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Lane JM, Zimmer A, Quiñones-Cordero MM, Sörensen S. Racial differences in the effect of verbal and nonverbal memory on concrete planning for future care needs among older adults: a multi-group structural equation modeling approach. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:587-604. [PMID: 37317954 PMCID: PMC10721738 DOI: 10.1080/13825585.2023.2223902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
Concrete planning for future care needs may positively impact older adults' subsequent mental health and quality of life. However, the cognitive factors that facilitate concrete planning among Black and White older adults are still poorly understood. We investigated whether there are significant differences between Black (n = 159) and White (n = 262) older adults in concrete planning and explored racial differences in the relationship between verbal and nonverbal episodic memory and concrete planning. Results revealed that Blacks showed lower engagement in concrete planning and lower scores than Whites on each verbal and nonverbal memory task. For Blacks, but not Whites, verbal memory and nonverbal memory performance predicted concrete planning with higher nonverbal memory relating to less concrete planning and higher verbal memory associated with more concrete planning. Our findings suggest racial differences exist in how episodic verbal and nonverbal memory affect concrete planning, a crucial factor for older adults' preparation for future care.
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Affiliation(s)
- Jamil M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alexis Zimmer
- Department of Counseling and Human Development, University of Rochester, Rochester, USA
| | - Maria M Quiñones-Cordero
- Elaine Hubbard Center for Nursing Research on Aging, University of Rochester School of Nursing, Rochester, NY, USA
| | - Silvia Sörensen
- Department of Counseling and Human Development, University of Rochester, Rochester, USA
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Owens J, Jones R, Marsiske M. The Effects of Occupational Complexity on Late Life Cognition in ACTIVE: Examining the Mediating and Moderating Effects of Race. J Aging Health 2023; 35:95S-106S. [PMID: 37994851 PMCID: PMC11160436 DOI: 10.1177/08982643211038837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Objectives: This article sought to determine (1) whether occupational complexity (OC) explains individual differences in cognition at baseline, (2) whether this relationship is differentially related to cognition by Black/White race, and (3) whether OC mediates some or all of the Black/White race-related variance in late life cognition. Methods: 2371 participants from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study reported longest held jobs and received OC ratings based on a factor analysis of 63 variables from the Dictionary of Occupational Titles. Results: We found that multiple dimensions of OC are related to cognition, but there were relatively few Black/White differences in these associations. Across all cognitive dimensions except for useful field of view, a history of having jobs lower in substantive complexity and fine motor skills and higher in physical demands may explain some of the Black/White race differences in elder's cognition. Discussion: We conclude that occupations can be a target to reduce social disparities in late life cognition.
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Affiliation(s)
- Joshua Owens
- Department of Clinical and Health Psychology, University of Florida
| | | | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida
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Loizos M, Zhu CW, Akrivos J, Sewell M, Li C, Neugroschl J, Melnick J, Ljekocevic M, Martin J, Grossman H, Aloysi A, Schimming C, Sano M. Evaluating memory testing to distinguish dementia severity among White, Black, and Spanish-speaking individuals in the Uniform Data Set (UDS). Alzheimers Dement 2023; 19:3625-3634. [PMID: 36840724 PMCID: PMC10440216 DOI: 10.1002/alz.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/26/2023]
Abstract
INTRODUCTION Little work has compared the effectiveness of using multiple types of memory tests alone or in combination to distinguish dementia severity in diverse research cohorts including Black individuals and Spanish speakers. Here we evaluate word list and paragraph recall tests to distinguish cognitively normal, mild cognitively impaired, and those with Alzheimer's disease in diverse cohorts. METHODS Using Uniform Data Set (UDS) and site-specific supplemental data, logistic regression models and receiver operating characteristic-area under the curve were used to compare paragraph recall versus word list in differentiating among Clinical Dementia Rating (CDR) scale level. RESULTS Results reveal high discriminability for all groups and no difference between either test in distinguishing between CDR levels. Combining tests improved discriminability for the whole group but did not for Black individuals or Spanish speakers. DISCUSSION Our findings indicate that using multiple memory tests may not improve differentiation between cognitive impairment levels for diverse cohorts. The burden of added testing may be a barrier for maximizing inclusion of under-represented groups in research.
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Affiliation(s)
- Maria Loizos
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Carolyn W. Zhu
- Icahn School of Medicine at Mount Sinai, New York, NY USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Jimmy Akrivos
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | - Clara Li
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | | | | | - Jane Martin
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Hillel Grossman
- Icahn School of Medicine at Mount Sinai, New York, NY USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Amy Aloysi
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Corbett Schimming
- Icahn School of Medicine at Mount Sinai, New York, NY USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Mary Sano
- Icahn School of Medicine at Mount Sinai, New York, NY USA
- James J. Peters VA Medical Center, Bronx, NY, USA
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Clark AL, Weigand AJ, Clay OJ, Owens J, Fiala J, Crowe M, Marsiske M, Thomas KR. Associations between social determinants of health and 10-year change in everyday functioning within Black/African American and White older adults enrolled in ACTIVE. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12385. [PMID: 36514539 PMCID: PMC9732812 DOI: 10.1002/dad2.12385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/31/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Abstract
Introduction Given prior work showing racial differences on baseline social determinants of health (SDoH) and 10-year trajectories of everyday functioning, we examined associations between SDoH and longitudinal everyday functioning performance in Black/African American and White older adults. Methods Participants were 2505 older adults (Mage = 73.5; 28% Black/African American) without dementia. SDoH included economic stability/status, education access/quality, health-care access, neighborhood/built environment, and social/community contexts. The Observed Tasks of Daily Living (OTDL) measured everyday functioning and was administered at baseline and 1-, 2-, 3-, 5-, and 10-year visits. Results Across the sample, social and community context and economic stability/status were associated with steeper age-related OTDL declines (βs = 0.05 to 0.07, Ps < 0.001). Lower levels of social and community context (β = 0.08, P = 0.002) and economic stability/status (β = 0.07, P = 0.04) were associated with OTDL linear age declines in Black/African American participants, but not in White participants (Ps > 0.30). Discussion Inequities across SDoH accelerate age-related declines in everyday functioning among Black/African American older adults.
