Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-24T14:13:44.049Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological impairment in racial/ethnic minorities with HIV infection and low literacy levels: Effects of education and reading level in participant characterization

Published online by Cambridge University Press:  16 December 2005

ELIZABETH L. RYAN ,
REON BAIRD ,
MONICA RIVERA MINDT ,
DESIREE BYRD ,
JENNIFER MONZONES  and
SUSAN MORGELLO
ELIZABETH L. RYAN
Affiliation:
Department of Psychiatry, The Mount Sinai Medical Center, New York, New York Department of Pathology, The Mount Sinai Medical Center, New York, New York
REON BAIRD
Affiliation:
Department of Pathology, The Mount Sinai Medical Center, New York, New York Department of Psychology, The Graduate Center of the City University of New York (CUNY), Queens, New York
MONICA RIVERA MINDT
Affiliation:
Department of Psychiatry, The Mount Sinai Medical Center, New York, New York Department of Pathology, The Mount Sinai Medical Center, New York, New York Department of Psychology, Fordham University, Bronx, New York
DESIREE BYRD
Affiliation:
Department of Psychiatry, The Mount Sinai Medical Center, New York, New York Department of Pathology, The Mount Sinai Medical Center, New York, New York
JENNIFER MONZONES
Affiliation:
Department of Pathology, The Mount Sinai Medical Center, New York, New York
SUSAN MORGELLO
Affiliation:
Department of Pathology, The Mount Sinai Medical Center, New York, New York The Manhattan HIV Brain Bank
Get access Rights & Permissions [Opens in a new window]

Abstract

Educational attainment is an important factor in the interpretation of cognitive test scores but years of education are not necessarily synonymous with educational quality among racial/ethnic minority populations. This study investigated the comparability of educational attainment with reading level and examined whether discrepancies in education and reading level accounted for differences in neuropsychological test performance between HIV+ racial/ethnic minority and nonminority participants. Study participants (N = 200) were derived from the Manhattan HIV Brain Bank (MHBB) where 50% of the cohort had ≤8th grade reading level but only 5% had ≤8 years of education. Significantly lower reading ability and education was found among African Americans and Hispanics, and these participants were more likely to have discrepant reading and education levels compared to non-Hispanic Whites. Discrepancy in reading and education level was associated with worse neuropsychological performance while racial/ethnic minority status was not. As years of schooling overestimated racial/ethnic minority participants' educational quality, standard norms based on education may inflate impairment rates among racial/ethnic minorities. Identifying appropriate normative standards is and will continue to be important in the detection of cognitive impairment in racial/ethnic minorities with HIV. (JINS, 2005, 11, 889–898.)

