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Fabea L, Intiful FD, Hatsu IE, Larry-Afutu J, Boateng L. Body composition is related to cognitive function among young adults in Ghana. BMC Psychol 2024; 12:114. [PMID: 38429727 PMCID: PMC10908039 DOI: 10.1186/s40359-024-01569-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/01/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND A growing body of evidence suggests that obesity can affect cognitive function. However, it is unclear whether this effect is independent of obesity-related comorbidities. This study thus sought to determine the association between body composition and cognitive function of young adults in Ghana with less predisposition to obesity-related comorbidities. METHODS A cross-sectional study design was employed, involving 381 participants recruited by simple random sampling. After consenting, participants completed questionnaires that assessed sociodemographic characteristics, along with assessments for anthropometric measures and cognitive function. Analyses for associations were conducted by either Pearson's correlation test or chi-Square test of independence. RESULTS Over half (60%) of participants were females and 69.6% were in the first year with a mean age of 20.18 ± 2.52 years. Based on Pearson's correlation test, no significant association was found between Body Mass Index (BMI) and Waist to Hip Ratio (WHR), and Trail Making Test-A and B (TMT-A and TMT-B). Nonetheless, a chi-square test showed a significant association, between BMI and TMT-A (p = 0.01), and WHR and both TMT-A (p = 0.001) and TMT-B (p = 0.02). Weak direct correlations were found between body fat percentage and TMT-A (r = 0.120, p = 0.019) and TMT-B (r = 0.133, p = 0.009). Further, a weak inverse correlation was found between muscle mass and TMT-A (r = - 0.141, p = 0.006) and TMT-B (r = - 0.144, p = 0.005). CONCLUSION High body fat, low muscle mass and body fat distribution may have a significant association with cognitive functions and must be considered in obesity interventions. This study provided more insight on the association between BMI and cognitive function and would be helpful in designing new weight management interventions or modifying existing interventions to consider the influence of obesity on cognitive function.
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Affiliation(s)
- Linda Fabea
- Department of Dietetics, University of Ghana, Accra, Ghana
| | | | - Irene E Hatsu
- Department of Human Sciences; College of Education and Human Ecology, Ohio State University, Columbus, OH, USA
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Zhang P, Gan D, Chi X, Mao D, Gao Y, Li Y, Zhou D, Li Q, Zhang M, Lu B, Li F, Xue J, Wang X, Du H, Li X, Liang Y, Ye Y. Regression-based Chinese norms of number connection test A and digit symbol test for diagnosing minimal hepatic encephalopathy. Sci Rep 2024; 14:4005. [PMID: 38369632 PMCID: PMC10874952 DOI: 10.1038/s41598-024-54696-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 02/15/2024] [Indexed: 02/20/2024] Open
Abstract
Number connection test A (NCT-A) and digit symbol test (DST), the preferential neuropsychological tests to detect minimal hepatic encephalopathy (MHE) in China, haven't been standardized in Chinese population. We aimed to establish the norms based on a multi-center cross-sectional study and to detect MHE in cirrhotic patients. NCT-A and DST were administered to 648 healthy controls and 1665 cirrhotic patients. The regression-based procedure was applied to develop demographically adjusted norms for NCT-A and DST based on healthy controls. Age, gender, education, and age by education interaction were all predictors of DST, while age, gender, and education by gender interaction were predictors of log10 NCT-A. The predictive equations for expected scores of NCT-A and DST were established, and Z-scores were calculated. The norm for NCT-A was set as Z ≤ 1.64, while the norm for DST was set as Z ≥ - 1.64. Cirrhotic patients with concurrent abnormal NCT-A and DST results were diagnosed with MHE. The prevalence of MHE was 8.89% in cirrhotic patients, and only worse Child-Pugh classification (P = 0.002, OR = 2.389) was demonstrated to be the risk factor for MHE. The regression-based normative data of NCT-A and DST have been developed to detect MHE in China. A significant proportion of Chinese cirrhotic patients suffered from MHE, especially those with worse Child-Pugh classification.
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Affiliation(s)
- Peng Zhang
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongfang Hospital, Beijing, China
| | - Danan Gan
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Xiaoling Chi
- Department of Hepatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Dewen Mao
- Department of Hepatology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Province, China
| | - Yueqiu Gao
- Department of Hepatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong Li
- Department of Hepatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Daqiao Zhou
- Department of Hepatology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Qin Li
- The Fourth Ward, Fuzhou Infectious Disease Hospital, Fuzhou, Fujian Province, China
| | - Mingxiang Zhang
- Department of Integrated Traditional and Western Medicine on Liver Diseases, Shenyang Infectious Disease Hospital, Shenyang, Liaoning Province, China
| | - Bingjiu Lu
- Department of Hepatology, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Fengyi Li
- Treatment and Research Center of Infectious Disease, The Fifth Medical Center of the General Hospital of the People's Liberation Army, Beijing, China
| | - Jingdong Xue
- Department of Hepatology, Shanxi Hospital of Traditional Chinese Medicine, Xi'an, Shanxi Province, China
| | - Xianbo Wang
- Department of Hepatology, Beijing Ditan Hospital, Beijing, China
| | - Hongbo Du
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Xiaoke Li
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Yijun Liang
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Yongan Ye
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China.
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.
