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

ArticleinJournal of the International Neuropsychological Society 8(3):341-8 · April 2002with29 Reads
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.
    • "For instance, O'Connor, Pollitt, and Treasure (1991) reported that education does not have any influence on the probability of dementia diagnosis performed by a specialist in a sample from general practice, but other authors, using a randomized clinical trial, have indicated that people with lower education are more likely to be diagnosed of dementia (Teresi, Grober, Eimicke, & Ehrlich, 2012). Despite that education is a relevant factor on cognitive test scores, literacy skills measured through reading ability may have a higher impact on cognitive scores than years of education (Contador, Bermejo-Pareja, Del Ser, & BenitoLeón, 2015; Manly, Jacobs, Touradji, Small, & Stern, 2002 ). Years of schooling may not necessarily be a good index of mental abilities, especially for people with limited access to education (Manly, Byrd, Touradji, Sanchez, & Stern, 2004) but many studies cannot distinguish between the effect of literacy and the effect of nonexposure to formal education (Manly et al., 2004). "
    [Show abstract] [Hide abstract] ABSTRACT: Background: The effect of different educational indices on clinical diagnosis of dementia requires more investigation. Objective: We compared the differential influence of two educational indices (EIs): years of schooling and level of education (i.e., null/low literacy, can read and write, primary school, and secondary school) on global cognition, functional performance, and the probability of having a dementia diagnosis. Method: A total of 3,816 participants were selected from the population-based study of older adults "Neurological Disorders in Central Spain" (NEDICES). The 37-item version of the Mini-Mental State Examination (MMSE-37) and the Pfeffer's questionnaire were applied to assess cognitive and functional performance, respectively. The diagnosis of dementia was performed by expert neurologists according to Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criteria. Logistic regression models adjusted for potential confounders were carried out to test the association between the two EIs and dementia diagnosis. Results: Both EIs were significantly associated with cognitive and functional scores, but individuals with null/low literacy performed significantly worse on MMSE-37 than literates when these groups were compared in terms of years of schooling. The two EIs were also related to an increased probability of dementia diagnosis in logistic models, but the association's strength was stronger for level of education than for years of schooling. Conclusion: Literacy predicted cognitive performance over and above the years of schooling. Lower education increases the probability of having a dementia diagnosis but the impact of different EIs is not uniform.
    Article · Aug 2016
    • "In addition, the CR latent variable was constructed using three variables: years of education, vocabulary, and comprehension ability. Although years of education is the most commonly used proxy variable for CR, and vocabulary and comprehension introduce important information about the quality of education (Manly et al., 2002 ), a CR construct examining indictors related to social and lifestyle experiences might have yielded different findings for this population of healthy older adults (Lojo-Seoane, Facal, Guàrdia-Olmos, Juncos- Rabadán, 2014). For example, in a study by Reed and colleagues (2011), engaging in leisure cognitive activities at age 40 and in late life was found to be a stronger predictor of CR than socioeconomic status and education. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction: The use of compensatory strategies plays an important role in the ability of older adults to adapt to late-life memory changes. Even with the benefits associated with compensatory strategy use, little research has explored specific mechanisms associated with memory performance and compensatory strategies. Rather than an individual's objective memory performance directly predicting their use of compensatory strategies, it is possible that some other variables are indirectly influencing that relationship. The purpose of this study was to: (a) examine the moderating effects of cognitive reserve (CR) and (b) evaluate the potential mediating effects of memory self-efficacy on the relationship between objective memory performance and compensatory strategy use. Method: Two structural equation models (SEM) were used to evaluate CR (latent moderator model) and memory self-efficacy (mediator model) in a sample of 155 community-dwelling older adults over the age of 55. Results: The latent variable moderator model indicated that CR was not substantiated as a moderator variable in this sample (p = .861). However, memory self-efficacy significantly mediated the association between objective memory performance and compensatory strategy use (β = .22, 95% confidence interval, CI [.002, .437]). More specifically, better objective memory was associated with lower compensatory strategy use because of its relation to higher memory self-efficacy. Conclusions: These findings provide initial support for an explanatory framework of the relation between objective memory and compensatory strategy use in a healthy older adult population by identifying the importance of an individual's memory perceptions.
    Article · Mar 2016
    • "The ease of collecting these measurements is to their advantage; however, they also each have drawbacks. Years of education does not assess quality of education (Manly et al., 2002). It also does not include age of acquisition of education. "
    [Show abstract] [Hide abstract] ABSTRACT: This study investigated the relationship between education and physical activity and the difference between a physiological prediction of age and chronological age. Cortical and subcortical grey matter regional volumes were calculated from 331 healthy adults (range: 19-79 years). Multivariate analyses identified a covariance pattern of brain volumes best predicting chronological age (CA)(R2 = 47%). Individual expression of this brain pattern served as a physiologic measure of brain age (BA). The difference between CA and BA was predicted by education and self-report measures of physical activity. Education and the daily number of flights of stairs climbed were the only two significant predictors of decreased brain age. Effect sizes demonstrated that brain age decreased by 0.95 years for each year of education and by 0.58 years for one additional daily FOSC. Effects of education and FOSC on regional brain volume were largely driven by temporal and subcortical volumes. These results demonstrate that higher levels of education and daily FOSC are related to larger brain volume than predicted by chronological age which supports the utility of regional grey matter volume as a biomarker of healthy brain aging.
    Full-text · Article · Feb 2016 · Journal of Clinical and Experimental Neuropsychology
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