSIQ. Notably, FSIQ was the most consistent predictor of PVT failure rates, with increasing FSIQ score being associated with lower likelihood of PVT failure (all p < .001). Findings suggest largely comparable failure rates across racial/ethnic/linguistic groups, reinforcing the clinical utility of PVTs in racially diverse populations.

Objective: The accurate diagnosis of posttraumatic stress disorder (PTSD) is essential in both clinical and forensic contexts. Indices assessing for PTSD symptom invalidity have primarily been validated in Western nations, and more research about the equivalence of these measures is needed when utilized in other countries. Therefore, this study cross-validated existing PTSD Checklist for DSM-5 (PCL-5) symptom validity indices in an African forensic sample. Method: Examinees were 115 African (Ugandan, Kenyan, and Zimbabwean) foreign nationals who had been employed as contractors on U.S. military bases in Iraq and Afghanistan. Examinees were seen for evaluation in a forensic context for claimed PTSD under the purview of the Defense Base Act, a mechanism for pursuing Worker's Compensation type claims. Examinees were classified as credible or non-credible responders based on independent, established symptom validity test findings. Results: The credible and non-credible groups did not differ based on demographic and background variables. Conversely, all three PCL-5 validity indices significantly differentiated the groups with medium effect sizes, and additional validity measures also differentiated groups with medium to large effects, supporting the accuracy of the classifications. Optimal PCL-5 cutoffs closely mirrored those identified in North American samples. When specificity was held at &#x2265;.90, two of the three PCL-5 validity indices yielded sensitivity rates of &#x2265;.30. Conclusions: The findings provide cross&#x2011;cultural support for PCL&#x2011;5 symptom validity indices and contribute to a growing body of evidence demonstrating their utility across diverse international samples. Consistent patterns across geographic regions suggest these indices may have broader applicability than previously established.

This systematic review and meta-analysis aims to synthesize the performance of older adults with and without neurocognitive impairment on the Auditory Verbal Learning Test (AVLT). Specifically, the study seeks to characterize the main features of AVLT versions used in older populations, identify the most frequently assessed psychometric measures and process-based indices, and evaluate how varying levels of neurocognitive impairment affect AVLT scores. This systematic review and meta-analysis was registered in PROSPERO and was conducted following PRISMA 2020 guidelines. A total of 44 studies were included in the review, with 42 included in the meta-analysis. Effect sizes were calculated using Hedges' g, and moderation and meta-regression analyses were performed. The most reported version was the Rey AVLT with 15-word lists, five learning trials, and a 20-minute delay interval. Process-based indices were underreported. Individuals with neurocognitive disorders (ND) showed significantly lower AVLT scores than healthy controls, with performance worsening in line with ND severity, particularly in delayed recall. Differences in Mini-Mental State Examination scores significantly moderated total learning effect sizes, while age significantly moderated recognition hits. The AVLT, particularly delayed recall, may be a robust tool for distinguishing among normal aging, mild and major ND. However, variability in AVLT administration reduces the diagnostic potential of AVLT. The diagnostic potential of process-based indices has not been explored adequately. Future research should prioritize the standardization of AVLT protocols and the integration of process-based indices to maximize its clinical utility in detecting and tracking neurocognitive decline.

Objective: The present study aimed to better understand key conceptualizations and operationalizations of intraindividual variability (IIV). We expected that differing types and metrics of IIV would relate to one another and predict outcomes (academic achievement) similarly. Method: The sample comprised 238 young adults. IIV was computed within and across six measures - three related to math and three more generally cognitive; in each case, score was separated from response time. We computed three types of IIV (inconsistency, dispersion, and dispersion of inconsistency), across several metrics (standard deviation, coefficient of variability, residualized standard deviation), and assessed their interrelations, and their prediction of academic achievement. Results: Differing metrics of variability were related to one another, but variably so. For prediction, whether or not inconsistency IIV metrics were significant was highly dependent on the measure they were derived from, with or without the primary score for a given measure also included. For dispersion of inconsistency and dispersion, variability metrics were often significant, though this was eliminated in most cases when score was also included in models. Conclusions: By concurrently examining multiple metrics and types of IIV within the same set of measures, this study highlights the need to (a) clarify the type of IIV utilized and why; (b) clarify the rationale for the kinds of measures used to compute IIV, particularly dispersion; and (c) include score alongside timing. Doing so will likely improve the generalizability of IIV findings, and prompt future research avenues, both psychometric- (e.g. simulations) and clinical-related (e.g. across ages and populations).

Technological advancements have boosted neuropsychology development. Recently, the term Digital Neuropsychology (DN) has been introduced to describe the assessment and training of cognitive functions using digital tools. However, little is known about the development and implementation of these tools, particularly in low-and middle-income countries. This study aimed to synthesize state-of-the-art DN tools in Latin America (LA). Following PRISMA guidelines, a scoping review was conducted between June and December 2024. Three electronic databases were searched: PubMed/MEDLINE, SciELO, and RedALyC. A gray literature search was also performed using Google Scholar and university thesis repositories. Studies published between 2014 and 2024 in English or Spanish were included. Of the 662 screened studies, 28 met the inclusion criteria and were fully reviewed. Brazil and Chile accounted for the highest number of studies. A likelihood ratio test indicated no significant deviation from equal distribution across countries. Cognitive assessment was the primary focus in 57.1% of studies, and serious video games were the most used technology (39.3%). Tablets (42.9%) and personal computers (32.1%) were the most frequently employed devices. No associations were found between technology and purpose, technology and device type, or country and purpose. Memory and attention were the most frequently assessed cognitive domains (32.1%). The increasing body of research highlights the potential of digital technology for cognitive assessment in LA. However, the development of DN in the region faces challenges, including the need for ecological validation studies, more extensive and diverse samples, and the establishment of normative data.