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Lojo-Seoane C, Facal D, Delgado-Losada ML, Rubio-Valdehita S, López-Higes R, Frades-Payo B, Pereiro AX. Normative scores for attentional tests used by the Spanish consortium for ageing normative data (SCAND) study: Trail Making Test, Digit Symbol and Letter Cancellation. Clin Neuropsychol 2023; 37:1766-1786. [PMID: 36772821 DOI: 10.1080/13854046.2023.2173304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/20/2023] [Indexed: 02/12/2023]
Abstract
Objective: This paper reports normative data for different attentional tests obtained from a sample of middle-aged and older native Spanish adults and considering effects of age, educational level and sex. Method: 2,597 cognitively intact participants, aged from 50 to 98 years old, participated voluntarily in the SCAND consortium studies. The statistical procedure included conversion of percentile ranges into scaled scores. The effects of age, education and sex were taken into account. Linear regressions were used to calculate adjusted scaled scores. Results: Scaled scores and percentiles corresponding to the TMT, Digit Symbol and Letter Cancellation Task are shown. Additional tables show the values to be added to or subtracted from the scaled scores, for age and education in the case of the TMT and Letter Cancellation Task measures, and for education in the case of the Digit Symbol subtest. Conclusions: The current norms provide clinically useful data for evaluating Spanish people aged 50 to 98 years old and contribute to improving detection of initial symptoms of cognitive impairment.
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Affiliation(s)
- Cristina Lojo-Seoane
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - David Facal
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Luisa Delgado-Losada
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Susana Rubio-Valdehita
- Department of Social, Work and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Ramón López-Higes
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | | | - Arturo X Pereiro
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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4
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Kamalyan L, Guareña LA, Díaz-Santos M, Suarez P, Cherner M, García Alcorn MY, Umlauf A, Franklin DR, Mindt MR, Fortuny LAI, Heaton RK, Marquine MJ. Influence of Educational Background, Childhood Socioeconomic Environment, and Language Use on Cognition among Spanish-Speaking Latinos Living Near the US-Mexico Border. J Int Neuropsychol Soc 2022; 28:876-890. [PMID: 34486514 PMCID: PMC8898321 DOI: 10.1017/s1355617721001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES We investigated the impact of culturally relevant social, educational, and language factors on cognitive test performance among Spanish speakers living near the US-Mexico border. METHODS Participants included 254 healthy native Spanish speakers from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project (Age: M = 37.3, SD = 10.4; Education: M = 10.7, SD = 4.3; 59% Female). A comprehensive neuropsychological battery was administered in Spanish. Individual test scaled scores and T-scores (based on region-specific norms adjusted for age, education, and sex) were averaged to create Global Mean Scaled and T-scores. Measures of culturally relevant factors included a self-reported indicator of educational quality/access (proportion of education in Spanish-speaking country, quality of school/classroom setting, stopped attending school to work), childhood socioeconomic environment (parental education, proportion of time living in Spanish-speaking country, childhood socioeconomic and health status, access to basic resources, work as a child), and Spanish/English language use and fluency. RESULTS Several culturally relevant variables were significantly associated with unadjusted Global Scaled Scores in univariable analyses. When using demographically adjusted T-scores, fewer culturally relevant characteristics were significant. In multivariable analyses, being bilingual (p = .04) and working as a child for one's own benefit compared to not working as a child (p = .006) were significantly associated with higher Global Mean T-score, accounting for 9% of variance. CONCLUSIONS Demographically adjusted normative data provide a useful tool for the identification of brain dysfunction, as these account for much of the variance of sociocultural factors on cognitive test performance. Yet, certain culturally relevant variables still contributed to cognitive test performance above and beyond basic demographics, warranting further investigation.
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Affiliation(s)
- Lily Kamalyan
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
| | - Lesley A. Guareña
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
- Department of Medicine, Division of Geriatrics and Gerontology, University of California, San Diego
| | - Mirella Díaz-Santos
- Department of Psychiatry and Biobehavioral Sciences, Hispanic Neuropsychiatric Center of Excellence, University of California, Los Angeles
| | - Paola Suarez
- Department of Psychiatry and Biobehavioral Sciences, Hispanic Neuropsychiatric Center of Excellence, University of California, Los Angeles
| | - Mariana Cherner
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | | | - Anya Umlauf
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Donald R. Franklin
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Monica Rivera Mindt
- Department of Psychology & Latino American and Latino Studies Institute, Fordham University
| | | | - Robert K. Heaton
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - María J. Marquine
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
- Department of Medicine, Division of Geriatrics and Gerontology, University of California, San Diego
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Hilsabeck RC, Marquine MJ. Editorial from the TCN department of culture and gender in neuropsychology: moving the field toward broader representation in neuropsychological studies. Clin Neuropsychol 2022; 36:779-789. [PMID: 35435148 DOI: 10.1080/13854046.2022.2056924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Robin C Hilsabeck
- Department of Neurology, The University of Texas at Austin Dell Medical School, Austin, TX, USA.,Comprehensive Memory Center, Mulva Clinic for the Neurosciences, Austin, TX, USA
| | - María J Marquine
- Departments of Medicine and Psychiatry, University of California San Diego, San Diego, CA, USA
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6
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Iñesta C, Oltra-Cucarella J, Bonete-López B, Calderón-Rubio E, Sitges-Maciá E. Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Digit Span, Letters and Numbers, Trail Making Test and Symbol Digit Modalities Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9958. [PMID: 34639265 PMCID: PMC8507906 DOI: 10.3390/ijerph18199958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 12/31/2022]
Abstract
In this work, we developed normative data for the neuropsychological assessment of independent and cognitively active Spanish older adults over 55 years of age. METHOD Regression-based normative data were calculated from a sample of 103 non-depressed independent community-dwelling adults aged 55 or older (67% women). Raw data for Digit Span (DS), Letters and Numbers (LN), the Trail Making Test (TMT), and the Symbol Digit Modalities Test (SDMT) were regressed on age, sex, and education. The model predicting TMT-B scores also included TMT-A scores. Z-scores for the discrepancy between observed and predicted scores were used to identify low scores. The base rate of low scores for SABIEX normative data was compared to the base rate of low scores using published normative data obtained from the general population. RESULTS The effects of age, sex, and education varied across neuropsychological measures. Although the proportion of low scores was similar between normative datasets, there was no agreement in the identification of cognitively impaired individuals. CONCLUSIONS Normative data obtained from the general population might not be sensitive to identify low scores in cognitively active older adults, incorrectly classifying them as cognitively normal compared to the less-active population. We provide a friendly calculator for use in neuropsychological assessment in cognitively active Spanish people aged 55 or older.
