Psychology and Aging Copyright 2004 by the American Psychological Association, Inc.

2004, Vol. 19, No. 1, 211–214 0882-7974/04/$12.00 DOI: 10.1037/0882-7974.19.1.211

Adult Age and Digit Symbol Substitution Performance: A Meta-Analysis

William J. Hoyer, Robert S. Stawski, Christina Wasylyshyn, and Paul Verhaeghen
Syracuse University

This article reports the results of a meta-analysis of the effects of age, education, and estimated year of
measurement on scores from the Wechsler Adult Intelligence Scale and the Wechsler Adult Intelligence
Scale—Revised Digit Symbol Substitution Test. Analysis of effect sizes for age reported in 141 studies
published between 1986 and 2002 indicated a mean standardized difference of –2.07. Age accounted for
86% of the variance in a regression model using age, education, and year submitted as predictors of Digit
Symbol scores. There was no association between years of education or year submitted and Digit Symbol
scores for younger adults or older adults.

One of the most widely used instruments for describing the
performance of younger and older adults in cognitive aging studies
is the Digit Symbol Substitution Test (DSST) from the Wechsler
Adult Intelligence Scale (WAIS; Wechsler, 1955) and the Wech-
sler Adult Intelligence Scale—Revised (WAIS–R; Wechsler,
1981). The DSST has two properties that make it a valuable tool
for aging research. First, the DSST seems to serve as a robust
marker for describing sample characteristics in studies of age
differences. Age–DSST correlations of between –.46 and –.77 are
typically reported (e.g., Birren, 1965; Birren & Morrison, 1961;
Doppelt & Wallace, 1955; Kaufman, Reynolds, & McLean, 1989;
Royer, Gilmore, & Gruhn, 1981; Salthouse, 1992). Second, scores
on the DSST have been shown to exhibit strong correlations with
measures that in some way involve perceptual speed (Laux &
Lane, 1985; Lindenberger & Baltes, 1997; Salthouse, 2000; Sli-
winski & Buschke, 1999), and perceptual speed or processing
speed is known to be a large source of the variance in many
age–performance relations (e.g., Birren, 1965; Cerella, 1990; Mad-
den, 2001; Salthouse, 1996).
The DSST consists of a look-up table showing pairs of digits
and hieroglyphic-like symbols and rows of boxes with a digit in
the top section and an empty space in the bottom section of each
box. A participant’s score is the number of empty boxes completed
in 90 s. The DSST is easily administered, and the procedures for
administration and scoring of the test leave relatively little room
for variation. Because the format and test materials for the DSST
have remained unchanged (Wechsler, 1955, 1981), the DSST data
already available in studies published during the past 16 years
William J. Hoyer, Robert S. Stawski, Christina Wasylyshyn, and Paul
Verhaeghen, Department of Psychology and Center for Health and Behav-
ior, Syracuse University.
This research was supported by National Institute on Aging Grant
AG-11451. We thank Serge Onyper and Silvie Semenec for assistance with
a preliminary data collection and Ulman Lindenberger for comments on an
earlier draft.
An Excel spreadsheet listing the studies providing data for the meta-
analysis and the effect sizes for each of the samples is available from
William J. Hoyer.
Correspondence concerning this article should be addressed to William
J. Hoyer, Department of Psychology, 430 Huntington Hall, Syracuse
University, Syracuse, NY 13244-2340. E-mail: wjhoyer@syr.edu
provide an ideal base for a comprehensive meta-analysis of the
relations between age and DSST scores and for exploring possible
relations between DSST scores and years of education and years of
measurement (estimated using year submitted for published
manuscripts).
In regard to possible relations between DSST scores and edu-
cational level, the available data, all from nonaggregated data sets,
suggest no relationship (Birren & Morrison, 1961; Salthouse,
1992). It would be useful to show that age–DSST relations are
independent of years of formal education across a broad range of
study samples. Although there are no reports directly examining
the relationship between age-related declines in DSST scores and
years of measurement, Schaie (1994) reported relatively stable
performance for measures of perceptual speed for cohorts born
between 1907 and 1966 and tested between 1956 and 1991. How-
ever, this finding stands somewhat in contrast to analyses by Flynn
(1987) and Raven (2000) indicating secular increases in intelli-
gence test scores. Flynn reported gains of between 5 and 25 points
in IQ scores during the past 50 years in secondary analyses of large
data sets taken from different countries. Raven described substan-
tial secular increases in scores on the Raven’s Progressive Matri-
ces (RPM) during the past 20 years, although RPM scores taken
prior to 1979 were found to be stable across testing occasions. In
light of the generally strong relations between intelligence and
perceptual speed reported in the literature (e.g., Postuma, de Geus,
& Boomsma, 2001; Salthouse, 1996; Sliwinski & Buschke, 1999;
Verhaeghen & Salthouse, 1997; Zimprich & Martin, 2002), it
would be useful to know whether there have been secular increases
in DSST scores in recent years.
In this study, we report the results of a meta-analysis of the
effects of age, education, and year of measurement (estimated
from year submitted for published manuscripts) on DSST perfor-
mance using all pertinent data published in Psychology and Aging
and the Journals of Gerontology (all subsections) between 1986
and 2002. That there is a large number of studies reporting DSST
scores for younger and older adults and that the format of the
WAIS and WAIS–R versions of the DSST has remained un-
changed (until recently; see Wechsler, 1997) makes it an ideal
dependent variable for assessing age–performance relations as a
function of educational characteristics of the samples and year
submitted.