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Affiliation(s)
- Alexandra L. Clark
- Department of PsychologyCollege of Liberal ArtsUniversity of Texas at AustinAustinTexasUSA
| | - Alexandra J. Weigand
- Department of PsychiatrySchool of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Olivio J. Clay
- Department of Psychology, College of Arts and SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Joshua Owens
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Jacob Fiala
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Michael Crowe
- Department of Psychology, College of Arts and SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Kelsey R. Thomas
- Department of PsychiatrySchool of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
- Research Services, VA San Diego Healthcare System (VASDHS)San DiegoCaliforniaUSA
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Byrd DR, Jiang Y, Zilioli S, Lichtenberg P, Thorpe RJ, Whitfield KE. The Interactive Effects of Education and Social Support on Cognition in African Americans. J Aging Health 2022; 34:1188-1200. [PMID: 36036159 PMCID: PMC10165879 DOI: 10.1177/08982643221122692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objectives: This study examines whether the effects of receiving and providing social support on cognition differ by education. Methods: Data from 602 African American adults (48-95 years) enrolled in the Baltimore Study of Black Aging-Patterns of Cognitive Aging were analyzed using multiple linear regression. Results: We found no main effects of receiving or providing social support on global cognition. Main effects for receiving or providing social support on memory were detected. Further, a significant moderation effect was observed for memory, such that received social support was more strongly associated with higher working memory among less-educated individuals than those with high levels of education, adjusting for age, sex, marital status, chronic conditions, and depressive symptoms. Discussion: Study findings demonstrate that social support and education have joint effects on memory outcomes, highlighting the importance of considering psychosocial protective factors that might alleviate, reduce, or even eliminate cognitive health disparities in African Americans.
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Affiliation(s)
| | - Yanping Jiang
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | | | | | - Roland J. Thorpe
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Pugh E, Robinson A, De Vito AN, Bernstein JPK, Calamia M. Representation of U.S. Black Americans in neuropsychology research: How well do our reporting practices show that Black lives matter? Clin Neuropsychol 2022; 36:214-226. [PMID: 34348590 DOI: 10.1080/13854046.2021.1958923] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/29/2021] [Accepted: 06/17/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Black American individuals comprise about 13% of the population in the United States (U.S.). It is estimated by 2045, approximately 50% of U.S. residents will belong to an ethnic minority group underscoring the importance of the provision of culturally competent services. The present study provides a critical/systematic review of the literature to examine the representation of Black Americans in recent neuropsychological research in U.S. neuropsychology journals. We examined the representation of U.S. Black American individuals across journals, year of study, and by study sample. METHOD We evaluated 1,151 journal articles published in 4 neuropsychology journals published in 2011, 2014, 2017 and 2019. Articles were coded for reporting of age, sex/gender, years of education, ethnicity/race, and if race was a focus of the study. We also recorded sample size and type of sample. RESULTS Out of the 397 articles meeting inclusion criteria, 37.5% did not report ethnic or racial demographic information. Additionally, 96% of the articles were not racially/ethnically focused. Black participants comprised 10.7% of participants in articles that reported race/ethnicity. The proportion of Black participants increased by 3.7% between 2011 and 2019. CONCLUSION Our results demonstrate the underrepresentation of U.S. Black Americans in neuropsychological research over the targeted years. This highlights our shortcomings as a field in demonstrating the importance of including Black Americans in research.
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Affiliation(s)
- Erika Pugh
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Anthony Robinson
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Alyssa N De Vito
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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Tan SC, Gamaldo AA, Brick T, Thorpe RJ, Allaire JC, Whitfield KE. The Effects of Selective Survival on Black Adults' Cognitive Development. J Gerontol B Psychol Sci Soc Sci 2021; 76:1489-1498. [PMID: 33406264 PMCID: PMC8436692 DOI: 10.1093/geronb/gbab003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The theory of selective survival suggests that possibly around 70-75 years of age, Blacks may display substantive changes in their pattern of cognitive decline. This study examined the age-graded pattern of cognitive decline within older Blacks by describing a trend that characterizes differences in the change of cognitive decline from ages 51.5 to 95.5, and hypothesized that this age-graded pattern is nonlinear. METHOD Utilizing 2 waves of longitudinal data from the Baltimore Study of Black Aging, this study used multilevel modeling to test whether the interaction between age and the 3-year study period (time between waves) had a positive effect on changes in inductive reasoning, declarative memory, working memory, and perceptual speed. RESULTS A significant positive interaction between age and wave was found for inductive reasoning, demonstrating an age-grade pattern of change/decline in cognitive pattern for Blacks aged 51.5-95.4. Simple slope probing via the Johnson-Neyman Technique suggested that Black adults ~64 years and younger experienced significant decline in inductive reasoning across study time, whereas for those older than 63.71, the decline was nonsignificant. No significant age-wave interactions were found for declarative memory, working memory, or perceptual speed. DISCUSSION Findings suggest a selective survival effect for inductive reasoning ability among Blacks. With decline evident so early, common cognitive intervention programs targeting adults 65+ may come too late for Blacks, signifying the importance and urgency for early health interventions and public policy designed to promote cognitive reserve.