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Affiliation(s)
- Clara Iñesta
- SABIEX, Universidad Miguel Hernández de Elche, Av. de la Universidad, 03207 Elche, Spain; (C.I.); (B.B.-L.); (E.C.-R.); (E.S.-M.)
| | - Javier Oltra-Cucarella
- SABIEX, Universidad Miguel Hernández de Elche, Av. de la Universidad, 03207 Elche, Spain; (C.I.); (B.B.-L.); (E.C.-R.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernandez University of Elche, 03202 Elche, Spain
| | - Beatriz Bonete-López
- SABIEX, Universidad Miguel Hernández de Elche, Av. de la Universidad, 03207 Elche, Spain; (C.I.); (B.B.-L.); (E.C.-R.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernandez University of Elche, 03202 Elche, Spain
| | - Eva Calderón-Rubio
- SABIEX, Universidad Miguel Hernández de Elche, Av. de la Universidad, 03207 Elche, Spain; (C.I.); (B.B.-L.); (E.C.-R.); (E.S.-M.)
| | - Esther Sitges-Maciá
- SABIEX, Universidad Miguel Hernández de Elche, Av. de la Universidad, 03207 Elche, Spain; (C.I.); (B.B.-L.); (E.C.-R.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernandez University of Elche, 03202 Elche, Spain
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7
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Salo SK, Marceaux JC, McCoy KJM, Hilsabeck RC. Removing the noose item from the Boston naming test: A step toward antiracist neuropsychological assessment. Clin Neuropsychol 2021; 36:311-326. [PMID: 34148526 DOI: 10.1080/13854046.2021.1933187] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: The Boston Naming Test-Second Edition (BNT-2), the "gold-standard" assessment of confrontation naming used to diagnosis disorders such as dementia, includes aculturally insensitive item, the noose. Given calls to stop structural racism in psychology, this study examined changes in scores and performance classification if the noose item were omitted from the BNT-2. Methods: Participants were 291 Black, White, and Latinx adults who were administered the BNT-2 within a comprehensive neuropsychological evaluation. Ethnoracial differences in BNT-2 scores with and without the noose item and percentages of participants answering the noose item incorrectly were investigated. Results: Significant differences were found between ethnoracial groups in BNT-2 raw scores, T-scores, and percentage of participants incorrectly answering the noose item. Follow-up analyses revealed White participants obtained significantly higher raw scores and had significantly fewer participants answer the noose item incorrectly than Black and Latinx groups, who did not differ significantly. For T-scores, Black participants obtained significantly higher scores than White participants who obtained significantly higher scores than Latinx participants. Despite these differences, giving credit for the omitted noose item changed performance classification for only 10 participants (3.4%). Conclusions: Performance classification did not change significantly for the vast majority of a large ethnoculturally diverse sample when giving credit for the noose item as if it were not administered. Therefore, the non-noose BNT-2remains accurate while reducing cultural insensitivity towards Black populations, emphasizing a step in working towards anti-racism and fostering culturally-competent services within psychology.
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Affiliation(s)
- Sarah K Salo
- Adult Neuropsychology, ThedaCare Behavioral Health, Appleton, Menasha, WI, USA
| | | | - Karin J M McCoy
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Robin C Hilsabeck
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
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Marquine MJ, Yassai-Gonzalez D, Perez-Tejada A, Umlauf A, Kamalyan L, Morlett Paredes A, Suarez P, Rivera Mindt M, Franklin D, Artiola I Fortuny L, Cherner M, Heaton RK. Demographically adjusted normative data for the Wisconsin Card Sorting Test-64 item: Results from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) project. Clin Neuropsychol 2021; 35:339-355. [PMID: 31900055 PMCID: PMC7523029 DOI: 10.1080/13854046.2019.1703042] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 11/30/2019] [Accepted: 12/04/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The Wisconsin Card Sorting Test (WCST) is among the most commonly used tests of executive functioning. We aimed to generate normative data on the 64-item version of this test (WCST-64) for Spanish-speakers living in the U.S.-Mexico Border region. METHODS Participants included 189 native Spanish-speakers (Age: 19-60; Education: 0-20; 59.3% female) from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) project who completed the WCST-64. Univariable and interactive associations between demographic variables and raw scores were examined via Spearman correlations, Wilcoxon Rank-sum tests and linear regressions. T-scores for various WCST-64 measures (Total Errors, Perseverative Responses, Perseverative Errors, Conceptual Level Responses and Number of Categories) were obtained using fractional polynomial equations with weights for age, education, and gender. Percentile scores were reported for Failures to Maintain Set. Rates of impairment (T-score < 40) were calculated by applying the newly developed norms and published norms for non-Hispanic English-speaking Whites and Blacks. RESULTS Older age was associated with worse performance and education was linked to better performance on most WCST-64 raw scores, with stronger education effects among females than males. The norms developed here resulted in expected rates of impairment (14-16% across measures). Applying published norms for non-Hispanic Blacks resulted in generally comparable impairment rates. In contrast, applying previously published norms for non-Hispanic Whites overestimated impairment (38-52% across measures). CONCLUSIONS These data will enhance interpretation performance on the WCST-64 for Spanish-speakers living in the U.S.-Mexico Border region. Future work will need to examine the generalizability of these norms to other Hispanic/Latino groups.
