Brain & Nervous System Alzheimer's Diagnosis What Is the Digit Symbol Test? By Esther Heerema, MSW | Reviewed by Claudia Chaves, MD Updated August 01, 2017 Share Pin Email Print Show Article Table of Contents What Is the Digit Symbol Test? What Does the Test Measure? Other Variations of the Test Scores on the Digit Symbol Test Other Uses of the Digit Symbol Test Back To Top More in Alzheimer's Diagnosis Symptoms Causes & Risk Factors Treatment Living With Support & Coping Prevention For Caregivers Dementia & Related Cognitive Disorders View All What Is the Digit Symbol Test?The digit symbol test is an evaluation tool used to assess cognitive functioning. It initially was part of the Wechsler Adult Intelligence Test (WAIS), a well-known test that measures an individual's intelligence quotient (IQ).The digit symbol test involves a key consisting of the numbers 1-9, each paired with a unique, easy-to--draw symbol such as a "V", "+" or ">". Below the key are a series of the numbers 1-9 in random order and repeated several times. The test-taker is then allowed 90 or 120 seconds (depending on the test version) to fill in the corresponding symbol for each number. This task requires the individual to visually scan the answer key provided at the top of the test and then write the correct symbol by each number.Before beginning, the test taker should complete the practice questions provided to ensure that he or she understands the task. After the test is completed, the administrator will score the test, giving one point for each correct response.Other NamesDigit Symbol Coding TestSymbol Digit Modalities TestDigit Symbol Substitution TestWhat Does the Test Measure?The digit symbol test measures processing speed, working memory, visuospatial processing and attention. In particular, this test appears to be sensitive to changes in people whose cognition is quite good, whereas other tests might be unable to differentiate between persons with normal cognition and those with just the beginnings of mild cognitive impairment. Other Variations of the TestOther versions include the switching of the symbols and the numbers. In this version, the symbol is provided and the person must write the correct number for each one.Another option is the oral version of this test, where the correct answer (the number) is said verbally for each symbol provided. Administering the test orally allows someone who does not have the ability to write (or whose physical ability is hindered in some way, for example, by a stroke) to be able to take the test and provide the answers orally.Scores on the Digit Symbol TestSome research has found that how people score on this test is predictive of their chances of developing dementia within 5 and 10 years. In one study, more than 2500 participants without dementia were part of the study. They were administered the digit symbol test along with other cognitive tests. Some received a full diagnostic assessment for dementia after 5 years and others were assessed after 10 years. The researchers found that lower digit symbol test scores were correlated with a higher risk of developing dementia in both the 5 and 10 year groups.Read more: What's the Difference between Alzheimer's and Dementia?Other Uses of the Digit Symbol TestThis test has been used for multiple purposes, including the following:Assessing cognitive ability to drive a vehicle-- Poor performance on this test has been correlated with poor driving ability in persons with dementia.Concussion evaluation-- Following a suspected concussion, this test is sometimes used to assist in evaluating cognitive functioning. Read more: Preventing Alzheimer's: Can Concussions Cause Dementia?Multiple sclerosis-- The digit symbol test has been used to evaluate diagnosis, progression, and ability to work in people with multiple sclerosis.Parkinson's-- This test can identify some early cognitive impairment in Parkinson's disease that might be missed by the mini mental state exam.Read more: 10 Things to Know about Parkinson's DementiaHuntington's disease-- The digit symbol test is part of the Unified Huntington’s Disease Rating Scale which is used to assess functioning in Huntington's disease.Read more: The Complete Guide to Understanding Huntington's Disease Mild cognitive impairment-- Research has shown that the digit symbol test is able to identify mild cognitive impairment, a condition that sometimes- but not always- progresses to dementia.Read more: What's the Difference between Mild Cognitive Impairment and Dementia?Sources:American Journal of Epidemiology. (2007) 165 (3): 344-350. 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Psychometrics and normative data for the Multiple Sclerosis Functional Composite: replacing the PASAT with the Symbol Digit Modalities Test. http://www.ncbi.nlm.nih.gov/pubmed/20028710National Institute of Neurological Disorders and Stroke. Symbol Digit Modality Test. Accessed July 19, 2015. http://commondataelements.ninds.nih.gov/Doc/NOC/Symbol_digit_modality_Test_NOC_Link.pdf Continue Reading