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Affiliation(s)
- Shyuan Ching Tan
- Human Development and Family Studies, Pennsylvania State University, University Park, USA
| | - Alyssa A Gamaldo
- Human Development and Family Studies, Pennsylvania State University, University Park, USA
- School of Aging Studies, University of South Florida, Tampa, USA
| | - Timothy Brick
- Human Development and Family Studies, Pennsylvania State University, University Park, USA
| | - Roland J Thorpe
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jason C Allaire
- Department of Psychology, North Carolina State University, Raleigh, USA
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Parisi JM, Sharifian N, Rebok GW, Aiken-Morgan AT, Gross AL, Zahodne LB. Subjective memory, objective memory, and race over a 10-year period: Findings from the ACTIVE study. Psychol Aging 2021; 36:572-583. [PMID: 34351184 DOI: 10.1037/pag0000622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The longitudinal associations between subjective and objective memory functioning in later life remain unclear. This may be due, in part, to sociodemographic differences across studies, given the hypothesis that these associations differ across racial groups. Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE; N = 2,694; 26% African American), multiple-group, parallel-process latent growth curve models were used to explore relationships between subjective and objective memory over 10 years and assess racial differences in these associations. Across African Americans and whites, we found bidirectional associations between subjective and objective memory such that greater self-reported forgetting at baseline predicted faster subsequent verbal episodic memory declines, and higher baseline objective memory scores predicted less increase in self-reported forgetting over time. However, rates of change in self-reported frequency of forgetting were correlated with rates of change in verbal episodic memory in whites, but not in African Americans. Subjective memory complaints may be a harbinger of future memory declines across African Americans and whites but may not track with objective memory in the same way across these racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
| | | | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
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Evans E, Coley SL, Gooding DC, Norris N, Ramsey CM, Green-Harris G, Mueller KD. Preliminary assessment of connected speech and language as marker for cognitive change in late middle-aged Black/African American adults at risk for Alzheimer's disease. APHASIOLOGY 2021; 36:982-1005. [PMID: 36016839 PMCID: PMC9398189 DOI: 10.1080/02687038.2021.1931801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 05/03/2021] [Indexed: 06/15/2023]
Abstract
Background Connected speech-language (CSL) has been a promising measure of assessing cognitive decline in populations at-risk for Alzheimer's disease and related dementias (ADRD) populations. A common way to obtain CSL is through using picture description tasks such as the most frequently used image Cookie Theft (CT). However, questions have been raised about using CT for diverse communities. Little is known about the CSL produced in response to this task in Black/African American (BAA) adults aged 48-74. Goals The present study's goals were to characterize CSL in BAA adults by sex and APOE-ε4 status from Milwaukee in the Wisconsin Registry for Alzheimer's Prevention (WRAP) study when presented with the CT picture description task and to identify differences in CSL output between BAAs and non-Hispanic Whites (NHW). Methods and Procedures We collected CSL samples from the CT picture from 48 BAA participants and 30 NHW participants from the WRAP participants in Milwaukee, WI group. CSL was analyzed using chi-square tests, T-tests, and ANCOVA. Linear mixed effect regression models were used to determine the association between cognitive status and longitudinal CSL in BAA participants with more than 1 timepoint. Outcomes and Results Declines in CSL of BAA participants were associated with subtle declines in cognition. Among BAA participants, we found no significant differences in speech measures in terms of sex and APOE-ε4 status. Our results showed no significant differences in speech measures between BAA and NHW groups. Conclusions CSL analysis provides an inexpensive way to evaluate preclinical changes in cognitive status that may not be as affected by other factors, such as ethnocultural background. Future studies with larger sample sizes and participants from other geographic locations can clarify these findings.
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Affiliation(s)
- Elizabeth Evans
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Sheryl L Coley
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Diane C Gooding
- Department of Psychology and Psychiatry, University of Wisconsin-Madison, Madison, WI University of Wisconsin, Madison, Wisconsin, USA
| | - Nia Norris
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Celena M Ramsey
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Gina Green-Harris
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kimberly D Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Wisconsin, USA
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Reporting of Demographic Variables in Neuropsychological Research: An Update of O'Bryant et al.'s Trends in the Current Literature. J Int Neuropsychol Soc 2021; 27:497-507. [PMID: 33176898 DOI: 10.1017/s1355617720001083] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Demographic trends and the globalization of neuropsychology have led to a push toward inclusivity and diversity in neuropsychological research in order to maintain relevance in the healthcare marketplace. However, in a review of neuropsychological journals, O'Bryant et al. found systematic under-reporting of sample characteristics vital for understanding the generalizability of research findings. We sought to update and expand the findings reported by O'Bryant et al. METHOD We evaluated 1648 journal articles published between 2016 and 2019 from 7 neuropsychological journals. Of these, 1277 were original research or secondary analyses and were examined further. Articles were coded for reporting of age, sex/gender, years of education, ethnicity/race, socioeconomic status (SES), language, and acculturation. Additionally, we recorded information related to sample size, country, and whether the article focused on a pediatric or adult sample. RESULTS Key variables such as age and sex/gender (both over 95%) as well as education (71%) were frequently reported. Language (20%) and race/ethnicity (36%) were modestly reported, and SES (13%), and acculturation (<1%) were more rarely reported. SES was more commonly reported in pediatric than adult samples, and the opposite was true for education. There were differences between the present results and those of O'Bryant et al., though the same general trends remained. CONCLUSIONS Reporting of demographic data in neuropsychological research appears to be slowly changing toward greater comprehensiveness, though clearly more work is needed. Greater systematic reporting of such data is likely to be beneficial for the generalizability and contextualization of neurocognitive function.
