Neuropsychological and Neuropsychiatric Prediction of Global Cognitive Status Among Older Spanish-Speaking Hispanics and English-Speaking Whites

Abstract

Background Neuropsychological and depression measures have been found to predict cognitive functioning. We compared these associations among whites and Spanish-speaking Hispanics. Methods Fifty-two pairs of whites and Hispanics were matched demographically and clinically in a cross-sectional study. Hierarchical regression analyses predicted Global Deterioration Scale (GDS) rating by baseline neuropsychological tests and depression symptoms. Results Neuropsychological tests predicted GDS better in whites; depression symptoms—specifically retardation—predicted well in Hispanics but not whites. Immediate recall of the New York University (NYU)-Paragraph Test and the Retardation item of the Hamilton Depression Rating Scale were associated with GDS in Hispanics and delayed recall of the NYU-Paragraph Test and Wechsler Adult Intelligence Scale-Digit Symbol in whites. Neuropsychological tests and depression symptoms predicted GDS differently in Hispanics and whites. Discussion These results suggest that other measures should be considered to increase the predictive accuracy of neuropsychological tests when assessing cognitive status in Spanish-speaking Hispanics. Additional studies of specific ethnic/racial and sociodemographic subgroups are warranted.

Relationship between Cognitive Performance and Measures of Neurodegeneration among Hispanic and White Non-Hispanic Individuals with Normal Cognition, Mild Cognitive Impairment, and Dementia

“…Individuals with greater cognitive reserve may also perform at a higher level on cognitive tests and functional measures, than would otherwise be expected for the severity of their underlying neurodegenerative or vascular brain disease. In this study, no difference in cognitive reserve between the two ethnic groups would be expected, based on our findings that no statistical difference in age and education level was present between the Hispanic and WNH participants within each diagnostic group, a finding consistent with other studies (Espino et al, 2004; Gasquoine, 1999; Guerrero-Berroa et al, 2014, 2016; Uzzell, Ponton, & Ardila, 2013). …”

“…Studies comparing White non-Hispanics (WNHs) to ethnic minorities on tests of cognitive performance among individuals with dementia have consistently shown lower scores in memory, executive function, and overall cognitive performance among Hispanics, even when controlling for factors such as age, sex, education, and socioeconomic status (Boone, Victor, Wen, Razani, & Pontón, 2007; Castora-Binkley, Peronto, Edwards, & Small, 2015; Espino & Lewis, 1998; Espino, Lichtenstein, Palmer, & Hazuda, 2004; Gasquoine, 1999; Guerrero-Berroa et al, 2014, 2016). Among the elderly, one explanation for these differences in cognitive performance could be the greater reported prevalence of neurodegenerative disease, such as Alzheimer’s disease (AD).…”

Depressive Symptoms Are Associated with Cognitive Function in the Elderly with Type 2 Diabetes

“…In the general elderly population, the association between neuropsychiatric symptoms (and in particular depressive symptoms) and cognitive impairment/ decline including dementia has been robustly found [ 1, 2 ]. This association has been reported in the elderly from different ethnic backgrounds [ 3 ] and has been supported by neuropathological findings [ 4, 5 ]. However, longitudinal studies have reported an association that affects only men [ 6 ] or those with higher educational attainment [ 7 ].…”

“…The lack of report of the effect sizes of the association make comparisons of these results with those of other studies challenging. One cross-sectional study with a small sample ( n = 52 white non-diabetic older adults) reported larger effect sizes (correlations ranging from 0.311 to 0.497) for the associations between depressive symptoms (as measured by the total score or two individual items from the Hamilton Depression Rating Scale) [ 38 ] and cognitive status, after controlling for demographics [ 3 ].…”