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Affiliation(s)
- María J Marquine
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - David Yassai-Gonzalez
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Alan Perez-Tejada
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Anya Umlauf
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Lily Kamalyan
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, La Jolla, California, USA
| | | | - Paola Suarez
- Department of Psychiatry and Behavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Monica Rivera Mindt
- Department of Psychology and Latin American and Latina/o Studies Institute, Fordham University, The Bronx, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Donald Franklin
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | | | - Mariana Cherner
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Robert K Heaton
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
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Mindt MR, Marquine MJ, Aghvinian M, Scott TM, Cherner M, Paredes AM, Taylor MJ, Umlauf A, Suarez P, Diaz-Santos M, Kamalyan L, Heaton A, Fortuny LAI, Heaton RK. Demographically-adjusted norms for the processing speed subtests of the WAIS-III in a Spanish-speaking adult population: Results from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) project. Clin Neuropsychol 2021; 35:293-307. [PMID: 32233833 PMCID: PMC8186464 DOI: 10.1080/13854046.2020.1723707] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 01/14/2020] [Accepted: 01/23/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The Wechsler Adult Intelligence Scale (WAIS) processing speed subtests are among the most ubiquitous indices of processing speed in the field. The aim of this study was to develop and examine demographically-adjusted normative data for Spanish language versions of the WAIS-III Digit Symbol Coding (DSC) and Symbol Search (SS) subtests for US-dwelling Spanish-speakers living in the US/Mexico border region. METHODS The sample included 203 healthy participants who were part of the larger Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project (DSC: n = 201; SS: n = 200). RESULTS Older age and higher education were both related to lower scores on the DSC and SS subtests (all ps < .0001). There were no significant effects for gender (all ps > .05). Raw-to-scaled score conversions were calculated for both subtests, and fractional polynomial equations were derived to compute demographically-adjusted T-scores accounting for age, education, and gender for each subtest and the Processing Speed Index. Published norms for English-speaking non-Hispanic white adults slightly overestimated impairment rates (T-scores <40) on both the DSC and SS subtests, while the norms for English-speaking non-Hispanic Black/African Americans and the new NP-NUMBRS norms Spanish-speakers both yielded impairment rates that fell within expected limits for healthy controls (i.e. 13%-14%). CONCLUSIONS This study suggests that population-specific normative data can improve the diagnostic validity of these measures for U.S.-dwelling Spanish-speakers living in the US/Mexico border region. Future research is needed to investigate the utility of these norms for other U.S.-dwelling Spanish-speaking subpopulations (e.g. Caribbean, Central American, South American).
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Affiliation(s)
- Monica Rivera Mindt
- Department of Psychology, Fordham University
- Department of Neurology, Icahn School of Medicine at Mount Sinai
| | | | | | | | - Mariana Cherner
- Department of Psychiatry, University of California, San Diego
| | | | | | - Anya Umlauf
- Department of Psychiatry, University of California, San Diego
| | - Paola Suarez
- Department of Psychiatry, University of California, San Diego
| | | | - Lily Kamalyan
- Department of Psychiatry, University of California, San Diego
| | - Anne Heaton
- Department of Psychiatry, University of California, San Diego
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10
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Paredes AM, Gooding A, Fortuny LAI, Mindt MR, Suárez P, Scott TM, Heaton A, Heaton RK, Cherner M, Marquine MJ. The state of neuropsychological test norms for Spanish-speaking adults in the United States. Clin Neuropsychol 2021; 35:236-252. [PMID: 32141802 PMCID: PMC7484438 DOI: 10.1080/13854046.2020.1729866] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/27/2020] [Accepted: 02/09/2020] [Indexed: 01/10/2023]
Abstract
Objective: The present review paper aimed to identify published neuropsychological test norms developed for Spanish-speakers living in the United States (U.S.). Methods: We conducted a systematic review of the literature via an electronic search on PubMed using keywords "Normative data," "Neuropsychological test," "norms", "Hispanic/Latinos," "Spanish Speakers," and "United States." We added other studies and published manuals as identified by citations in papers from the original search. Results Eighteen sources of normative data for Spanish-speakers in the U.S. were identified. Of the 18 citations identified, only four provide normative data on comprehensive batteries of tests for Spanish-Speakers. Two of these are based on persons living in the southwest of the U.S., who tend to be of Mexican origin. Overall, a number of the studies are focused on older persons and although the majority include participants with wide ranges of education, participants in the ends of the education distribution tend to be underrepresented. Conclusion: Here we provide a detailed description of the neuropsychological normative data currently available for Spanish-speakers living in the U.S. While there has been increased attention towards developing norms for neuropsychological batteries in Spanish-speaking countries (e.g., Latin America and Spain), there is still an urgent need to standardize neuropsychological tests among diverse groups of Spanish-speaking adults living in the U.S. The present review presents a list of norms for U.S.-dwelling Spanish-speakers, thus providing an important tool for clinicians and researchers.