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Gregory SH, King CR, Ben Abdallah A, Kronzer A, Wildes TS. Abnormal preoperative cognitive screening in aged surgical patients: a retrospective cohort analysis. Br J Anaesth 2020; 126:230-237. [PMID: 32943193 DOI: 10.1016/j.bja.2020.08.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/24/2020] [Accepted: 08/09/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Preoperative cognitive dysfunction has been associated with adverse postoperative outcomes. There are limited data characterising the epidemiology of preoperative cognitive dysfunction in older surgical patients. METHODS This retrospective cohort included all patients ≥65 yr old seen at the Washington University preoperative clinic between January 2013 and June 2018. Cognitive screening was performed using the Short-Blessed Test (SBT) and Eight-Item Interview to Differentiate Aging and Dementia (AD8) screen. The primary outcome of abnormal cognitive screening was defined as SBT score ≥5 or AD8 score ≥2. Multivariable logistic regression was used to identify associated factors. RESULTS Overall, 21 666 patients ≥65 yr old completed screening during the study period; 23.5% (n=5099) of cognitive screens were abnormal. Abnormal cognitive screening was associated with increasing age, decreasing BMI, male sex, non-Caucasian race, decreased functional independence, and decreased metabolic functional capacity. Patients with a history of stroke or transient ischaemic attack, chronic obstructive pulmonary disease, diabetes mellitus, hepatic cirrhosis, and heavy alcohol use were also more likely to have an abnormal cognitive screen. Predictive modelling showed no combination of patient factors was able to reliably identify patients who had a <10% probability of abnormal cognitive screening. CONCLUSIONS Routine preoperative cognitive screening of unselected aged surgical patients often revealed deficits consistent with cognitive impairment or dementia. Such deficits were associated with increased age, decreased function, decreased BMI, and several common medical comorbidities. Further research is necessary to characterise the clinical implications of preoperative cognitive dysfunction and identify interventions that may reduce related postoperative complications.
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Affiliation(s)
- Stephen H Gregory
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA.
| | - Christopher R King
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Arbi Ben Abdallah
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Alex Kronzer
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Troy S Wildes
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
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Werry AE, Daniel M, Bergström B. Group differences in normal neuropsychological test performance for older non-Hispanic White and Black/African American adults. Neuropsychology 2019; 33:1089-1100. [PMID: 31343234 PMCID: PMC6823108 DOI: 10.1037/neu0000579] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Although researchers have documented the influence of cultural factors on neuropsychological test performance, few studies have examined the distribution of test scores among neurologically healthy older adults from different ethnic groups. The objective of this study was to determine whether there are group differences in neuropsychological test score distributions with ethnicity-specific norms for non-Hispanic White and Black/African American older adults. METHOD Participants from the National Alzheimer's Coordinating Center were selected if they were not diagnosed with dementia within 5 years (Mage = 75.26, SDage = 6.98; Meducation = 15.70, SDeducation = 2.91). Groups were formed based on self-identified ethnicity of White (n = 5,311) or Black/African American (n = 1,098). All participants completed neuropsychological testing, including the Mini Mental State Exam, Logical Memory Immediate and Delayed, Digit Span Forward and Backward, Trail Making Test A & B, Animal Naming, Vegetable Naming, Digit Symbol, and Boston Naming Test. RESULTS Based on combined ethnicity norms, the scores of Black participants were overrepresented in the below-average and low-average clinical ranges, and the scores of White participants were overrepresented in the high-average and superior clinical ranges for all 11 neuropsychological measures. When group specific norms were used, the unbalanced pattern of score categorization was no longer present for any of the neuropsychological measures. CONCLUSIONS 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. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Amy E Werry
- School of Graduate Psychology, Pacific University
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13
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Fox ME, Panwala TF, King TZ. Organizational Strategies Partially Account for Race-related Differences in List Recall Performance. Arch Clin Neuropsychol 2019; 34:70-80. [DOI: 10.1093/arclin/acy015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/01/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Michelle E Fox
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Tanya F Panwala
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Tricia Z King
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, GA, USA
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14
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Vonk JMJ, Rentería MA, Medina VM, Pericak-Vance MA, Byrd GS, Haines J, Brickman AM, Manly JJ. Education Moderates the Relation Between APOE ɛ4 and Memory in Nondemented Non-Hispanic Black Older Adults. J Alzheimers Dis 2019; 72:495-506. [PMID: 31594222 PMCID: PMC8876947 DOI: 10.3233/jad-190415] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The APOEɛ4 allele is a well-known risk factor for Alzheimer's disease (AD). Previous research argues that higher education helps to preserve cognition in older adults with AD pathology because of its key role in cognitive reserve and resilience. OBJECTIVE To test if higher educational level buffers the effect of APOEɛ4 on cognition among older non-Hispanic Blacks. METHODS Participants were 849 non-demented older non-Hispanic Blacks (38.3% APOEɛ4+), who underwent a comprehensive neuropsychological evaluation. Multiple linear regression models tested the relationship between APOEɛ4 status and twelve cognitive measures with education (up to high school and beyond high school) as a moderator. RESULTS Education buffered the effects of the APOEɛ4 allele, such that there was no impact of APOEɛ4 status on word-list memory retention and working memory among participants with more than a high school degree. This pattern was not observed for ten other cognitive measures of verbal and visual episodic memory, semantic memory, executive function, and processing speed-although a similar trend was observed for switching ability in executive functioning. The buffering effect of education was stronger among women than men. CONCLUSION Our findings suggest that genetic effects on late-life cognition may be modified by environmental factors such as educational attainment. These results are consistent with the framework of cognitive reserve such that engaging in cognitively enriching activities and acquiring skills and knowledge with more years of education may increase the capacity to maintain cognitive function despite high genetic risk for impairment.