Keywords

LiteracyEducationEthnicityHIVNeuropsychologyPremorbid IQ
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 7 , November 2005 , pp. 889 - 898
Copyright
© 2005 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adams, R.L., Boake, C., & Crain, C. (1982). Bias in a neuropsychological test classification related to age, education and ethnicity. Journal of Consulting and Clinical Psychology, 50, 143–145.Google Scholar
Albert, S. & Teresi, J. (1999). Reading ability, education, and cognitive status assessment among older adults in Harlem, New York City. American Journal of Public Health, 89, 95–97.Google Scholar
Ardilia, A., Rosselli, M., & Rosas, P. (1989). Neuropsychological assessment in illiterates: Visuospatial and memory abilities. Brain Cognition, 11, 147–166.Google Scholar
Baker, F.M., Johnson, J.T., Velli, S.A., & Wiley, C. (1996). Congruence between education and reading levels of older persons. Psychiatric Services, 47, 194–196.Google Scholar
Benedict, R.H. (1997). Brief Visuospatial Memory Test–Revised. Odessa, FL: Psychological Assessment Resources.
Benedict, R.H., Schretlen, D., Groninger, L., & Brandt, J. (1998). Hopkins Verbal Learning Test–Revised: Normative data and analysis of inter-form and test-retest reliability. The Clinical Neuropsychologist, 12, 43–55Google Scholar
Byrd, D., Miller, S., Reilly, J., Weber, S., Wall, T., & Heaton, R. (in press). Early environmental factors, ethnicity, and adult cognitive test performance. The Clinical Neuropsychologist.
Carey, K. (2004). The Funding Gap 2004: Many states still shortchange low-income and minority students. The Education Trust, 2004, 1–17.Google Scholar
Carroll, T., Fulton, K., Abercrombie, K., & Yoon, I. (2004). Fifty years after Brown v. Board of Education: A two-tiered education system. The National Commission on Teaching and America's Future. Washington, DC (202-429-2570). The report is available online at www.nctaf.org/documents/nctaf/Brown%5fFull%5fReport%5fFinal.pdf
Centers for Disease Control and Prevention. 2004 HIV/AIDS Surveillance Report, 2003 (Vol. 15). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 1–46.
Da Ronchi, D., Faranca, I., Berardi, D., Scudellari, P., Borderi, M., Manfredi, R., & Fratiglioni, L. (2002). Risk factors for cognitive impairment in HIV-1-infected persons with different risk behaviors. Archives of Neurology, 59, 812–818.Google Scholar
D'Elia, L. & Satz, P. (1996). Color Trails Test. Odessa, FL: Psychological Assessment Resources.
Diehr, M.C., Cherner, M., Wolfson, T.J., Miller, S.W., Grant, I., Heaton, R.K., & the HIV Neurobehavioral Research Center Group. (2003). The 50- and 100-item short forms of Paced Auditory Serial Addition Task (PASAT): Demographically corrected norms and comparisons with the full PASAT in normal and clinical samples. Journal of Clinical Experimental Neuropsychology, 25, 571–585.Google Scholar
Farinpour, R., Miller, E.N., Satz, P., Selnes, O.A., Cohen, B.A., Becker, J.T., Skolasky, R.L., & Visscher, B.R. (2003). Psychosocial risk factors of HIV morbidity and mortality: Findings from the MACS. Journal of Clinical Experimental Neuropsychology, 25, 654–670.Google Scholar
Fryer, R.G. & Levitt, S.D. (2004). Understanding the Black-White test score gap in the first two years of school. Review of Economics and Statistics, 86, 447–467.Google Scholar
Gladsjo, J.A., Schuman, C.C., Evans, J.D., Peavy, G.M., Miller, S.W., & Heaton, R.K. (1999). Norms for letter and category fluency: Demographic corrections for age, education, and ethnicity. Assessment, 6, 147–178.Google Scholar
Grissmer, D., Flanagan, A., & Williamson, S. (1998). Why did the Black-White score gap narrow in the 1970's and 1980's? In C. Jencks & M. Phillips (Eds.), The Black-White test score gap (pp. 182–228). Washington, DC: The Brookings Institute.
Heaton, R.K., Taylor, M., & Manly, J. (2001). Demographic effects and demographically corrected norms with the WAIS-III and WMS-III. In D. Tulsky, R.K. Heaton, G.J. Chelune, I. Ivnik, R.A. Bornstein, A. Prifitera, & M. Ledbetter (Eds.), Clinical interpretations of the WAIS-III and WMS-III (pp. 181–210). San Diego, CA: Academic Press.
Heaton, R., Grant, I., & Matthews, C.G. (1991). Comprehensive norms for an expanded Halstead-Reitan Battery: Demographic corrections, research findings, and clinical applications. Odessa, FL: Psychological Assessment Resources.
