Improving accuracy of cross-cultural neuropsychological testing

To evaluate the elderly for memory loss and dementia, neuropsychologists use a variety of memory, image recognition, and abstract reasoning tests.The tests require participants to name objects from drawings, match similar shapes, and remember lists of items. Neuropsychologists assess people who take the test based on their age and years of schooling, among other factors.

But African Americans do not perform as well as whites on these tests even if test-takers from both ethnic groups have attained the same number of years of schooling. Because of the lower scores, healthy African Americans may be more likely to be misdiagnosed with Alzheimers disease or other cognitive defects.

In an effort to make neuropsychological tests more accurate, Columbia Health Sciences researchers decided to study whether quality of education, rather than quantity, could explain the lower test scores among African Americans.

In their study, the investigators measured quality of schooling by administering a reading test to 192 elderly African Americans and 192 elderly non-Hispanic whites from Northern Manhattan. The participants, who were all 65 years and older, did not have dementia and were functioning normally in their daily lives.

The researchers found that they could eliminate most of the racial differences found in the neuropsychological test assessments by factoring in the scores from the reading tests. Both blacks and whites with a poor reading test result achieved similar neuropsychological test scores.

The findings suggest that including an assessment of reading skills will help neuropsychologists know what scores to expect from elders with diverse educational backgrounds, says Dr. Jennifer Manly, lead author of the study and assistant professor of neuropsychology in the

Contact: Annie Bayne
Columbia University Medical Center

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