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Affiliation(s)
- Jet M. J. Vonk
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Miguel Arce Rentería
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Valerie M. Medina
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Margaret A. Pericak-Vance
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, Florida
| | - Goldie S. Byrd
- North Carolina Agricultural and Technical State University, Dean, College of Arts and Sciences, Greensboro, North Carolina
| | - Jonathan Haines
- Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
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15
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Berg JE. Psychometric testing of immigrants and natives in an acute psychiatry facility. Ment Illn 2017; 9:6987. [PMID: 29383216 PMCID: PMC5768086 DOI: 10.4081/mi.2017.6987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- John E Berg
- Faculty of Health Sciences, Oslo and Akershus University Hospital, Oslo, Norway
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16
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Zahodne LB, Schupf N, Brickman AM, Mayeux R, Wall MM, Stern Y, Manly JJ. Dementia Risk and Protective Factors Differ in the Context of Memory Trajectory Groups. J Alzheimers Dis 2017; 52:1013-20. [PMID: 27079709 DOI: 10.3233/jad-151114] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous research has identified multiple risk and protective factors for late onset Alzheimer's disease (LOAD). However, it is not known whether these risk and protective factors differ for individuals who are cognitively stable versus those already experiencing declines. OBJECTIVE This study examined how dementia risk factors differ across subgroups of older adults defined by memory trajectory. This line of research may lead to more individualized risk profiles. METHODS Risk factors for incident LOAD were compared across previously-validated groups of older adults exhibiting different memory trajectories ("Stable-High," "Stable-Low," "Decliner," "Rapid Decliner") using stratified Cox regressions. Participants included 2,593 racially/ethnically diverse older adults (mean age of 76 at study entry) in the Washington Heights-Inwood Columbia Aging Project. RESULTS Predictors of incident dementia differed across trajectory groups: older age only incurred independent risk in stable groups, education did not incur independent protection in the rapidly declining group, depression only incurred independent risk in the stable-low group, stroke incurred independent risk in the two extreme groups, and APOE-ɛ4 only incurred independent risk in the rapidly declining group. CONCLUSION The finding that different risk factors for LOAD were associated with specific memory trajectories may reflect the existence of resilience or vulnerability factors that modify the individual influences of risk/protective factors. This study highlights the utility of considering interactions between dementia risk factors and a patient's unique cognitive history.
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Affiliation(s)
- Laura B Zahodne
- Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Adam M Brickman
- Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - Richard Mayeux
- Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Melanie M Wall
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Yaakov Stern
- Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - Jennifer J Manly
- Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA
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17
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Zahodne LB, Wall MM, Schupf N, Mayeux R, Manly JJ, Stern Y, Brickman AM. Late-life memory trajectories in relation to incident dementia and regional brain atrophy. J Neurol 2015; 262:2484-90. [PMID: 26259562 PMCID: PMC4819990 DOI: 10.1007/s00415-015-7871-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/24/2015] [Accepted: 07/25/2015] [Indexed: 10/23/2022]
Abstract
The trajectory, or slope, of cognitive decline may provide differentiation of older adults with and without incipient neurodegenerative disease. Cognitive aging phenotypes based on memory trajectories could be used as outcome measures for clinical trials or observational studies of risk and protective factors for dementia. This study used growth mixture modeling (GMM) to identify trajectory groups based on age- and education-corrected composite memory scores derived from immediate, delayed and recognition trials of the Selective Reminding Test. Participants included 2593 participants initially without dementia (mean age at entry = 76) in a community-based study of aging and dementia in northern Manhattan. Trajectory groups were compared on consensus diagnoses of dementia and structural MRI measures of hippocampal volume and entorhinal cortical thickness. Heterogeneity in memory trajectories allowed us to identify four groups: Stable-High (43.5 %), Stable-Low (17.1 %), Decliner (26.8 %), and Rapid Decliner (12.5 %). Decliners had more brain atrophy and higher rates of conversion to dementia. This study highlights the heterogeneity in cognitive aging and provides evidence that most elderly maintain memory function as they age. Associations with dementia and imaging measures validate subgroups of older adults identified with GMM based on their memory trajectories. Future research should use these memory trajectory phenotypes to determine whether dementia risk and protective factors differ for individuals following different memory trajectories.
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Affiliation(s)
- Laura B Zahodne
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Melanie M Wall
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Biostatistics, School of Public Health, Columbia University, New York, NY, USA
| | - Nicole Schupf
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, School of Public Health, Columbia University, New York, NY, USA
| | - Richard Mayeux
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, School of Public Health, Columbia University, New York, NY, USA
| | - Jennifer J Manly
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Yaakov Stern
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Adam M Brickman
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA.
- The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
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18
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Thomas KR, Marsiske M. Age trajectories of everyday cognition in African American and White older adults under prompted and unprompted conditions. Neuropsychol Rehabil 2015; 27:522-539. [PMID: 26480946 DOI: 10.1080/09602011.2015.1092453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We investigated how race and verbal prompting interacted with age to predict age trajectories on a performance-based measure of everyday cognition. African American (n = 727) and White (n = 2052) older adults from the ACTIVE clinical trial were given the Observed Tasks of Daily Living (OTDL; a performance-based measure of medication management/finances/telephone use) at baseline and 1-, 2-, 3-, 5-, and 10-year follow-ups. When participants said "I don't know" or did not respond, they received a standardised verbal prompt, which served only as a cue to initiate the first step. At each occasion, unprompted (sum of items correct without prompting) and prompted (sum of correct prompted and unprompted items) scores were derived for each participant. Mixed effects models for change were used to determine the age trajectories of OTDL performance by race. When not prompted, African Americans demonstrated more rapid decline in OTDL performance than Whites, especially after age 80. When prompted, both groups had improved performance and evinced shallower decline, although African Americans continued to demonstrate a slightly more rapid decline. Simple prompting attenuated age-related changes of African Americans and Whites on a measure of everyday cognition. Prompting may be especially helpful for older African Americans.
