Objective: Although researchers have documented that cultural factors influence performance on neuropsychological tests, few studies have examined the distribution of test performance for neurologically healthy older adults from different ethnic groups. The objective of this study was to determine if there are ethnic group differences in the distribution of neuropsychological test scores across five clinical ranges for healthy older adults. Method: Subjects from the National Alzheimer's Coordinating Center were selected if they were not diagnosed with dementia within 5 years (mean/SD: age = 75.37/7.00; education = 15.70/5.41). Groups were formed based on self-identified ethnicity of White (n = 6896) or Black (n = 1346). All subjects were evaluated with comprehensive neuropsychological testing including: Mini Mental State Exam, Logical Memory Immediate and Delayed, Digit Span Forward, Digit Span Backward, Trail Making Test A & B, Animal Naming, Vegetable Naming, Digit Symbol, and Boston Naming Test. Chi-square analyses were used to determine if the groups’ scores were distributed proportionally across clinical performance ranges: Below average, Low-average, Average, High-average, Superior. Results: Each analysis produced a significant χ2 value (χ2(4) = 22.84-837.53, p < .001), indicating the proportion of scores across clinical performance ranges depended on ethnicity. For all 11 neuropsychological measures, the Black members’ scores were overrepresented in the Below average and Low-average categories and the White group's scores were overrepresented in the High-average and Superior categories. Conclusion: These findings emphasize the importance of developing and using ethnically and culturally appropriate neuropsychological test norms, as well as the risk of interpreting some Black individual's scores as below average when they likely are not.
Ethnic Group Differences in Normal Neuropsychological Test Performance for Older Adults
A Werry, M Daniel, B Bergström; C-77
Ethnic Group Differences in Normal Neuropsychological Test Performance for Older Adults. Arch Clin Neuropsychol 2016; 31 (6): 669. doi: 10.1093/arclin/acw043.226
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