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Affiliation(s)
| | - Amanda Gooding
- Department of Psychiatry, University of California San Diego, United States
| | | | - Monica Rivera Mindt
- Department of Psychology and Latin American and Latina/o Studies Institute, Fordham University, New York, New York
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paola Suárez
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Travis M. Scott
- Department of Psychology and Latin American and Latina/o Studies Institute, Fordham University, New York, New York
- VA Palo Alto Health Care System, Sierra Pacific MIRECC
| | - Anne Heaton
- Department of Psychiatry, University of California San Diego, United States
| | - Robert K. Heaton
- Department of Psychiatry, University of California San Diego, United States
| | - Mariana Cherner
- Department of Psychiatry, University of California San Diego, United States
| | - María J. Marquine
- Department of Psychiatry, University of California San Diego, United States
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11
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Gooding A, Seider T, Marquine M, Suárez P, Umlauf A, Mindt MR, Heaton RK, Fortuni LAI, Cherner M. Demographically-adjusted norms for the paced auditory serial addition test and letter number sequencing test in Spanish-speaking adults: Results from the neuropsychological norms for the U.S.-Mexico border region in Spanish (NP-NUMBRS) Project. Clin Neuropsychol 2021; 35:324-338. [PMID: 32043418 PMCID: PMC8211411 DOI: 10.1080/13854046.2019.1711199] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 12/23/2019] [Accepted: 12/27/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The Paced Auditory Serial Addition Test (PASAT) and Wechsler Adult Intelligence Scale Letter Number Sequencing subtest (LNS) are two commonly used measures of working memory. Demographic variables (age, education, ethnicity, etc.) can impact performance on these measures, underscoring the need for demographically adjusted norms. We aimed to develop normative data for the PASAT and LNS for Spanish-speaking adults living in the U.S.-Mexico border region as part of a larger normative effort. METHOD Participants were native Spanish-speakers from the Neuropsychological Norms for the U.S. Mexico Border Region in Spanish (NP-NUMBRS) project. Two hundred and forty-nine participants completed the PASAT and 202 participants completed LNS. Ages ranged from 19 to 60 and education from 0 to 20 years. RESULTS Older age was associated with lower scores on LNS (p < .01) but not PASAT. Lower education was associated with lower scores on both tests (ps < .001). Women obtained lower raw scores than men on PASAT (ps < .003), and there were no significant main effects of gender on LNS raw scores. Raw-to-scaled score conversions were calculated, and fractional polynomial equations were developed to calculate demographically-adjusted T-scores accounting for age, education, and gender. Published norms for English-speaking non-Hispanic Whites substantially overestimated rates of impairment (defined as T-score < 40) on both the PASAT and LNS. CONCLUSIONS The use of the population-specific normative data may improve detection of working memory dysfunction in U.S. Spanish-speaking adults and contribute to improved diagnostic accuracy and treatment planning in this population. Whether the norms generalize to U.S. Spanish-speakers from other countries remains to be determined.
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Affiliation(s)
- Amanda Gooding
- Department of Psychiatry, University of California, San Diego, CA
| | - Talia Seider
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Maria Marquine
- Department of Psychiatry, University of California, San Diego, CA
| | - Paola Suárez
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Anya Umlauf
- Department of Psychiatry, University of California, San Diego, CA
| | - Monica Rivera Mindt
- Department of Psychology and Latin American Latino Studies Institute, Fordham University, New York, NY
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Robert K. Heaton
- Department of Psychiatry, University of California, San Diego, CA
| | | | - Mariana Cherner
- Department of Psychiatry, University of California, San Diego, CA
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12
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Díaz-Santos M, Suárez PA, Marquine MJ, Umlauf A, Rivera Mindt M, Artiola i Fortuny L, Heaton RK, Cherner M. Updated demographically adjusted norms for the Brief Visuospatial Memory Test-revised and Hopkins Verbal Learning Test-revised in Spanish-speakers from the U.S.-Mexico border region: The NP-NUMBRS project. Clin Neuropsychol 2021; 35:374-395. [PMID: 33380275 PMCID: PMC8218787 DOI: 10.1080/13854046.2020.1861329] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We generated demographically adjusted norms for the Brief Visuospatial Memory Test-revised (BVMT-R) and the Hopkins Verbal Learning Test-revised (HVLT-R) for Spanish-speakers from the U.S.-Mexico border region as part of a larger normative project. Methods: Healthy native Spanish-speakers (n = 203; Age: 19-60 years; Education: 0-20 years, 59% women) living in Arizona (n = 63) and California (n = 140) completed the BVMT-R and the HVLT-R as part of the larger Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) project. Raw scores were converted to T-scores utilizing fractional polynomial equations, which considered linear and non-linear effects of demographic variables (age, education, sex). To demonstrate the benefit of employing our population-specific norms, we computed the proportion of our participants whose test performance fell below one standard deviation (T-score < 40) when applying published norms from non-Hispanic English-speakers, compared to the base rate derived from the new normative sample. Results: The resulting demographically adjusted T-scores showed the expected psychometric properties and corrected the misclassification in rates of impairment that were obtained when applying norms based on the English-speaking sample. Unexpectedly, participants in Arizona obtained slightly lower HVLT-R T-scores than those in California. This site effect was not explained by available sociodemographic or language factors. Supplementary formulas were computed adjusting for site in addition to demographics. Conclusions: These updated norms improve accuracy in identification of learning and memory impairment among Spanish-speaking adults living in the U.S.-Mexico border region. It will be important to generate additional data for elders, as the present norms are only applicable to adults age 60 and younger.
