Reading level attenuates differences in neuropsychological test performance between African American and White elders

Cognitive Neuroscience Division, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Journal of the International Neuropsychological Society (Impact Factor: 2.96). 04/2002; 8(3):341-8. DOI: 10.1017/S1355617702813157
Source: PubMed


The current study sought to determine if discrepancies in quality of education could explain differences in cognitive test scores between African American and White elders matched on years of education. A comprehensive neuropsychological battery was administered to a sample of African American and non-Hispanic White participants in an epidemiological study of normal aging and dementia in the Northern Manhattan community. All participants were diagnosed as nondemented by a neurologist, and had no history of Parkinson's disease, stroke, mental illness, or head injury. The Reading Recognition subtest from the Wide Range Achievement Test-Version 3 was used as an estimate of quality of education. A MANOVA revealed that African American elders obtained significantly lower scores than Whites on measures of word list learning and memory, figure memory, abstract reasoning, fluency, and visuospatial skill even though the groups were matched on years of education. However, after adjusting the scores for WRAT-3 reading score, the overall effect of race was greatly reduced and racial differences on all tests (except category fluency and a drawing measure) became nonsignificant. These findings suggest that years of education is an inadequate measure of the educational experience among multicultural elders, and that adjusting for quality of education may improve the specificity of certain neuropsychological measures.

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    • "In the absence of published cognitive test norms for low-income minority women, we followed Heaton et al. (1991) and prior work within the WIHS (Maki et al. 2015; Manly et al. 2011; Rubin et al. 2015; Rubin et al. 2014; Valcour et al. 2015), using a regression approach to estimate premorbid levels of function for the total sample based on scores of the comparison group (HIV− women ). We did this by regressing each cognitive outcome on age, years of education, race/ethnicity, and results of the reading recognition subtest from the Wide Range Achievement Test— Revised (WRAT-R) (Wilkinson 1993), as a proxy for educational quality (Manly et al. 2002). The resulting unstandardized beta weights, constants, and standard errors were used to calculate predicted scores for each test that were then subtracted from each woman's actual score and transformed to scores (using means of 50 and standard deviations of 10) that could be more easily compared across all cognitive outcomes. "
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    ABSTRACT: The prevalence of post-traumatic stress disorder (PTSD) is higher among HIV-infected (HIV+) women compared with HIV-uninfected (HIV-) women, and deficits in episodic memory are a common feature of both PTSD and HIV infection. We investigated the association between a probable PTSD diagnosis using the PTSD Checklist-Civilian (PCL-C) version and verbal learning and memory using the Hopkins Verbal Learning Test in 1004 HIV+ and 496 at-risk HIV- women. HIV infection was not associated with a probable PTSD diagnosis (17 % HIV+, 16 % HIV-; p = 0.49) but was associated with lower verbal learning (p < 0.01) and memory scores (p < 0.01). Irrespective of HIV status, a probable PTSD diagnosis was associated with poorer performance in verbal learning (p < 0.01) and memory (p < 0.01) and psychomotor speed (p < 0.001). The particular pattern of cognitive correlates of probable PTSD varied depending on exposure to sexual abuse and/or violence, with exposure to either being associated with a greater number of cognitive domains and a worse cognitive profile. A statistical interaction between HIV serostatus and PTSD was observed on the fine motor skills domain (p = 0.03). Among women with probable PTSD, HIV- women performed worse than HIV+ women on fine motor skills (p = 0.01), but among women without probable PTSD, there was no significant difference in performance between the groups (p = 0.59). These findings underscore the importance of considering mental health factors as correlates to cognitive deficits in women with HIV.
    Journal of NeuroVirology 09/2015; DOI:10.1007/s13365-015-0380-9 · 2.60 Impact Factor
    • "The relative meaning of education can be different for different people and populations based on structural, social, economic, or individual factors. For example, African Americans in the United States often have lower cognitive test scores in late life, even after adjusting for education; however, adjusting for measures of educational quality— including, for example, days spent in schooling, student-to-teacher ratio, and length of school terms—accounts for a substantial proportion of these inequalities (Manly et al. 2002; Sisco et al. 2014). Richards and Sacker (2003) note that latelife literacy measures encapsulate capability, education , occupation, and developmental environmental characteristics but may further indicate engagement in cognitively demanding activity throughout life. "
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    ABSTRACT: Education is a fundamental cause of social inequalities in health because it influences the distribution of resources, including money, knowledge, power, prestige, and beneficial social connections, that can be used in situ to influence health. Recent studies have highlighted early-life cognition as commonly indicating the propensity for educational attainment and determining health and age of mortality. Health behaviors provide a plausible mechanism linking both education and cognition to later-life health and mortality. We examine the role of education and cognition in predicting smoking, heavy drinking, and physical inactivity at midlife using data from the Wisconsin Longitudinal Study (N = 10,317), National Survey of Health and Development (N = 5,362), and National Childhood Development Study (N = 16,782). Adolescent cognition was associated with education but was inconsistently associated with health behaviors. Education, however, was robustly associated with improved health behaviors after adjusting for cognition. Analyses highlight structural inequalities over individual capabilities when studying health behaviors. © American Sociological Association 2015.
    Journal of Health and Social Behavior 09/2015; 56(3):323-40. DOI:10.1177/0022146515594188 · 2.72 Impact Factor
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    • "performance-based tests, it is not surprising that reading tests better predict cognitive performance than standard years of education (e.g., Manly et al., 2002; Rohit et al., 2007). No research to date has empirically tested whether self-rated QEd indeed predicts reading performance despite its widespread use as a proxy measure for QEd. "
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    ABSTRACT: The current study examined whether self-rated education quality predicts Wide Range Achievement Test-4th Edition (WRAT-4) Word Reading subtest and neurocognitive performance, and aimed to establish this subtest's construct validity as an educational quality measure. In a community-based adult sample (N = 106), we tested whether education quality both increased the prediction of Word Reading scores beyond demographic variables and predicted global neurocognitive functioning after adjusting for WRAT-4. As expected, race/ethnicity and education predicted WRAT-4 reading performance. Hierarchical regression revealed that when including education quality, the amount of WRAT-4's explained variance increased significantly, with race/ethnicity and both education quality and years as significant predictors. Finally, WRAT-4 scores, but not education quality, predicted neurocognitive performance. Results support WRAT-4 Word Reading as a valid proxy measure for education quality and a key predictor of neurocognitive performance. Future research should examine these findings in larger, more diverse samples to determine their robust nature.
    Archives of Clinical Neuropsychology 10/2014; 29(8):731-736. DOI:10.1093/arclin/acu059 · 1.99 Impact Factor
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