Cross-cultural neuropsychological assessment: A comparison of randomly selected, demographically matched cohorts of English-and Spanish-speaking older adults

Abstract

As the US population of elderly Hispanics continues to grow, there is an increasingly greater need for neuropsychological measures that are appropriate for assessing Spanish-speaking elders. The current study compared the performance of randomly selected, community-based samples of English- and Spanish-speaking elders on a brief neuropsychological test battery. Subject groups were matched for age and education. Multivariate analysis indicated significant group differences on the test battery. English and Spanish speakers scored comparably on many language-based tasks, but Spanish speakers scored significantly lower on almost all of the nonverbal measures. Significant group differences were observed on multiple-choice matching and recognition memory for stimuli from the Benton Visual Retention Test, as well as on Identities and Oddities from the Mattis Dementia Rating Scale, category fluency, and Complex Ideational Material from the Boston Diagnostic Aphasia Examination (BDAE). Results suggest that caution is warranted when using nonverbal as well as verbal measures to assess non-English-speaking individuals.

A novel language-neutral Visual Cognitive Assessment Test (VCAT): validation in four Southeast Asian countries

“…1). For a VCAT cutoff score of 17 which is indicative of cognitive impairment [21], sensitivity is 92.1% and specificity is 74.2%.…”

“…There is evidence to demonstrate that when using cognitive screening tools that have been modified or translated to meet local demands, these tests often result in overdiagnosis of cognitive impairment in non-English speakers [19]. Furthermore, the lack of standardized cognitive screening tools across Asian countries [20] will prevent meaningful crosscultural comparisons and poses major challenges when conducting international clinical trials with cognition as outcome measures [21].…”

An exploratory study of long-term neurocognitive outcomes following recovery from opportunistic brain infections in HIV+ adults

“…It was possible that the scores observed for the TE group were artificially deflated due to the large number of primary Spanish speakers in that group (Jacobs et al, 1997;Lyness, Hernandez, Chui, & Teng, 2006). To examine this, we performed independent samples t tests for each of the cognitive domains, using language (Spanish vs. English) as the grouping variable.…”

“…On all but the memory domain, it was the TE group that had significantly lower scores than the comparison group. Relative to the comparison group, PML group had significantly lower scores on the speed of information processing and motor domains, while the CM group had lower scores on the verbal fluency and motor domains.It was possible that the scores observed for the TE group were artificially deflated due to the large number of primary Spanish speakers in that group (Jacobs et al, 1997;Lyness, Hernandez, Chui, & Teng, 2006). To examine this, we performed independent samples t tests for each of the cognitive domains, using language (Spanish vs. English) as the grouping variable.…”

Neuropsychological impairment in racial/ethnic minorities with HIV infection and low literacy levels: Effects of education and reading level in participant characterization

“…Racial0ethnic differences in neuropsychological test performance are widely observed Jacobs et al, 1997Tang et al, 2001) and without appropriate normative corrections, the potential to misclassify racial0ethnic minorities as having cognitive dysfunction exists (Adams et al, 1982;Manly et al, 1998b;Heaton et al, 2001). Racial0 ethnic minorities tend to have lower education levels and lower socioeconomic status than non-Hispanic Whites, but even when groups are matched for education and socioeconomic status African Americans tend to have lower scores on verbal and nonverbal tests (Stern et al, 1992;Welsh et al, 1995;Manly et al, 1998aManly et al, , 1998bManly et al, , 2002.…”