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Affiliation(s)
- Kelsey R Thomas
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , USA
| | - Michael Marsiske
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , USA
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Abstract
Racially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We summarized the proportion of variation in outcomes attributable to state of school attendance and compared the magnitude of racial disparities across states. Among WHICAP African Americans, state of school attendance accounted for 9% of the variance in years of schooling, 6% of memory, and 12% of language. Among HRS African Americans, state of school attendance accounted for 13% of the variance in years of schooling and also contributed to variance in cognitive function (7%), memory (2%), and vocabulary (12%). Random slope models indicated state-level African American and white disparities in every Census region, with the largest racial differences in the South. State of school attendance may contribute to racial disparities in cognitive outcomes among older Americans. Despite tremendous within-state heterogeneity, state of school attendance also accounted for some variability in cognitive outcomes. Racial disparities in older Americans may reflect historical patterns of segregation and differential access to resources such as education.
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20
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Zahodne LB, Meyer OL, Choi E, Thomas ML, Willis SL, Marsiske M, Gross AL, Rebok GW, Parisi JM. External locus of control contributes to racial disparities in memory and reasoning training gains in ACTIVE. Psychol Aging 2015; 30:561-72. [PMID: 26237116 DOI: 10.1037/pag0000042] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Racial disparities in cognitive outcomes may be partly explained by differences in locus of control. African Americans report more external locus of control than non-Hispanic Whites, and external locus of control is associated with poorer health and cognition. The aims of this study were to compare cognitive training gains between African American and non-Hispanic White participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study and determine whether racial differences in training gains are mediated by locus of control. The sample comprised 2,062 (26% African American) adults aged 65 and older who participated in memory, reasoning, or speed training. Latent growth curve models evaluated predictors of 10-year cognitive trajectories separately by training group. Multiple group modeling examined associations between training gains and locus of control across racial groups. Compared to non-Hispanic Whites, African Americans evidenced less improvement in memory and reasoning performance after training. These effects were partially mediated by locus of control, controlling for age, sex, education, health, depression, testing site, and initial cognitive ability. African Americans reported more external locus of control, which was associated with smaller training gains. External locus of control also had a stronger negative association with reasoning training gain for African Americans than for Whites. No racial difference in training gain was identified for speed training. Future intervention research with African Americans should test whether explicitly targeting external locus of control leads to greater cognitive improvement following cognitive training.
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Affiliation(s)
- Laura B Zahodne
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University
| | - Oanh L Meyer
- Alzheimer's Disease Center, Department of Neurology, University of California, Davis
| | - Eunhee Choi
- School of Social Work, Health and Human Sciences, Colorado State University
| | | | - Sherry L Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida
| | - Alden L Gross
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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21
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Opdebeeck C, Martyr A, Clare L. Cognitive reserve and cognitive function in healthy older people: a meta-analysis. AGING NEUROPSYCHOLOGY AND COGNITION 2015; 23:40-60. [PMID: 25929288 DOI: 10.1080/13825585.2015.1041450] [Citation(s) in RCA: 263] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The associations between proxy measures of cognitive reserve (CR) and cognition vary across studies and cognitive domains. This meta-analysis aimed to assess the relationship between CR and cognition in multiple domains (memory, executive function, visuospatial ability, and language). CR was considered in terms of three key proxy measures - educational level, occupational status, and engagement in cognitively stimulating activities - individually and in combination. One-hundred and thirty-five studies representing 128,328 participants were included. Of these, 109 used a measure of education, 19 used a measure of occupation, 31 used a measure of participation in cognitively stimulating activities, and 6 used a combination of these. All three proxy measures had a modest positive association with cognition; occupational status and cognitive activities showed the most variation across cognitive domains. This supports the view that the commonly used proxy measures of CR share an underlying process but that each additionally provides a unique contribution to CR.
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Affiliation(s)
- Carol Opdebeeck
- a Research in Ageing and Cognitive Health, School of Psychology , Bangor University , Bangor , UK
| | - Anthony Martyr
- b Centre for Research in Ageing and Cognitive Health, School of Psychology , University of Exeter , Exeter EX4 4QG , UK
| | - Linda Clare
- b Centre for Research in Ageing and Cognitive Health, School of Psychology , University of Exeter , Exeter EX4 4QG , UK
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22
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Aiken-Morgan AT, Gamaldo AA, Sims RC, Allaire JC, Whitfield KE. Education Desegregation and Cognitive Change in African American Older Adults. J Gerontol B Psychol Sci Soc Sci 2015; 70:348-56. [PMID: 25361918 PMCID: PMC4580551 DOI: 10.1093/geronb/gbu153] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 09/25/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The present study examined the relationship between desegregated schooling and cognitive change in a sample of 420 community-dwelling African American elders (mean age = 68.6; SD = 9.1). METHOD Participants were recruited for the Baltimore Study of Black Aging - Patterns of Cognitive Aging. Cognitive measures from six domains of function were administered at baseline and follow-up 33 months later. Repeated measures multivariate analysis of covariance was conducted; the between subjects factors were schooling type and age cohort, and the within subjects factor was time. Analyses controlled for age, years of education, and sex, and follow-up univariate analyses were used to determine which individual cognitive scores drove the multivariate effects. RESULTS There were significant multivariate within-group, between-group, and interaction effects (p < .05). Univariate analyses indicated that the desegregated schooling group scored significantly better on Language and Perceptual Speed (p < .01), and the youngest age cohort (50- to 59-year-olds) performed better on measures of Perceptual Speed. There were no significant univariate interactions between schooling group or age cohort and cognitive change over time. DISCUSSION Overall, these findings suggest a slight advantage of desegregated schooling for cognitive performance, but no advantage of desegregated schooling on the rate of cognitive change over time in this sample.
