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: 3.01). 04/2002; 8(3):341-8. DOI: 10.1017/S1355617702813157
Source: PubMed

ABSTRACT 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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    • "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 · 1.92 Impact Factor
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    • "In our study, besides having included a wide range of demographic variables, we have controlled other potential confounding factors represented by a word pronunciation test. The word pronunciation test used in this study (SAT) has the same structure as the National Adult Reading Test (NART) and the Wide Range Achievement Test (WRAT), which have been used to estimate quality of education (Manly et al., 2002), premorbid verbal intelligence (Johnstone et al., 1996), crystallized cognitive abilities (Wolf et al., 2012), and cognitive reserve (Bleecker et al., 2007). These concepts have been employed in different contexts, but they represent a common underling construct that can have a critical role on how adequately patients can navigate through the health-care system. "
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    ABSTRACT: The purpose of this study was to explore the relationship between health literacy and specific cognitive abilities in hospital users. A neuropsychological battery was administered and the Short Test of Functional Health Literacy in Adults was used to classify individuals as having adequate or limited functional health literacy. Of the 322 participants, 102 (31.7%) presented limited health literacy. Even after adjusting for demographics, years of education, and quality of education, health literacy was strongly associated with measures of cognitive performance, but the strength of association was variable across different cognitive abilities.
    Journal of Health Psychology 02/2014; DOI:10.1177/1359105313520337 · 1.88 Impact Factor
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    • "Adjusting obtained scores for word recognition performance, considered a proxy measure of education " quality " and its corollaries (e.g., literacy; Manly et al., 2002; Schneider & Lichtenberg, 2011), has emerged as a promising alternative. Manly and colleagues (2002) found that differences between education-matched healthy elderly African Americans and Caucasians on tests of word list learning and memory, figure memory, abstract reasoning, word generation, and visuospatial skills were attenuated by controlling for word recognition scores on the Wide Range Achievement Test, Version 3 (WRAT-3). In another study with older non-demented African Americans, WRAT-3 scores strongly predicted neuropsychological performance above and beyond age, sex, years of education, and acculturation (Manly, Byrd, Touradji, & Stern, 2004). "
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    ABSTRACT: Ethnically diverse examinees tend to perform lower on neuropsychological tests. The practice of adjusting normative comparisons for the education level and/or race to prevent overpathologizing low scores is problematic. Education quality, as measured by reading recognition, appears to be a more accurate benchmark for premorbid functioning in certain populations. The present study aimed to extend this line of research to traumatic brain injury (TBI). We hypothesized that a measure of reading recognition, the Wechsler Test of Adult Reading (WTAR), would account for racial differences in neuropsychological performance after TBI. Fifty participants (72% African American, 28% Caucasian) with moderate to severe TBI underwent neuropsychological testing at 1-year post-injury. Reading recognition accounted for all the same variance in neuropsychological performance as race and education (together), as well as considerable additional variance. Estimation of premorbid functioning in African Americans with TBI could be refined by considering reading recognition.
    Archives of Clinical Neuropsychology 08/2013; 28(5):485-91. DOI:10.1093/arclin/act023 · 1.92 Impact Factor
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