Objective: This study confirms the validity and diagnostic utility of the CINDD (Cargiver's Inventory Neuropsychological Diagnostic Dementia) in assessing cognitive status and behavioral-personality changes through informant-based questions grounded in real-life contexts. We explored the discriminative capacity of the CINDD across various dementia types. Method: We enrolled caregivers of 111 patients at their first diagnostic evaluation. The Clinical population included patients with Alzheimer's Disease (AD), behavioral Fronto-Tempoal Dementia (bvFTD), Dementia with Lewy Body (LBD), non-fluent Primary Progressive Aphasia (nfvPPA), and AD-like Mild Cognitive Impairment (MCI-AD). Patients also underwent a comprehensive neuropsychological assessment including memory, language, visuospatial, and executive function tests. Results: Each CINDD's domain demonstrated meaningful correlations with standard cognitive measures, supporting its construct validity. Notably, the Memory cluster showed strong associations with verbal memory but not with executive or language tasks, while the Language and Perception clusters aligned well with respective cognitive domains. Conversely, Executive and Personality/Behavior clusters did not show significant correlations with any of the neuropsychological measures. The Illusion/Delusion cluster, though targeting neuropsychiatric symptoms, also captured elements of cognitive disorganization seen in conditions like LBD and bvFTD. Diagnostic analyses provided robust cluster-specific cutoffs with acceptable sensitivity and specificity. Particularly, the Memory cluster effectively distinguished memory-dominant dementias (e.g. AD, MCI-AD) from language-predominant variants (e.g. nfvPPA). Conclusion: Finally, given its informant-based structure, the CINDD is especially valuable for assessing individuals with low education, illiteracy, or migrant backgrounds. We recommend its integration with traditional neuropsychological tools to enhance diagnostic accuracy in diverse clinical populations.

Objective: Investigate the association between concussion and reactivity of cardiovascular, salivary, and electrodermal indicators of autonomic nervous system (ANS) function in the context of cognitive stress. Method: Individuals (N&#x2009;=&#x2009;37) with concussion were prospectively recruited from a level 1 trauma center emergency department, along with 23 uninjured community controls (UC). Participants were assessed twice (1-week and 1-month post-injury for the concussion group). Electrocardiogram, impedance cardiography, electrodermal skin conductance, and saliva samples were collected before, during, and after a modified Paced Auditory Serial Addition Test. Analyses evaluated the effect of Group, Visit, and task Event on behavioral and physiological variables. Physiological reactivity to the task was correlated with Rivermead Post Concussive Symptom Questionnaire (RPQ) total scores. Results: The UC group showed augmented heart rate (HR) task responses when compared to the concussion group (effect ranging from d&#x2009;=&#x2009;0.53 to 0.82). Similarly, the UC group had reduced high-frequency HR variability (HF-HRV) task response, indicating parasympathetic (PNS) withdrawal during cognitive engagement (effects ranging from d&#x2009;=&#x2009;0.25 to 0.80). The concussion group displayed no significant HF-HRV changes during the task. There were no reliable group differences in sympathetic nervous system measures (i.e. PEP, skin conductance, and salivary alpha amylase). Among concussed individuals, greater increase in HR task response at 1&#x2009;week was associated with lower concussion symptom burden at 1&#x2009;month. Conclusions: Findings indicate that blunted ANS, and especially PNS, reactivity to cognitive stress is associated with concussion in community adults and that ANS dysfunction may be prognostic of symptom recovery.

Accurate cognitive screening tests for culturally, linguistically, and educationally diverse populations remain scarce, contributing to diagnostic inequities. To address this, we examined the cross-cultural properties and diagnostic accuracy of the Multicultural Cognitive Examination (MCE) in classifying mild cognitive impairment (MCI), dementia, Alzheimer's disease (AD) dementia, and non-AD dementia in participants with diverse backgrounds. In this retrospective cross-sectional study, we aggregated data from 1,449 participants across 11 countries. Multiple linear regression models were used to determine the influence of demographic variables on MCE scores, which informed the creation of regression-based normative data. Diagnostic accuracies were examined using Receiver Operating Characteristics (ROC) curves. The cohort consisted of 1001 cognitively intact participants, 140 patients with MCI, and 308 patients with dementia. 54.2% had immigrant backgrounds and originated from 63 different countries. MCE scores were significantly influenced by education and age, but not by sex or immigrant status. The MCE demonstrated high accuracy in differentiating cognitively intact participants from patients with dementia (AUC: .95) and MCI (AUC: .84). The MCE was both accurate for classifying AD dementia (AUC: .97) and non-AD dementia (AUC: .94). This study supports the clinical utility of the MCE as a culturally robust and highly accurate cognitive screening test. Future studies should examine the ability of the MCE to monitor cognitive decline.