digit symbol substitution test

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| purpose =test which is sensitive to brain damage

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Digit symbol substitution test (DSST) is a neuropsychological test sensitive to brain damage, dementia, age and depression. The test is not sensitive to the location of brain-damage (except for damage comprising part of the visual field).{{cite book |author1=Lezak, M.D. |author2=Howieson, D.B. |author3= Loring, D.W. |name-list-style=amp |title= Neuropsychological assessment |publisher= Oxford University Press|location= New York|year= 2004| url=https://books.google.com/books?id=FroDVkVKA2EC&q=%22Digit+Symbol-Coding%22&pg=PA368| pages=368–370 |isbn= 978-0-19-511121-7 }}

It consists of (e.g. nine) digit-symbol pairs (e.g. 1/-, 2/┴, ... 7/Λ, 8/X, 9/=) followed by a list of digits.{{cite journal | url=http://www.stacommunications.com/journals/diagnosis/2002/02-February/dxfeb02Concussion.pdf | title=Concussions: A Head-On Approach | author=Chris Adam | author2=Neil Craton | journal=The Canadian Journal of Diagnosis | year=2002 | pages=101–115}}{{cite journal | url=http://www.sportmed.mb.ca/uploads/pdfs/Concussions-Craton.pdf | title=Concussions-Craton.pdf | archive-url=https://web.archive.org/web/20110706184941/http://www.sportmed.mb.ca/uploads/pdfs/Concussions-Craton.pdf | archive-date=2011-07-06}}{{cite book |author1=Brukner, P. |author2=Khan, K. |author3= Kron, J. |name-list-style=amp |title= The encyclopedia of exercise, sport and health|publisher= Allen & Unwin |location=Crows Nest, N.S.W.|year= 2004| url=https://books.google.com/books?id=SCld4N1xpdMC&q=%22Digit+symbol+substitution+test%22&pg=PA109|page=109 |isbn= 1-74114-058-7 }} Under each digit the subject should write down the corresponding symbol as fast as possible. The number of correct symbols within the allowed time (e.g. 90 or 120 sec) is measured.

The DSST contained in the Wechsler Adult Intelligence Scale is called 'Digit Symbol' (WAIS-R), 'Digit-Symbol-Coding' (WAIS-III), or most recently, 'Coding' (WAIS-IV). Based on The Boston Process Approach to assessment, in order to examine the role of memory in Digit-Symbol-Coding performance, WAIS-III (but not WAIS-IV{{cite book |url=https://books.google.com/books?id=4iHTzkqdQYQC&q=deletions+%22Digit+Symbol%22+%22Incidental+Learning%22&pg=PT49|lccn=2009015529

|author=Lichtenberger, E.O.

|title=Essentials of WAIS-IV assessment

|author2=Kaufman, A.S.

|location=Hoboken, N.J.

|publisher=Wiley

|year=2009

|series= Essentials of Psychological Assessment

|page=27

|isbn=978-0-471-73846-6}}) contains an optional implicit learning test: after the Digit Symbol-Coding test paired and free recall of the symbols is assessed.{{cite book

|title=Understanding psychological assessment

|series=Perspectives on individual differences

|page=23

|author=Ryan, J.J. | author2= Lopez, S.J.|name-list-style=amp

|chapter=Wechsler adult intelligence scale-III

|publisher= Kluwer Academic/Plenum Publishers

|location=New York

|year=2001

|editor1=W.I. Dorfman |editor2=M. Hersen |chapter-url=https://books.google.com/books?id=RkBuWf28ok0C&q=%22Digit+Symbol-Incidental+learning%22+&pg=PA36

|isbn=978-0-306-46268-9

}}{{cite book |author= Milberg, W.P. | author2= Hebben, N. | author3=Kaplan, E.|name-list-style=amp

| chapter= The Boston Process Approach to Neuropsychological Assessment

|chapter-url=https://books.google.com/books?id=8_tmbkk8OQ8C&q=WAIS-III+incidental+learning&pg=PT66

|title=Neuropsychological assessment of neuropsychiatric and neuromedical disorders

|editor1=I. Grant |editor2=K.M. Adams |year=2009

|page=49

|edition=3rd

|location= Oxford

|publisher= Oxford University Press

|isbn=978-0-19-537854-2

}}{{cite book |page=125

|title=Neuropsychological interpretation of objective psychological tests

|author1=Golden, C.J. |author2=Espe-Pfeifer, P. |author3= Wachsler-Felder, J. |name-list-style=amp |location=New York

|publisher=Kluwer Academic/Plenum

|year=2000

|series=Critical issues in neuropsychology

|isbn=978-0-306-46224-5

|url= https://books.google.com/books?id=7O66Q2-Oa9gC&q=WAIS-III+incidental+learning&pg=PA125

}}{{cite book |author1=Lezak, M.D. |author2=Howieson, D.B. |author3= Loring, D.W. |name-list-style=amp |title= Neuropsychological assessment |publisher= Oxford University Press|location= New York|year= 2004| url=https://books.google.com/books?id=FroDVkVKA2EC&q=Digit-Symbol+%22incidental+learning%22&pg=PA472| page=472 |isbn= 978-0-19-511121-7 }}

The National Health and Nutrition Examination Survey (NHANES) administered the DSST to over three thousand participants 60 years and older in 2011–2014. Trained interviewers administered the test at the end of a face-to-face private interview in an examination center and two interviewers independently scored the test. An extensive analysis of these data has been published.{{cite journal |last1=Brody |first1=D.J. |last2=Kramarow |first2=E.A. |last3=Taylor |first3=C.A. |last4=McGuire |first4=L.C. |title=Cognitive Performance in Adults Aged 60 and Over: National Health and Nutrition Examination Survey, 2011-2014 |journal=Natl Health Stat Report |date=1 Sep 2019 |issue=126 |pages=1–23 |publisher=CDC/National Center for Health Statistics|pmid=31751207 }} Scores (mean, 25th percentile, 75th percentile) declined with age: 60-69y: 57, 46, 68; 70-79y: 48, 38, 68; 80+y: 40, 29, 49.