Key result
The Hayling and Brixton tests effectively detected cognitive decline in adults with dementia, with Automatic RT and Inhibition Errors showing the largest effects compared to healthy controls.
Why the study?
The effectiveness of the Hayling and Brixton tests for detecting cognitive decline in dementia, neurodegenerative disorders, and mild cognitive impairment had not yet been collated.
Are the Hayling and Brixton tests effective for detecting cognitive decline in middle to older aged adults with dementia, neurodegenerative disorders, or mild cognitive impairment compared to healthy controls?
Systematic Review (n=3,905)
Are the Hayling and Brixton tests effective for detecting cognitive decline in middle to older aged adults with dementia, neurodegenerative disorders, or mild cognitive impairment compared to healthy controls?
The Hayling and Brixton tests are effective for detecting cognitive decline in middle to older aged adults, particularly those with dementia, though they cannot reliably differentiate between dementia types.
Answers are grounded in this paper and cite their sources.
Supports Hayling and Brixton tests for dementia cognitive screening; confirms large effects on inhibitory control measures.
The aging population is increasing the prevalence of dementia, neurodegenerative disorders, and mild cognitive impairment, which are associated with cognitive declines in executive functioning. In people with these disorders, accurate tests can aid in the early detection of executive functioning decline and facilitate access to interventions. The Hayling and Brixton tests (HBTs) are popular executive functioning tests that assess inhibitory control. The HBTs may be especially effective for detecting people with disorders that are associated with disinhibition, such as behavioral-variant frontotemporal dementia (bvFTD). However, the effectiveness of the HBTs for detecting cognitive decline in dementia, neurodegenerative disorders, and mild cognitive impairment has yet to be collated. A comprehensive search of five databases identified 50 studies that compared the HBTs performances of adults aged 40 years and over with a dementia, neurodegenerative disorder, or mild cognitive impairment (e.g., Parkinson's disease, Alzheimer's dementia, bvFTD) and cognitively-healthy controls. Hedges' g effect sizes compared groups on the five HBTs scores (Inhibition Errors, Inhibition Reaction Time (RT), Automatic RT, Inhibition minus Automatic RT, and Brixton Errors). The disorders (combined) showed negative effects on all HBTs scores (g - 0.37 to - 1.13), with dementia (combined) performing the worst (g - 0.54 to - 1.56). Automatic RT and Inhibition Errors were the most effective scores for detecting cognitive decline in dementia (g - 1.55; g - 1.34). The dementia types performed similar after outliers were removed and only studies with low risk-of-bias were analyzed. Overall, the HBTs are effective for detecting cognitive decline in middle to older aged adults, especially those with dementia. However, no score type can be recommended for differentiating the dementia types, such as AD and bvFTD.
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Palombo et al. (2025) conducted a systematic review in Dementia, Progressive Cognitive Decline, and Mild Cognitive Impairment (n=3,905). Hayling and Brixton Tests vs. Cognitively healthy controls was evaluated on Detection of cognitive decline in dementia (Inhibition Errors score) (Hedges' g -1.34, p=<0.05). The Hayling and Brixton tests effectively detected cognitive decline in adults with dementia, with Automatic RT and Inhibition Errors showing the largest effects compared to healthy controls.
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