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Devora PV, Motes MA, Hilsabeck RC, Gonzales M, Detoledo J, Maestre G, Hart J. Analyzing direct effects of education level and estimated IQ between cognitively intact Mexican Americans and Non-Hispanic whites on a confrontational naming task. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-10. [PMID: 38470863 DOI: 10.1080/23279095.2024.2326587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Confrontational naming is widely used in diagnosing neurodegenerative disorders like MCI and dementia, and previous research indicates that healthy Non-Hispanic Whites outperform Hispanics in such tasks. However, understanding the factors contributing to score differences among ethnic groups remains limited. This study focuses on cognitively intact Mexican Americans and Non-Hispanic White older adults from the TARCC Hispanic Cohort project. Hierarchical regression analyses reveal that sex, age, ethnicity, education level, and estimated IQ significantly predict performance on the Boston Naming Test (BNT). Notably, education level and estimated IQ more strongly influence BNT performance in Mexican Americans than in Non-Hispanic Whites. When controlling for education level, estimated IQ has a more pronounced impact on BNT performance in aging Mexican Americans compared to Non-Hispanic Whites. Conversely, after controlling for estimated IQ, the influence of education level is weaker for Mexican Americans than Non-Hispanic Whites. These findings emphasize the need for careful evaluation of confrontational naming task scores in diverse ethnic groups, emphasizing the critical role of education and estimated IQ in understanding performance disparities.
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Affiliation(s)
- Paulina Vanessa Devora
- The University of Texas at Dallas School of Behavioral and Brain Sciences, Richardson, TX, USA
| | - Michael A Motes
- The University of Texas at Dallas School of Behavioral and Brain Sciences, Richardson, TX, USA
| | - Robin C Hilsabeck
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Mitzi Gonzales
- The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - John Detoledo
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Gladys Maestre
- The University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - John Hart
- The University of Texas at Dallas School of Behavioral and Brain Sciences, Richardson, TX, USA
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Jacobs M, Evans E, Ellis C. Intersectional sociodemographic and neurological relationships in the naming ability of persons with post-stroke aphasia. JOURNAL OF COMMUNICATION DISORDERS 2023; 105:106352. [PMID: 37331326 DOI: 10.1016/j.jcomdis.2023.106352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/16/2023] [Accepted: 06/08/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Significant attention has been given to the role of brain function and disruption in determining performance on naming tasks among individuals with aphasia. However, scholarly pursuit of a neurological explanation has overlooked the fundamental cornerstone of individual health-the underlying social, economic, and environmental factors that shape how they live, work, and age, also known as the social determinants of health (SDOH). This study examines the correlation between naming performance and these underlying factors. METHODS Individual level data from the 2010 Moss Aphasia Psycholinguistic Project Database (MAPPD) was matched with the 2009-2011 Medical Expenditure Panel Survey (MEPS) using a propensity score algorithm based on functional, health, and demographic characteristics. Multilevel, generalized, nonlinear regression models were applied to the resulting data set to assess the correlation between the Boston Naming Test (BNT) percentile score and age, income, sex, race, household size, marital status, aphasia type, and region of residence. Poisson regression models with bootstrapped standard errors were used to estimate these relationships RESULTS: Discrete dependent variable estimation with non-normal prior specification included individual level (age, marital status, years of education), socioeconomic (family income), health (aphasia type), household (family size), and environmental (region of residence) characteristics. Regression results indicated that, relative to individuals with Wernicke's, individuals with Anomic (0.74, SE = 0.0008) and Conduction (0.42, SE = 0.0009) aphasia performed better on the BNT. While age at the time of testing was not significantly correlated, higher income level (0.15, SE = 0.0003) and larger family size (0.002, SE = 0.002) was associated with higher BNT score percentiles. Finally, Black persons with aphasia (PWA) (-0.0124, SE = 0.0007) had lower average score percentiles when other factors were held constant. CONCLUSIONS The findings reported here suggest higher income and larger family size are associated with better outcomes. As expected, aphasia type was significantly associated with naming outcomes. However, poorer performance by Black PWA and individuals with low income suggests that SDOH can play a critical role (positive and negative) in naming impairment in some populations with aphasia.
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Affiliation(s)
- Molly Jacobs
- Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, United States
| | - Elizabeth Evans
- Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, United States
| | - Charles Ellis
- Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, United States.
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Tilton-Bolowsky VE, van der Stelt CM, DeMarco A, Laks A, Dobbins C, Snider SF, Turkeltaub PE, Vallila-Rohter S. Evaluating circumlocution in naming as a predictor of communicative informativeness and efficiency in discourse. APHASIOLOGY 2023; 38:237-260. [PMID: 38559315 PMCID: PMC10977788 DOI: 10.1080/02687038.2023.2183076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/16/2023] [Indexed: 04/04/2024]
Abstract
Background Discourse analyses yield quantitative measures of functional communication in aphasia. However, they are historically underutilized in clinical settings. Confrontation naming assessments are used widely clinically and have been used to estimate discourse-level production. Such work shows that naming accuracy explains moderately high proportions of variance in measures of discourse, but proportions of variance remain unexplained. We propose that the inclusion of circumlocution productions into predictive models will account for a significant amount more of the variance. Circumlocution productions at the naming-level, while they may not contain the target word, are similar to the content that contributes to discourse informativeness and efficiency. Thus, additionally measuring circumlocution may improve our ability to estimate discourse performance and functional communication. Aim This study aimed to test whether, after controlling for naming accuracy, the addition of a measure of circumlocution into predictive models of discourse-level informativeness and efficiency would account for a significant amount more of the variance in these discourse-level outcomes. Methods & Procedures Naming and discourse data from 43 people with poststroke aphasia were analyzed. Naming data were collected using 120 pictured items and discourse data were collected using two picture description prompts. Data scoring and coding yielded measures of naming accuracy, incorrect response type, communicative informativeness, and efficiency. We used robust hierarchical regression to evaluate study predictions. Outcomes & Results After controlling for naming accuracy, the inclusion of circumlocution into predictive models accounted for a significant amount more of the variance in both informativeness and efficiency. The subsequent inclusion of other response types, such as real word and nonword errors, did not account for a significant amount more of the variance in either outcome. Conclusions In addition to naming accuracy, the production of circumlocution during naming assessments may correspond with measures of informativeness and efficiency at the discourse-level. Reducing the burden of estimating patients' functional communication will increase our ability to estimate functional communication using tools that are easy to administer and interpret.