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Affiliation(s)
- Adrienne T Aiken-Morgan
- Center on Biobehavioral Health Disparities Research, Duke University, Durham, North Carolina.
| | | | | | - Jason C Allaire
- Department of Psychology, North Carolina State University, Raleigh
| | - Keith E Whitfield
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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23
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Chapman B, Fiscella K, Duberstein P, Kawachi I, Muennig P. Measurement confounding affects the extent to which verbal IQ explains social gradients in mortality. J Epidemiol Community Health 2014; 68:728-33. [PMID: 24729404 PMCID: PMC4846277 DOI: 10.1136/jech-2013-203741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND IQ is thought to explain social gradients in mortality. IQ scores are based roughly equally on Verbal IQ (VIQ) and Performance IQ tests. VIQ tests, however, are suspected to confound true verbal ability with socioeconomic status (SES), raising the possibility that associations between SES and IQ scores might be overestimated. We examined, first, whether two of the most common types of VIQ tests exhibited differential item functioning (DIF) favouring persons of higher SES and/or majority race/ethnicity. Second, we assessed what impact, if any, this had on estimates of the extent to which VIQ explains social gradients in mortality. METHODS Data from the General Social Survey-National Death Index cohort, a US population representative dataset, was used. Item response theory models queried social-factor DIF on the Thorndike Verbal Intelligence Scale and Wechsler Adult Intelligence Scales, Revised Similarities test. Cox models examined mortality associations among SES and VIQ scores corrected and uncorrected for DIF. RESULTS When uncorrected for DIF, VIQ was correlated with income, education, occupational prestige and race, with correlation coefficients ranging between |0.12| and |0.43|. After correcting for DIF, correlations ranged from |0.06| to |0.16|. Uncorrected VIQ scores explained 11-40% of the Relative Index of Inequalities in mortality for social factors, while DIF-corrected scores explained 2-29%. CONCLUSIONS Two of the common forms of VIQ tests appear confound verbal intelligence with SES. Since these tests appear in most IQ batteries, circumspection may be warranted in estimating the amount of social inequalities in mortality attributable to IQ.
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Affiliation(s)
- Benjamin Chapman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Center for Communication and Disparities Research, Rochester, New York, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Paul Duberstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
- Department of Family Medicine, University of Rochester Medical Center, Center for Communication and Disparities Research, Rochester, New York, USA
| | - Ichiro Kawachi
- Department of Society, Human Development, and Health, Harvard University School of Public Health, Boston, Massachusetts, USA
| | - Peter Muennig
- Department of Health Management and Policy, Columbia University, Mailman School of Public Health, New York, New York, USA
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Marsiske M, Dzierzewski JM, Thomas KR, Kasten L, Jones R, Johnson K, Willis S, Whitfield K, Ball K, Rebok G. Race-related disparities in 5-year cognitive level and change in untrained ACTIVE participants. J Aging Health 2013; 25:103S-27S. [PMID: 24385632 PMCID: PMC3882334 DOI: 10.1177/0898264313497794] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The current study examined a 5-year cognitive change in untrained African American and White participants from the Advanced Cognitive Training in Independent and Vital Elderly (ACTIVE) study. METHOD Five-year trajectories of memory, reasoning, visual processing speed/useful field of view, digit-symbol substitution, and vocabulary were investigated. Education, health, gender, age, and retest/practice effects were controlled for, and a missing data pattern mixture approach was used to adjust for dropout effects. RESULTS After considering age, education, health, and gender, being African American uniquely explained 2% to 7% of the variance in cognitive performance. There were virtually no significant race differences in the rates of change. DISCUSSION Race-related results in the current study are consistent with previous research suggesting that social advantage factors such as education have a stronger influence on the level of performance than the rate of change. The small remaining effects of being African American on performance levels likely reflect uncontrolled variation in factors like literacy and financial advantage.
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Affiliation(s)
- Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida
| | | | - Kelsey R. Thomas
- Department of Clinical and Health Psychology, University of Florida
| | | | - Rich Jones
- Social and Health Policy Research, Hebrew Senior Life
| | - Kathy Johnson
- Department of Psychology, Indiana University Purdue University at Indianapolis
| | - Sherry Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | | | - Karlene Ball
- Department of Psychology, University of Alabama-Birmingham
| | - George Rebok
- Department of Mental Health, Johns Hopkins University
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25
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Ruiz JG, Andrade AD, Garcia-Retamero R, Anam R, Rodriguez R, Sharit J. Communicating global cardiovascular risk: are icon arrays better than numerical estimates in improving understanding, recall and perception of risk? PATIENT EDUCATION AND COUNSELING 2013; 93:394-402. [PMID: 23916416 DOI: 10.1016/j.pec.2013.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 06/17/2013] [Accepted: 06/29/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Experts recommend that adults have their global cardiovascular risk assessed. We investigated whether icon arrays increase understanding, recall, perception of CVR, and behavioral intent as compared with numerical information. METHODS Male outpatient veterans, at an intermediate to high cardiovascular risk participated in a randomized controlled trial of a computer tutorial presenting individualized risk. Message format was presented in 3 formats: percentages, frequencies, and frequencies with icon arrays. We assessed understanding immediately (T1) and recall at 20 min (T2) and 2 weeks (T3) after the intervention. We assessed perceptions of importance/seriousness, intent to adhere, and self-efficacy at T1. Self-reported adherence was assessed at T3. RESULTS One-hundred and twenty male veterans participated. Age, education, race, health literacy and numeracy were comparable at baseline. There were no differences in understanding at T1 [p = .31] and recall at T3 [p = .10]. Accuracy was inferior with frequencies with icon arrays than percentages or frequencies at T2 [p ≤ .001]. There were no differences in perception of seriousness and importance for heart disease, behavioral intent, self-efficacy, actual adherence and satisfaction. CONCLUSION Icon arrays may impair short-term recall of CVR. PRACTICE IMPLICATIONS Icon arrays will not necessarily result in better understanding and recall of medical risk in all patients.
