Systematic Reviews
Copyright ©The Author(s) 2015.
World J Psychiatr. Sep 22, 2015; 5(3): 305-314
Published online Sep 22, 2015. doi: 10.5498/wjp.v5.i3.305
Table 2 Clinical studies using the months backward test
Ref.Population and study purposeAssessment of MBT performance
Halstead[10,28] (1944)To develop a battery of tests for “senility” in 38 subjects, 20 with recognised dementiaPass/fail according to capacity to recite months in reverse from December to January
Young et al[20] (1997)To compare the performance of 522 uninjured high school athletes on three simple mental status tests that are commonly used on the sidelines for the evaluation of concussionsParticipants were given 1-min time limits for each test, with passing defined as either 7 consecutive correct iterations or 11 correct with one mistake
Ball et al[8] (1999)To evaluate the efficacy and reliability of the time to recite the months of the year in reverse order as a simple measure of central processing speed in 120 community-dwelling women, aged 67-94Timing of MBT performance commenced when the subject starts the sequence and continues regardless of omissions, juxtapositions, or corrections until the sequence is complete or 75 s has elapsed. Those unable to complete the sequence received a score of 75 s
Wildgruber et al[34] (1999)Comparison of MBT vs MFT in respect of brain activation using fMRI in 18 neurologically normal subjects aged 19-36Subjects silently recited the MFT and subsequently the MBT as fast as possible and continuously across the whole length of each activation period
Ettlin et al[27] (2000)Developing a scale (The FLS) to distinguish patients with various Ornagic brain difficultiesMBT rated from 0-2 in respect of both (1) accuracy (1 point for > 1 error of any kind) and (2) 1 point if completion time > 24 s
Lamar et al[22] (2002)A comparison of the capacity to sustain mental set in participants with AD vs IVD vs a NCAn AcI was calculated using the following algorithm: AcI = {1 - [(false positive + misses)/number of possible correct]} × 100 This algorithm yielded a percentage score such that patients obtaining a score of 100% correctly identified all targets and made no false positive responses or misses
Alderson et al[29] (2003)To develop a brief scale for assessing cognition in patients with TBIA 4 point scale was applied where 0 = unable to complete of ≥ 2 errors; 1 = able to complete but with 2 errors; 2 = able to complete but with one error; 3 = completed without error
Marinus et al[9] (2003)Development of a scale to assess cognition in PD. Eighty-five PD patients and 75 control subjects were assessed with a battery of tests of which the MBT was a significantly discriminating test of attention. Test–retest reliability was assessed in 30 patients after 6 wkPerformance rated on a scale of 0-2 but unclear how these scores were attributed
Rudolph et al[5] (2006)To determine the extent to which preoperative performance on tests of executive function and memory was associated with delirium after coronary artery bypass graft surgeryPass/fail according to ability to successfully recite from December back to January
Dubois et al[21] (2007)To develop consensus amongst an expert group regarding diagnostic procedures for PD dementiaPass/fail according to ability to successfully recite from December back to January. An unsuccessful performance equated with omission of two or more months, incorrect sequencing of the months, or failure to complete the test within 90 s
Ostberg et al[11] (2008)To explore the utility of the MBT in diagnosis of cognitive impairment in N = 234 memory clinic attenders with subjective cognitive impairments, mild cognitive impairment and ADParticipants recited the months in reverse chronological order as quickly as possible. Ability to conduct the test accurately and duration to task completion were measured
Shehata et al[14] (2009)To determine baseline symptom and neurocognitive norms in 260 university athletes with and without concussion histories using the SCATMonths in reverse order was assessed on a pass/fail basis where a subject passed if they were able to recite the 12 mo in reverse order with no mistakes. The test was considered a fail if any months were in the wrong order or missed
Roca et al[24] (2010)Comparison of neuropsychological performance in patients with documented frontal lobe lesions (n = 15) vs matched neurologically unimpaired controlsThe patient was asked to list the months of the year backwards, starting with December. If subjects made no errors, the score was 2; for one error, the score was 1; otherwise the score was 0
Schneider et al[15] (2010)Assessing performance on tests of cognition in hockey players aged 9-17 with and without a history of concussionThe MBT was conducted as part of the SCAT: Months in reverse order was assessed on a pass/fail basis where a subject passed if they were able to recite the 12 mo in reverse order with no mistakes
Grober et al[6] (2011)Investigating for predictors of diabetes control in 169 elderly diabeticsA composite score was constructed with 5 levels based upon animal naming and MBT performance as completed without errors, uncorrected errors or failed test
Östberg et al[19] (2012)Identification of adult norms and test-retest reliability for durational and response accuracy on the MBT in 216 neurologically intact adults (aged 18-88). A retest was conducted with 40 participants after 3 wkParticipants were instructed to recite the months in backward order as quickly as possible without making any errors. The duration from commencement to cessation was defined as the MB duration score. Any uncorrected sequence error was noted down, and the total number of errors was defined as the MB response accuracy score. Errors were taken to include omissions and transpositions. Repetitions were not scored as errors
Jinguji et al[13] (2012)To determine baseline scores in cognitive performance domains among 214 high school athletes with no prior history of a concussionAbility to recite the months of the year in reverse order to January
Ryan et al[16] (2013) and O’Regan et al[17] (2014)To screen for attention problems in 311 general hospital inpatients for further testing regarding possible delirium and dementiaPass vs fail according to whether subjects could reach July without major error/with minimal prompting
Tardiff et al[12] (2013)To identify predictors of cognitive decline in patients with Alzheimer’s dementiaPass vs fail according to whether subjects could correctly order the months from December to January
Bellelli et al[18] (2014)To evaluate a new screening tool for delirium (4AT) in 236 elderly medical patientsMBT performance rated as: Achieves 7 mo correctly = 0 Refuses or starts but scores < 7 mo = 1 Untestable = 2