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Affiliation(s)
- Mirella Díaz-Santos
- Hispanic Neuropsychiatric Center of Excellence – Cultural Neuropsychology Program, Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Paola A. Suárez
- Hispanic Neuropsychiatric Center of Excellence – Cultural Neuropsychology Program, Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - María J. Marquine
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Anya Umlauf
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Monica Rivera Mindt
- Department of Psychology & Latin American Latino Studies Institute, Fordham University and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Robert K. Heaton
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Mariana Cherner
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
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13
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Heaton A, Gooding A, Cherner M, Umlauf A, Franklin DR, Rivera Mindt M, Suárez P, Artiola I Fortuni L, Heaton RK, Marquine MJ. Demographically-adjusted norms for the Grooved Pegboard and Finger Tapping tests in Spanish-speaking adults: Results from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project. Clin Neuropsychol 2021; 35:396-418. [PMID: 32077791 PMCID: PMC7438231 DOI: 10.1080/13854046.2020.1713400] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 12/31/2019] [Accepted: 01/03/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We developed demographically-corrected norms for Spanish-speakers from the U.S.-Mexico border regions of California and Arizona on two tests of motor skills - the Grooved Pegboard Test (Pegboard) and Finger Tapping Test (Tapping) - as part of a larger normative effort. METHOD Participants were native Spanish-speakers from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project (Pegboard: N = 254; Tapping: N = 183; age: 19-60 years; education: 0-20 years; 59% women). We examined the association of demographics (age, education and gender) with raw scores. Raw test scores were then converted to demographically-corrected T-scores via fractional polynomial equations. We also examined rates of impairment (T-score < 40) based on the current norms and on previously published norms for English-speaking non-Hispanic Whites and Blacks. RESULTS Having more years of education was associated with better raw test score performance on both tests (p < .001), and increased age was associated with worse performance on Pegboard (p < .001). Men outperformed women on Tapping, and older age was associated with lower raw scores in men only on the Tapping non-dominant hand trial (p = .02). The normed T-scores were confirmed to be normally distributed and free from demographic influences, and resulted in expected rates of impairment. Applying existing norms for English-speaking non-Hispanic Whites and Blacks to the raw scores of Spanish-speakers generally yielded lower than expected impairment rates (2-13%), with one exception: non-dominant Pegboard, for which non-Hispanic White norms overestimated impairment (23%). CONCLUSIONS Present findings underscore the importance of appropriate, population-specific normative data, even for tests of motor ability.
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Affiliation(s)
- Anne Heaton
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Amanda Gooding
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Mariana Cherner
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Anya Umlauf
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Donald R Franklin
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Monica Rivera Mindt
- Department of Psychology and Latin American Latino Studies Institute, Fordham University, Bronx, NY, USA
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paola Suárez
- Hispanic Neuropsychiatric Center of Excellence - Cultural Neuropsychology Program, Semel Institute for NeuroScience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, CA, USA
| | | | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - María J Marquine
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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14
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Cherner M, Marquine MJ, Umlauf A, Paredes AM, Mindt MR, Suárez P, Yassai-Gonzalez D, Kamalyan L, Scott T, Heaton A, Diaz-Santos M, Gooding A, Fortuny LAI, Heaton RK. Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project: Methodology and sample characteristics. Clin Neuropsychol 2021; 35:253-268. [PMID: 32319851 PMCID: PMC7894577 DOI: 10.1080/13854046.2019.1709661] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/18/2019] [Accepted: 12/22/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The present paper describes the methodology and sample characteristics of the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project, which aimed to generate demographically-adjusted norms for a battery of neuropsychological tests in this population. METHODS The sample consisted of 254 healthy Spanish-speakers, ages 19-60 years, recruited from the U.S.-Mexico border regions of Arizona (n = 102) and California (n = 152). Participants completed a comprehensive neuropsychological test battery assessing multiple domains (verbal fluency, speed of information processing, attention/working memory, executive function, learning and memory, visual-spatial skills and fine motor skills). Fluency in both Spanish and English was assessed with performance-based measures. Other culturally-relevant data on educational, social, and language background were obtained via self-report. Demographic influences on test performances were modeled using fractional polynomial equations that allow consideration of linear and non-linear effects. RESULTS There were no significant demographic differences between participants tested in Arizona and California. Age and gender were similar across education ranges. Two thirds of the sample were Spanish dominant and the remainder were considered bilingual. Individual articles in this Special Issue detail the generation of demographically adjusted T-scores for the various tests in the battery as well as an exploration of bilingualism effects. DISCUSSION Norms developed through the NP-NUMBRS project stand to improve the diagnostic accuracy of neuropsychological assessment in Spanish-speaking young-to-middle-aged adults living in the U.S.-Mexico border region. Application of the present norms to other groups should be done with caution.