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Affiliation(s)
- Victoria E. Tilton-Bolowsky
- MGH Institute of Health Professions, Boston, MA, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Candace M. van der Stelt
- Georgetown University, Washington, D.C., USA
- Department of Neurology, Georgetown University Medical Center
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
- Research Division, MedStar National Rehabilitation Hospital
| | - Andrew DeMarco
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center
- Department of Rehabilitation Medicine, Georgetown University
| | - Alycia Laks
- Georgetown University, Washington, D.C., USA
- Department of Neurology, Georgetown University Medical Center
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | | | - Sarah F. Snider
- Georgetown University, Washington, D.C., USA
- Department of Neurology, Georgetown University Medical Center
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | - Peter E. Turkeltaub
- Georgetown University, Washington, D.C., USA
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center
- Department of Neurology, Georgetown University Medical Center
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
- Research Division, MedStar National Rehabilitation Hospital
- Department of Rehabilitation Medicine, Georgetown University
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D Hood E, B Boone K, S Miora D, E Cottingham M, L Victor T, A Zeigler E, A Zeller M, J Wright M. Are there differences in performance validity test scores between African American and White American neuropsychology clinic patients? J Clin Exp Neuropsychol 2022; 44:31-41. [PMID: 35670549 DOI: 10.1080/13803395.2022.2069230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The purpose of the present study was to compare performance on a wide range of PVTs in a neuropsychology clinic sample of African Americans and White Americans to determine if there are differences in mean scores or cut-off failure rates between the two groups, and to identify factors that may account for false positive PVT results in African American patients. METHOD African American and White American non-compensation-seeking neuropsychology clinic patients were compared on a wide range of standalone and embedded PVTs: Dot Counting Test, b Test, Warrington Recognition Memory Test, Rey 15-item plus recognition, Rey Word Recognition Test, Digit Span (ACSS, RDS, 3-digit time, 4-digit time), WAIS-III Picture Completion (Most discrepant index), WAIS-III Digit Symbol/Coding (recognition equation), Rey Auditory Verbal Learning Test, Rey Complex figure, WMS-III Logical Memory, Comalli Stroop Test, Trails A, and Wisconsin Card Sorting Test. RESULTS When groups were equated for age and education, African Americans obtained mean performances significantly worse than White Americans on only four of 25 PVT scores across the 14 different measures (Stroop Word Reading and Color Naming, Trails A, Digit Span 3-digit time); however, FSIQ was also significantly higher in White American patients. When subjects with borderline IQ (FSIQ = 70 to 79) were excluded (resulting in 74 White Americans and 25 African Americans), groups no longer differed in IQ and only continued to differ on a single PVT cutoff (Trails A). Further, specificity rates in African Americans were comparable to those of White Americans with the exception of the b Test, the Dot Counting Test, and Stroop B. CONCLUSIONS PVT performance generally does not differ as a function of Black versus White race once the impact of intellectual level is controlled, and most PVT cutoffs appear appropriate for use in African Americans of low average IQ or higher.
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Affiliation(s)
- Elexsia D Hood
- California School of Forensic Studies, Alliant International University, Los Angeles, USA
| | - Kyle B Boone
- California School of Forensic Studies, Alliant International University, Los Angeles, USA.,Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, USA
| | - Deborah S Miora
- California School of Forensic Studies, Alliant International University, Los Angeles, USA
| | - Maria E Cottingham
- Mental Health Care Line, Veterans Administration Tennessee Valley Healthcare System, Nashville, USA
| | - Tara L Victor
- Department of Psychology, California State University, Dominguez Hills, Carson, USA
| | | | - Michelle A Zeller
- West Los Angeles Veterans Administration Medical Center, Los Angeles, USA
| | - Matthew J Wright
- Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, USA
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Abstract
This study compared prorated Boston Naming Test (BNT-P; omitting the noose item) and standard administration (BNT-S) scores in physical medicine and rehabilitation patients ( N = 480). The sample was 34% female and 91% White with average age and education of 46 ( SD = 15) and 14 ( SD = 3) years, respectively. BNT-P was calculated by summing correct responses excluding item 48 and estimating the 60-item score with cross multiplication and division. BNT-P and BNT-S scores were compared via concordance correlation (CC) coefficients; reflected and log transformed data were examined with equivalence tests. BNT-P and BNT-S scores showed almost perfect agreement (CC = .99). Transformed scores demonstrated equivalence (±1.1 points). Raw and scaled score differences were 0 in 88% and 96% of cases, respectively. Race and ethnicity accounted for item 48 outcomes while controlling for age and education. Findings support the utility of prorated BNT scores in rehabilitation patients.
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