211
212 BRIEF REPORTS
Table 1
Means and Ranges for Measures of the Characteristics of the Research Participants
Measure No. of studies
Age (years, unweighted) 139
Age (years, weighted by n) 139
Education (unweighted) 117
Education (weighted by n) 117
Digit symbol (unweighted) 138
Digit symbol (weighted by n) 138
Note. The age groups consisted of 3,731 younger adults and 3,876 older adults. Education ⫽ number of years
of formal education. Digit symbol ⫽ score on Wechsler Adult Intelligence Scale or Wechsler Adult Intelligence
Scale—Revised Digit Symbol Substitution subtest.
Method
Sample of Studies
All volumes of Psychology and Aging and the Journals of Gerontology
(all subsections)1 published between 1986 and 2002 were hand searched
for articles reporting mean raw scores for the WAIS or WAIS–R DSST
(the standard paper-and-pencil version). Articles reporting at least one
sample of younger adults (with a mean age below 30 years) and one sample
of “healthy” older adults (with a mean age above 60 years) were included.
Scores derived from samples with participants reported to have dementia
were excluded. For longitudinal studies and for studies reporting multiple
administrations of the DSST to the same participants, only scores from the
first administration of the test were included. A total of 141 studies
reporting data from 3,731 younger adults and 3,876 older adults satisfied
these inclusion– exclusion criteria; 99 of the studies were in Psychology
and Aging, 40 were in Journal of Gerontology: Psychological and Social
Sciences, and 2 were in Journal of Gerontology: Medical Sciences. Mean
DSST scores and means and ranges for age and education for the younger
and older samples are reported in Table 1.
Statistical Analysis Procedures
A standard effect size analysis was performed to determine the age effect
on DSST scores (Hedges & Olkin, 1983). For each combination of scores
for younger adults and older adults, the mean standardized difference for
the size of the age effect was determined. The mean standardized differ-
ence was calculated as the mean score for older adults minus the mean
score for younger adults, divided by the pooled standard deviation. If
means and standard deviations were not reported, inferential statistics were
used to calculate the mean standardized difference, if possible; 46 of the
141 effect sizes were extracted from t or F tests. To test whether the mean
standardized difference for the size of the age effect can be represented as
a single value (the overall effect size), we calculated a homogeneity
statistic, Qt (Hedges & Olkin, 1983, pp. 154 –156). If Qt, which is a
chi-square statistic distributed with k ⫺ 1 degrees of freedom (where k
equals the number of effect sizes), exceeds the critical value, further
analysis of possible moderator variables is indicated.
Results
Figure 1 shows mean DSST scores by age. The averaged effect
size (d) for age was –2.07, the lower bound of the 95% confidence
interval was –2.12, and the upper bound of the 95% confidence
interval was –2.03. The overall effect size was heterogeneous,
Qt(141) ⫽ 511.18. A hierarchical regression analysis (weighted by
sample size) was performed on raw DSST scores, to examine
Younger adults Older adults
M Range M Range
21.4 18.1–30.7 69.5 60.7–78.9
21.6 69.8
13.9 12.0–16.7 15.2 11.7–17.9
14.1 15.3
69.3 51.2–82.7 48.2 38.8–66.8
69.8 48.6
possible moderators of the heterogeneity. In the first step (Model
1), age, years of education, and year submitted for the study were
entered simultaneously as predictors of DSST scores (k ⫽ 242). In
the second step (Model 2), we explored whether the slopes for age,
for years of education, and for year submitted differed as a func-
tion of age group. In Model 2, the three two-way interaction terms
for these factors were added as predictors of DSST scores. The
unstandardized B, standardized beta, and the t values for each of
the predictors in the two regression models are reported in Table 2.
The overall effect of Model 1, the three-parameter model, on
DSST scores was significant, F(3, 238) ⫽ 446.37, MSE ⫽ 20.93,
R2 ⫽ 0.85. The coefficients were significant for age ( p ⬍ .001)
and years of education ( p ⫽ .019), and the coefficient for year
submitted was not significant (t ⬍ 1). The overall effect of Model
2, the six-parameter model, on DSST scores was also significant,
F(6, 235) ⫽ 224.72, MSE ⫽ 20.85, R2 ⫽ 0.85. The fit for Model
2 was no better than the fit for Model 1, ⌬R2 ⫽ 0.002, F(3, 235) ⫽
1.31. In Model 2, only the coefficient for age ( p ⫽ .002) was
significant. The absence of interaction terms suggested that the
slopes for age and years of education for the two age groups were
not different. It is important to note that the Nonsignificant Age
(within groups) ⫻ Age Groups interaction (t ⫽ 1.70) suggests that
the slopes of the age–DSST relation were not different between the
two age groups and that the age–DSST relation is not an artifact or
distortion associated with using extreme groups. The regression
slope, – 0.46 items per year (Model 1), was consistent with the
value of the slope of – 0.47 reported by Salthouse (1992) and the
slope of – 0.43 reported by Emmerson, Dustman, Shearer, and
Turner (1989) using a symbol digit test.
Figure 2 shows the relation between DSST scores and educa-
tion, and Figure 3 shows the relation between DSST scores and
year submitted. The plots show the data from the 242 samples that
were used in the regressions. The differences in the distributions of
years of education between the samples of younger adults and
older adults were quite striking and are shown in histogram form
in Figure 4. As reported in Table 2, there was no relationship
1
This journal was called Journal of Gerontology prior to and including
Volume 41 (1986). The subsections of the Journals of Gerontology in-
cluded in the search were Biological Sciences, Medical Sciences, Psycho-
logical Sciences, and Social Sciences.
 BRIEF REPORTS 213

