Skip to main content
    • Aa
    • Aa

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

  • Beth E. Snitz (a1), Frederick W. Unverzagt (a2), Chung-Chou H. Chang (a3) (a4), Joni Vander Bilt (a5), Sujuan Gao (a6), Judith Saxton (a1), Kathleen S. Hall (a2) and Mary Ganguli (a5) (a7)...

Background: Neuropsychological tests, including tests of language ability, are frequently used to differentiate normal from pathological cognitive aging. However, language can be particularly difficult to assess in a standardized manner in cross-cultural studies and in patients from different educational and cultural backgrounds. This study examined the effects of age, gender, education and race on performance of two language tests: the animal fluency task (AFT) and the Indiana University Token Test (IUTT). We report population-based normative data on these tests from two combined ethnically divergent, cognitively normal, representative population samples of older adults.

Methods: Participants aged ≥65 years from the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) and from the Indianapolis Study of Health and Aging (ISHA) were selected based on (1) a Clinical Dementia Rating (CDR) score of 0; (2) non-missing baseline language test data; and (3) race self-reported as African-American or white. The combined sample (n = 1885) was 28.1% African-American. Multivariate ordinal logistic regression was used to model the effects of demographic characteristics on test scores.

Results: On both language tests, better performance was significantly associated with higher education, younger age, and white race. On the IUTT, better performance was also associated with female gender. We found no significant interactions between age and sex, and between race and education.

Conclusions: Age and education are more potent variables than are race and gender influencing performance on these language tests. Demographically stratified normative tables for these measures can be used to guide test interpretation and aid clinical diagnosis of impaired cognition.

Corresponding author
Correspondence should be addressed to: Beth E. Snitz, PhD, Department of Neurology, University of Pittsburgh, 3471 Fifth Avenue, Suite 802, Pittsburgh, PA 15213, U.S.A. Phone: +1 412–692-4820; Fax: +1 412–692-4031. Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

A. Acevedo (2000). Category fluency test: normative data for English- and Spanish-speaking elderly. Journal of the International Neuropsychological Society, 6, 760769.

K. I. Bolla , K. N. Lindgren , C. Bonaccorsy and M. L. Bleecker (1990). Predictors of verbal fluency (FAS) in the healthy elderly. Journal of Clinical Psychology, 46, 623628.

D. A. Byrd , D. Sanchez and J. J. Manly (2005). Neuropsychological test performance among Caribbean-born and U.S.-born African American elderly: the role of age, education and reading level. Journal of Clinical and Experimental Neuropsychology, 27, 10561069.

E de Renzi . and P. Faglioni (1978). Normative data and screening power of a shortened version of the Token Test. Cortex, 14, 4149.

P. G. Gasquoine (1999). Variables moderating cultural and ethnic differences in neuropsychological assessment: the case of Hispanic Americans. Clinical Neuropsychologist, 13, 376383.

C. P. Hughes , L. Berg , W. L. Danziger , L. A. Coben and R. L. Martin (1982). A new scale for the staging of dementia. British Journal of Psychiatry, 140, 566572.

R. J. Ivnik , J. F. Malec , G. E. Smith , E. G. Tangalos and R. C. Petersen (1996). Neuropsychological tests’ norms above age 55: COWAT, BNT, MAE token, WRAT-R reading, AMNART, STROOP, TMT, and JLO. Clinical Neuropsychologist, 10, 262278.

M. Johnson-Selfridge , C. Zalewski and J. Aboudarham (1998). The relationship between ethnicity and word fluency. Archives of Clinical Neuropsychology, 13, 319325.

S. N. Jones and C. R. Ayers (2006). Psychometric properties and factor structure of an expanded CERAD neuropsychological battery in an elderly VA sample. Archives of Clinical Neuropsychology, 21, 359365.

M. Lamar , A. B. Zonderman and S. Resnick (2002). Contribution of specific cognitive processes to executive functioning in an aging population. Neuropsychology, 16, 156162.

J. J. Manly (1998a). Cognitive test performance among nondemented elderly African Americans and whites. Neurology, 50, 12381245.

J. J. Manly , D. A. Byrd , P. Touradji and Y. Stern (2004). Acculturation, reading level, and neuropsychological test performance among African American elders. Applied Neuropsychology, 11, 3746.

W. G. Rosen (1980). Verbal fluency in aging and dementia. Journal of Clinical Neuropsychology, 2, 135146.

M. T. Sarno , A. Buonaguro and E. Levita (1985). Gender and recovery from aphasia after stroke. Journal of Nervous and Mental Disease, 173, 605609.

D. T. Stuss (1998). The effects of focal anterior and posterior brain lesions on verbal fluency. Journal of the International Neuropsychological Society, 4, 265278.

A. K. Troyer (2000). Normative data for clustering and switching on verbal fluency tasks. Journal of Clinical and Experimental Neuropsychology, 22, 370378.

F. W. Unverzagt (1996). Effects of age, education, and gender on CERAD neuropsychological test performance in an African American sample. Clinical Neuropsychologist, 10, 180190.

F. W. Unverzagt (1999). Clinical utility of CERAD neuropsychological battery in elderly Jamaicans. Journal of the International Neuropsychological Society, 5, 255259.

F. W. Unverzagt (2007). Mild cognitive dysfunction: an epidemiological perspective with an emphasis on African Americans. Journal of Geriatric Psychiatry and Neurology, 20, 215226.

D. Mungas , S. C. Marshall , M. Weldon , M. Haan and B. R. Reed (1996). Age and education correction of Mini-mental State Examination for English- and Spanish-speaking elderly. Neurology, 46, 700706.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 7
Total number of PDF views: 28 *
Loading metrics...

Abstract views

Total abstract views: 174 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st September 2017. This data will be updated every 24 hours.