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Affiliation(s)
- Jorge G Ruiz
- Laboratory of E-learning and Multimedia Research, Bruce W. Carter VA Geriatric Research Education and Clinical Center (GRECC), Miami, USA; University of Miami Miller School of Medicine, Miami, USA.
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Schneider BC, Lichtenberg PA. Influence of reading ability on neuropsychological performance in African American elders. Arch Clin Neuropsychol 2011; 26:624-31. [PMID: 21835850 DOI: 10.1093/arclin/acr062] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Use of normative data stratified by education may result in misclassification of African American older adults because reading ability, an estimate of educational attainment, is lower than reported years of education for some African American elders. This study examined the contribution of reading ability versus education to neuropsychological test performance in 86 community-dwelling African American elders ages 56-91 with 8-18 years of education. Hierarchical multiple regression analyses revealed that reading ability, but not education, was significantly associated with performances on the Trail Making Test, Controlled Oral Word Association Test, Animal Naming, Digit Span, and the Stroop test. Reading ability was not significantly related to performances on measures of memory. Medium to large effect sizes (Cohen's d = 0.58-1.41) were found when comparing mean performances on neuropsychological measures in groups with low versus high reading scores. Results indicate that reading ability contributes beyond educational attainment to performances on some neuropsychological measures among African American elders. These findings have implications for reducing misclassification among minority populations through the use of appropriate normative data.
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27
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Norman MA, Moore DJ, Taylor M, Franklin D, Cysique L, Ake C, Lazarretto D, Vaida F, Heaton RK. Demographically corrected norms for African Americans and Caucasians on the Hopkins Verbal Learning Test-Revised, Brief Visuospatial Memory Test-Revised, Stroop Color and Word Test, and Wisconsin Card Sorting Test 64-Card Version. J Clin Exp Neuropsychol 2011; 33:793-804. [PMID: 21547817 DOI: 10.1080/13803395.2011.559157] [Citation(s) in RCA: 214] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Memory and executive functioning are two important components of clinical neuropsychological (NP) practice and research. Multiple demographic factors are known to affect performance differentially on most NP tests, but adequate normative corrections, inclusive of race/ethnicity, are not available for many widely used instruments. This study compared demographic contributions for widely used tests of verbal and visual learning and memory (Brief Visual Memory Test-Revised, Hopkins Verbal Memory Test-Revised) and executive functioning (Stroop Color and Word Test, Wisconsin Card Sorting Test-64) in groups of healthy Caucasians (n = 143) and African Americans (n = 103). Demographic factors of age, education, gender, and race/ethnicity were found to be significant factors on some indices of all four tests. The magnitude of demographic contributions (especially age) was greater for African Americans than for Caucasians on most measures. New, demographically corrected T-score formulas were calculated for each race/ethnicity. The rates of NP impairment using previously published normative standards significantly overestimated NP impairment in African Americans. Utilizing the new demographic corrections developed and presented herein, NP impairment rates were comparable between the two race/ethnicities and were unrelated to the other demographic characteristics (age, education, gender) in either race/ethnicity group. Findings support the need to consider extended demographic contributions to neuropsychological test performance in clinical and research settings.
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Affiliation(s)
- Marc A Norman
- Department of Psychiatry, University of California, San Diego, CA, USA.
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28
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Aiken Morgan AT, Marsiske M, Dzierzewski JM, Jones RN, Whitfield KE, Johnson KE, Cresci MK. Race-related cognitive test bias in the active study: a mimic model approach. Exp Aging Res 2010; 36:426-52. [PMID: 20845121 PMCID: PMC2941916 DOI: 10.1080/0361073x.2010.507427] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present study investigated evidence for race-related test bias in cognitive measures used in the baseline assessment of the ACTIVE clinical trial. Test bias against African Americans has been documented in both cognitive aging and early life span studies. Despite significant mean performance differences, Multiple Indicators Multiple Causes (MIMIC) models suggested most differences were at the construct level. There was little evidence that specific measures put either group at particular advantage or disadvantage and little evidence of cognitive test bias in this sample. Small group differences in education, cognitive status, and health suggest positive selection may have attenuated possible biases.
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Affiliation(s)
- Adrienne T Aiken Morgan
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida 32610-0165, USA
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Tappen RM, Rosselli M, Engstrom G. Evaluation of the Functional Activities Questionnaire (FAQ) in cognitive screening across four American ethnic groups. Clin Neuropsychol 2010; 24:646-61. [PMID: 20473827 DOI: 10.1080/13854040903482855] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to examine the performance of the Functional Activities Questionnaire (FAQ) in four American ethnic groups (N = 691), evaluate the influence of demographic factors and depressive symptoms on the FAQ and compare its performance with two cognitive screening measures, the Mini-Cog and the MMSE. Half of FAQ items were less frequently done by men than women. FAQ total scores did not differ across the four ethnic groups but regression analyses indicated effects for age, education and depressive symptoms. The Mini-Cog and MMSE evidenced demographic and depressive symptom effects. FAQ performed well across the ethnic groups. Development of age and education corrections for the FAQ is recommended as is a screen for depression in cognitive screening batteries.
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Affiliation(s)
- Ruth M Tappen
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, Florida 33431-0991, USA.
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