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Affiliation(s)
- Mariana Cherner
- Department of Psychiatry, University of California San Diego
| | | | - Anya Umlauf
- Department of Psychiatry, University of California San Diego
| | | | - Monica Rivera Mindt
- Department of Psychology, Fordham University
- Department of Latin American and Latina/o Studies Institute, Fordham University
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | | | - Lily Kamalyan
- Department of Psychiatry, University of California San Diego
| | | | - Anne Heaton
- Department of Psychiatry, University of California San Diego
| | | | - Amanda Gooding
- Department of Psychiatry, University of California San Diego
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15
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Kamalyan L, Hussain MA, Diaz MM, Umlauf A, Franklin DR, Cherner M, Mindt MR, Fortuny LAI, Grant I, Heaton RK, Marquine MJ. Neurocognitive impairment in Spanish-speaking Latinos living with HIV in the US: Application of the neuropsychological norms for the US-Mexico border region in Spanish (NP-NUMBRS). Clin Neuropsychol 2021; 35:433-452. [PMID: 31847711 PMCID: PMC7453430 DOI: 10.1080/13854046.2019.1701084] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 11/01/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023]
Abstract
Objective Latinos in the US are at increased risk for HIV-associated neurocognitive impairment (NCI). Most studies of US Latinos living with HIV have included primarily English-speakers only. We investigated the rate, pattern, and correlates of HIV-associated NCI in native Spanish-speaking Latinos living in the US near the Mexican border. Methods Participants included 407 native Spanish-speaking Latinos (Age: M = 37.65, SD = 10.0; Education: M = 10.75, SD = 4.1; 53% male): 153 persons living with HIV (PLWH; 56% AIDS) and 254 healthy controls. All participants completed comprehensive neuropsychological assessments in Spanish. Raw neuropsychological test scores from seven domains were converted to demographically-adjusted T-scores using norms developed with healthy controls. Global and domain NCI were defined per established criteria. Among PLWH we applied norms developed for non-Hispanic (NH) Whites and Blacks, and investigated correlates of global NCI, including HIV disease characteristics and psychiatric comorbidities. Results Utilizing population specific norms, rates of global NCI were significantly higher among PLWH (39%) than healthy controls (17%), comparable to previously published rates. In contrast, rates of global NCI in the same group of PLWH were significantly different when NH White norms (63%, p < 0.0001) and NH Black norms were used (18%, p < 0.0001). Among PLWH without a history of lifetime substance use disorder, more years of antiretroviral exposure were significantly associated with decreased rates of global NCI. Conclusions Present findings lend support to the validity of newly developed norms for native Spanish-speakers living near the US-Mexico border, and underscore the importance of utilizing appropriate norms to accurately identify HIV-associated NCI.
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Affiliation(s)
- Lily Kamalyan
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
| | - Mariam A. Hussain
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
| | - Monica M. Diaz
- Department of Neurosciences, University of California, San Diego
| | - Anya Umlauf
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Donald R. Franklin
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Mariana Cherner
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Monica Rivera Mindt
- Department of Psychology & Latin American Latino Studies Institute, Fordham University and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Igor Grant
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Robert K. Heaton
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - María J. Marquine
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
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16
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Rivera Mindt M, Hilsabeck RC. Introductory editorial to the special issue on white privilege in neuropsychology and norms for spanish-speakers of the US-Mexico border region. Clin Neuropsychol 2021; 35:201-205. [PMID: 33390089 DOI: 10.1080/13854046.2020.1866076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Monica Rivera Mindt
- Psychology & Latin American Latino Studies Institute, Fordham University, New York City, NY, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Robin C Hilsabeck
- Neurology, Dell Medical School, University of Texas-Austin, Austin, TX, USA.,Comprehensive Memory Center, Mulva Clinic for the Neurosciences, Austin, UT, USA
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17
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Marquine MJ, Morlett Paredes A, Madriaga C, Blumstein Y, Umlauf A, Kamalyan L, Rivera Mindt M, Suarez P, Artiola I Fortuni L, Heaton RK, Cherner M. Demographically-adjusted norms for selected tests of verbal fluency: Results from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project. Clin Neuropsychol 2020; 35:269-292. [PMID: 32498654 DOI: 10.1080/13854046.2020.1762931] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Verbal fluency tests are sensitive to various disorders affecting the central nervous system and are commonly included in neuropsychological evaluations. We aimed to develop normative data for two verbal fluency tests in a sample of native Spanish-speakers living in the US-Mexico border region. METHOD Participants included 254 adults from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) Project (Age: range = 19-60; Education: range = 0-20, 59% female). Participants completed two verbal fluency tests (i.e., letter [PMR] and semantic/category fluency [Animal Naming]) as part of a larger neuropsychological test battery. We examined linear and nonlinear effects of demographic factors (age, education, and gender) on verbal fluency raw scores, and developed T-scores using fractional polynomial equations controlling for demographics. We also calculated the rates of "impairment" (T-scores < 40) that would be obtained by applying the newly developed norms and available norms for non-Hispanic English-speakers on comparable tests. RESULTS There were positive small effects of age and medium effects of education on verbal fluency raw scores. The normalized distribution of T-scores with the new norms showed expected psychometric properties. However, rates of impairment for both letter and semantic fluency were significantly higher when applying non-Hispanic White norms, and significantly lower when applying non-Hispanic Black norms. CONCLUSIONS We provide norms for Spanish-speakers living along the US-Mexico border region for two verbal fluency tests that are co-normed with a more extensive neuropsychological battery. These regional norms will improve interpretation of verbal fluency test performance in Spanish-speakers living in the US-Mexico borderland.
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Affiliation(s)
- María J Marquine
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | | | - Cecilia Madriaga
- Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Yanina Blumstein
- Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Anya Umlauf
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Lily Kamalyan
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA.,Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, USA
| | - Monica Rivera Mindt
- Department of Psychology and Latin American and Latina/o Studies Institute, Fordham University & Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paola Suarez
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Robert K Heaton
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Mariana Cherner
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
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18
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Marquine MJ, Rivera Mindt M, Umlauf A, Suárez P, Kamalyan L, Morlett Paredes A, Yassai-Gonzalez D, Scott TM, Heaton A, Diaz-Santos M, Gooding A, Artiola I Fortuny L, Heaton RK, Cherner M. Introduction to the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) Project. Clin Neuropsychol 2020; 35:227-235. [PMID: 32431209 DOI: 10.1080/13854046.2020.1751882] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The present introduction to the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) project aims to provide an overview of the conceptual framework and rationale that guided the development of this project. METHODS We describe important aspects of our conceptual framework, which was guided by some of the main purposes of neuropsychological testing, including the identification of underlying brain dysfunction, and the characterization of cognitive strengths and weakness relevant to everyday functioning. We also provide our rationale for focusing this norm development project on Spanish-speakers in the United States, and provide an outline of the articles included in this Special Issue focused on the NP-NUMBRS project. CONCLUSIONS The data presented in this Special Issue represent an important tool for clinicians and researchers working in the neuropsychological assessment of Spanish-speakers in the United States.