Figure 1. Digit symbol scores as a function of age. Triangles indicate
younger adults, and circles indicate older adults. DSST ⫽ Digit Symbol
Substitution Test.
between DSST scores and years of education when differences
between age groups were taken into account (Model 2).
Another weighted least squares regression analysis was per-
formed to determine whether the effect sizes for DSST scores were
predicted by the size of the difference in age or education between
age groups. The overall effect of the regression model on DSST
scores was significant, F(2, 117) ⫽ 5.23, MSE ⫽ 15,845, R2 ⫽
0.08. The coefficient for the age difference was significant (t ⫽
–3.18, p ⫽ .002), indicating that the strength of the age–DSST
relation was related to the size of the chronological age differences
for the groups. The coefficient for difference in years of education
was not significant (t ⬍ 1).
Discussion
The aim of this study was to assess the magnitude of the age
effect in DSST scores by applying meta-analytic methods to the
Figure 2. Digit symbol scores as a function of number of years of
education. Triangles indicate younger adults, and circles indicate older
adults. The solid line indicates the regression line for younger adults, and
the broken line indicates the regression line for older adults. DSST ⫽ Digit
Symbol Substitution Test.
data reported in age-comparative studies published in Psychology
and Aging and the Journals of Gerontology during the past 16
years. The magnitude of the effect of age on DSST scores obtained
from 141 age comparisons was substantial (d ⫽ –2.07). This
finding confirms the high correlations between age and DSST
scores reported in standardization studies (e.g., Birren & Morrison,
1961; Kaufman et al., 1989; Wechsler, 1997) and in large nonag-
gregated data sets with digit symbol and symbol digit measures
(e.g., Royer et al., 1981; Salthouse, 1992, 2000).
Although the biobehavioral processes underlying age effects on
DSST scores are not well understood (e.g., Laux & Lane, 1985;
Piccinin & Rabbitt, 1999; Salthouse, 1992, 2000), the results of the
present study indicate unequivocally that the speed of carrying out

Table 2
Summary Statistics for Two Regression Models

Predictor B ␤ t

Model 1 (R2 ⫽ .85)

Age ⫺0.46 ⫺0.95 ⫺33.09*

Education 0.62 0.07 2.37*
Year submitted ⫺0.01 ⫺0.00 ⫺0.61

Model 2 (R2 ⫽ .85)

Age ⫺0.65 ⫺1.34 ⫺3.14*

Education 0.82 0.09 1.79
Year submitted ⫺0.01 ⫺0.01 ⫺0.18
Age ⫻ Education ⫺0.15 ⫺0.10 ⫺0.27
Age ⫻ Year Submitted 0.01 ⫺0.73 ⫺1.47
Age ⫻ Age Groups (within groups) 0.40 1.20 1.70

Note. Models were least squares regressions weighted by n. Model 1 used Figure 3. Digit symbol scores by year submitted. Triangles indicate
three predictors, and Model 2 used six predictors. Data for year submitted younger adults, and circles indicate older adults. The solid line indicates
were the years indicated in the date of submission for the manuscripts. the regression line for younger adults, and the broken line indicates the
* p ⬍ .05. regression line for older adults. DSST ⫽ Digit Symbol Substitution Test.
214 BRIEF REPORTS
Figure 4. Frequency distribution of education scores for samples of
younger adults (unfilled bars) and older adults (hatched bars).
the combination of coding and substitution processes that comprise
DSST performance is slower for older adults than for younger
adults. Furthermore, the age–DSST relation, derived here from a
large and wide-ranging set of descriptive data, was independent of
years of education and was invariant across years of measurement
(estimated by year of submission). One implication of the robust-
ness of the age–DSST relationship is to suggest that the DSST be
used routinely as a general marker in age-comparative studies.
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Received January 8, 2003
Revision received March 31, 2003
Accepted April 7, 2003 䡲