The effect of African-American acculturation on neuropsychological test performance in normal and HIV-positive individuals

Abstract

Two studies were conducted to examine the relationship of acculturation to neuropsychological test performance among (1) medically healthy, neurologically normal African Americans (N = 170); and (2) HIV positive (HIV+) subgroups of African Americans and Whites (Ns = 20) matched on age, education, sex, and HIV disease stage. Acculturation was measured through self report for all participants, and linguistic behavior (Black English use) was assessed in a subset of medically healthy individuals (N = 25). After controlling for the effects of age, education, and sex, medically healthy African Americans who reported less acculturation obtained lower scores on the WAIS–R Information subtest and the Boston Naming Test than did more acculturated individuals. Black English use was associated with poor performance on Trails B and the WAIS–R Information subtest. HIV+ African Americans scored significantly lower than their HIV+ White counterparts on the Category Test, Trails B, WAIS–R Block Design and Vocabulary subtests, and the learning components of the Story and Figure Memory Tests. However, after accounting for acculturation, ethnic group differences on all measures but Story Learning became nonsignificant. These results suggest that there are cultural differences within ethnic groups that relate to neuropsychological test performance, and that accounting for acculturation may improve the diagnostic accuracy of certain neuropsychological tests. (JINS, 1998, 4, 291–302.)

Attention deficit hyperactivity disorder in African American children: What can be concluded from the past ten years?

“…It is also notable that none of the reviewed research examined ethnic differences in neuropsychological performance, although neuropsychological deficits are known to be associated with ADHD (Nigg, Blaskey, Huang-Pollock, & Rappley, 2002). Notably, controlling for acculturation has been shown to account for ethnic differences in neuropsychological test performance (Manly et al, 1998). …”

Effects of age, gender, education and race on two tests of language ability in community-based older adults

“…There is evidence that educational quality differences, as estimated by reading abilities, contribute to racial cognitive test performance differences (Manly et al , 1998a; Manly et al , 1998b; Manly et al , 2004; Gasquoine, 1999). …”

“…Important future research directions for similar normative studies would include introducing approaches to try to capture unmeasured variance in our demographic factors, such as “race”, (i.e., quality of education, measures of acculturation, persistence of poverty) (Manly et al , 1998a; Manly et al , 1998b; Manly et al , 2004; Gasquoine, 1999). As well, future studies should continue to expand the normative literature to more ethnic and cultural groups to keep pace with the ever increasing cultural diversity of older adults in many societies around the world.…”

“…The technical challenge associated with interpreting test performance is increased when a patient’s background diverges significantly from typical or published normative reference samples. Individuals from lower-educated or ethnic minority populations often have educational and cultural characteristics that complicate interpretation of cognitive test performance (Unverzagt et al , 2007; Byrd et al , 2005; Manly et al , 1998a; Manly et al , 1998b). Ethnic minority elders are the fastest-growing proportion of older adults in developed countries such as the United States (Day, 1996), highlighting a need for cognitive tests and normative data that can more accurately identify individuals with true cognitive impairment and early dementia.…”

The impact of ethnicity/race on the association between the Veterans Aging Cohort Study (VACS) Index and neurocognitive function among HIV-infected persons

“…HIV-infected Hispanics and NH blacks also appear to be at increased risk for worse neurocognitive outcomes than HIV-infected NH whites (Durvasula et al 2001; Heaton et al 2014; Manly et al 1998; Mindt et al 2008; Ryan et al 2005; Wojna et al 2006). Despite the availability of more effective combination antiretroviral treatment (cART), neurocognitive impairment (NCI) continues to be common and impactful in HIV.…”