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Affiliation(s)
- María J Marquine
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Monica Rivera Mindt
- Departments of Psychology, Fordham University, New York, New York, USA.,Latin American and Latina/o Studies Institute, Fordham University, New York, New York, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anya Umlauf
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Paola Suárez
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Lily Kamalyan
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | | | - David Yassai-Gonzalez
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Travis M Scott
- Departments of Psychology, Fordham University, New York, New York, USA.,VA Palo Alto Health Care System, Sierra Pacific MIRECC, Palo Alto, California, USA
| | - Anne Heaton
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Mirella Diaz-Santos
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Amanda Gooding
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | | | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Mariana Cherner
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
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19
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Scott TM, Morlett Paredes A, Taylor MJ, Umlauf A, Artiola I Fortuny L, Heaton RK, Cherner M, Marquine MJ, Rivera Mindt M. Demographically-adjusted norms for the WAIS-R Block Design and Arithmetic subtests: Results from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project. Clin Neuropsychol 2020; 35:419-432. [PMID: 31928314 DOI: 10.1080/13854046.2019.1707285] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Wechsler Adult Intelligence Scale (WAIS) Block Design and Arithmetic subtests are frequently used as measures of visuospatial construction and verbal working memory, respectively. As part of a larger test adaptation and norming effort for this population, we generated and investigated demographically-adjusted interpretive norms for WAIS-R Block Design and Arithmetic in Spanish-speaking adults living in the US-Mexico border region. METHOD Participants included 183 community-dwelling adults ages 20-55 (education range: 0-20 years; 58% women) from the NeuroPsychological-Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) Project. They completed the WAIS-R Block Design and Arithmetic subtests in Spanish. Demographically-adjusted T-scores were calculated for these subtests using fractional polynomial equations adjusting for linear and non-linear effects of age, education (continuous), and sex. We compared our rates of impairment (i.e. T < 40) against rates calculated using published English-speaking WAIS-R standardization sample norms adjusted for age, education, and sex. RESULTS Education was positively associated with performance on Block Design and Arithmetic subtests, and men outperformed women on both subtests. The present Spanish-speaker norms for these subtests yielded expected rates of "impairment" (i.e. 15-16% impaired, a 1 SD cutoff), while existing norms for English-speakers underestimated impairment (i.e. 5-6% impaired) when applied to our Spanish-speaking sample. CONCLUSIONS Regional normative data will improve interpretation of test performance on Block Design and Arithmetic subtests for Spanish-speakers living in the US-Mexico border region and may aid in bolstering the overall analysis of neuropsychological profile patterns in this population. Cross-validation with Spanish-speakers in other regions and/or with other national origins is needed.
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Affiliation(s)
- Travis M Scott
- Department of Psychology, Fordham University, New York, NY, USA.,VA Palo Alto Health Care System, Sierra Pacific MIRECC, Palo Alto, CA, USA
| | | | - Michael J Taylor
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Anya Umlauf
- Department of Psychiatry, University of California, San Diego, CA, USA
| | | | - Robert K Heaton
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Mariana Cherner
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - María J Marquine
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Monica Rivera Mindt
- Department of Psychology, Fordham University, New York, NY, USA.,Department of Latin American Latino Studies Institute, Fordham University, New York, NY, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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20
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Morlett Paredes A, Carrasco J, Kamalyan L, Cherner M, Umlauf A, Rivera Mindt M, Suarez P, Artiola I Fortuny L, Franklin D, Heaton RK, Marquine MJ. Demographically adjusted normative data for the Halstead category test in a Spanish-speaking adult population: Results from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS). Clin Neuropsychol 2020; 35:356-373. [PMID: 31913746 DOI: 10.1080/13854046.2019.1709660] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The present study aimed to develop norms applicable to Spanish-speakers living in the United States (U.S.)- Mexico border region for the Halstead Category Test (HCT), a test of executive function. METHODS Healthy native Spanish-speakers (N = 252; Age: range 19-60 years, M = 37.28, SD = 10.24; Education: range 0-20 years; M = 10.65, SD = 4.33; 58.33% women) living in the U.S.-Mexico border region of California and Arizona completed the HCT as part of a comprehensive neuropsychological test battery. The univariable and interactive effects of demographic variables on HCT raw scores were examined. Total scores were normed using fractional polynomial equations, controlling for age, education, and gender. T-scores were also computed for HCT scores of the current Spanish-speaking normative sample using published, demographically-adjusted norms for English-speaking non-Hispanic Whites and Blacks. Impairment rates (T-Scores < 40) were calculated using published and current norms. RESULTS Age was significantly associated with increased number of errors, and education and male gender were associated with decreased number of HCT errors (total raw scores). Applying norms developed for English-speaking non-Hispanic Whites and Blacks resulted in overestimation of impairment rates in the current sample (impairment: 48% with White norms and 27% with Black norms). This pattern was evident across levels of education except in participants with 13+ years of education, where rates of impairment using non-Hispanic Black norms were comparable to those based on newly developed norms. CONCLUSION The present study presents norms for the HCT in a sample of U.S. Spanish-speakers, providing an important tool for identifying executive dysfunction in this population.
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Affiliation(s)
| | - Jessica Carrasco
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Lily Kamalyan
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Mariana Cherner
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Anya Umlauf
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Monica Rivera Mindt
- Department of Psychology and Latin American and Latina/o Studies Institute, Fordham University, Bronx, NY, USA.,Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Paola Suarez
- Department of Psychiatry and Behavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Donald Franklin
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - María J Marquine
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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