Harmonization of the English and Spanish versions of the NIH Toolbox Cognition Battery crystallized and fluid composite scores.

Abstract

Objective: The National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) has both English-and Spanish-language versions producing crystallized and fluid cognition composite scores. This study examined measurement invariance between languages of administration. If established, measurement invariance would indicate that the composite scores measure the same construct across languages and provide scores that can be meaningfully compared and harmonized in future analyses. Method: Participants from the NIHTB-CB normative sample included adults tested in English (n = 1,038; M = 49.1 years old, SD = 18.6) or Spanish (n = 408; M = 44.1 years old, SD = 16.7). Participants completed seven NIHTB-CB tests: Two measuring crystallized cognition and five measuring fluid cognition. Each test score was converted to an age-adjusted standard score or demographic-adjusted T score. A two-factor model (i.e., crystallized cognition and fluid cognition factors) was evaluated using confirmatory factor analysis. Measurement invariance was evaluated by fitting the two-factor model for each language of administration and constraining model parameters to be equivalent across languages, testing configural, weak, strong, and strict models. Results: For age-adjusted and demographic-adjusted scores, the two-factor model fit adequately well, and each factor had adequate reliability among English-and Spanish-speaking participants. Strict invariance was established across languages of administration for both age-adjusted and demographic-adjusted scores. Conclusions: These findings support the harmonization of the Englishand Spanish-language NIHTB-CB crystallized and fluid composite scores, indicating that the composite scores measure the same constructs on the same scale. The results support future studies merging data from participants evaluated in both languages. Key PointsQuestion: Do the English-and Spanish-language versions of the NIH Toolbox Cognition Battery measure the same cognitive functions across languages of administration? Findings: The NIH Toolbox Cognition Battery produces two composite scores, measuring crystallized cognition (e.g., language abilities) and fluid cognition (e.g., processing speed, visual memory, and executive functions). The analyses supported strict invariance for the composite scores, meaning the English-and Spanishlanguage versions of the battery produce scores that measure the same cognitive ability on the same scale across languages. Importance: These findings support future studies merging data from participants evaluated in both English and Spanish, allowing for larger and more linguistically diverse samples. Next Steps: These results apply to English-and Spanish-speaking adults residing within the United States, and future studies should evaluate whether harmonization is supported for other populations of English and Spanish speakers residing in different countries.

Harmonization of neuropsychological and other clinical endpoints: Pitfalls and possibilities.

“…In an examination of measurement invariance between English and Spanish versions of the NIH Toolbox Cognition Battery, Karr et al (2023) establish that the crystallized and fluid cognition composite scores measure the same construct across languages, supporting the use of merged data from participants evaluated in both languages for harmonization in future analyses.…”

Cross-National Generalizability of WISC-V and CHC Broad Ability Constructs across France, Spain, and the US

“…Lastly, the NIHTB-BC was used to investigate the factorial invariance of English-speaking and Spanish-speaking adults taken from the normative sample data set ( Karr et al 2022 ). Strict invariance was found across languages for a two-factor model (labelled crystallized cognition and fluid cognition) allowing for the direct comparison of latent means across groups.…”