Hedges, L. & Nowell, A. (1998). Black-White test score convergence since 1965. In C. Jencks & M. Phillips (Eds.), The Black-White test score gap (pp. 149–181). Washington, DC: The Brookings Institute.
Hedges, L.V., Laine, R.D., & Greenwald, R. (1994). Does money matter? A meta-analysis of studies of differential school inputs on student outcomes. Educational Researcher, 23, 5–14.Google Scholar
Helms, J.E. (1997). The triple quandary of race, culture, and social class in standardized cognitive ability testing. In D.P. Flanagan, J.L. Genshaft, & P.L. Harrison (Eds.), Contemporary intellectual assessment: Theories, tests, and issues (pp. 517–532). New York: Guilford Press.
Helms, J., Jernigan, M., & Mascher, J. (2005). The meaning of race in psychology and how to change it: A methodological perspective. American Psychologist, 60, 27–36.Google Scholar
Humphreys, L. (1988). Trends in the level of academic achievement of blacks and other minorities. Intelligence, 12, 231–260.Google Scholar
Jacobs, D.M., Sano, M., Albert, S., Schofield, P., Dooneief, G., & Stern, Y. (1997). Cross-cultural neuropsychological assessment: A comparison of randomly selected, demographically matched cohorts of English- and Spanish-speaking older adults. Journal of Clinical and Experimental Neuropsychology, 19, 331–339.Google Scholar
Kennepohl, K., Douglas, S., Nabors, N., & Hanks, R. (2004). African American acculturation and neuropsychological test performance following traumatic brain injury. Journal of the International Neuropsychological Society, 10, 566–577.CrossRefGoogle Scholar
Kirsch, I.S., Jungeblut, A., Jenkins, L., & Kolstad, A. (2002). Adult literacy in America: A first look at the findings of the National Adult Literacy Survey. Washington, DC: U.S. Department of Education.
Kongs, S.K., Thompson, L.L., Iverson, G.L., & Heaton, R.K. (2000). Wisconsin Card Sorting Test–64 Card computerized version. Odessa, FL: Psychological Assessment Resources.
Lucas, J., Ivnik, R., Smith, G., Bohac, D., Tangalos, E., Graff-Radford, N., & Petersen, R. (1998). Mayo's older Americans normative studies: Category fluency norms. Journal of Clinical and Experimental Neuropsychology, 20, 194–200.Google Scholar
Manly, J.J. (2004). Acculturation, reading level, and neuropsychological test performance among African American elders. Applied Neuropsychology, 11, 37–46.Google Scholar
Manly, J.J. (2005). Advantages and disadvantages of separate norms for African Americans. The Clinical Neuropsychologist, 19, 270–275Google Scholar
Manly, J.J., Jacobs, D.M., Sano, M., Bell, K., Merchant, C.A., Small, S.A., & Stern, Y. (1998a). African American acculturation and neuropsychological test performance among nondemented community elders. Journal of the International Neuropsychological Society, 4, 77.Google Scholar
Manly, J.J., Jacobs, D.M., Sano, M., Bell, K., Merchant, C.A., Small, S.A., & Stern, Y. (1998b). Cognitive test performance among nondemented elderly African Americans and Whites. Neurology, 50, 1238–1245.Google Scholar
Manly, J.J., Jacobs, D.M., Touradji, P., Small, S.A., & Stern, Y. (2002). Reading level attenuates differences in neuropsychological test performance between African American and White elders. Journal of the International Neuropsychological Society, 8, 341–348Google Scholar
Manly, J.J., Touradji, P., Tang, M.-X., & Stern, Y. (2003). Literacy and memory decline among ethnically diverse elders. Journal of Clinical and Experimental Neuropsychology, 5, 680–690.Google Scholar
Mason, K., Campbell, A., Hawkins, P., Madhere, S., Johnson, K., & Takushi-Chinen, R. (1998). Neuropsychological functioning in HIV-positive African-American women with a history of drug use. Journal of the National Medical Association, 90, 665–674.Google Scholar
Mehta, K.M., Simonsick, E.M., Rooks, R., Newman, A.B., Pope, S.K., Rubin, S.M., & Yaffe, K. (2004). Black and white differences in cognitive function test scores: What explains the difference? Journal of the American Geriatric Society, 52, 2120–2127.Google Scholar
Miller, E.N., Bing, E.G., Selnes, O.A., Wesch, J., & Becker, J.T. (1993). The effects of sociodemographic factors on reaction time and speed of information processing [abstract]. Journal of Clinical and Experimental Neuropsychology, 15, 66.Google Scholar
Miller, S., Heaton, R., Kirson, D., & Grant, I. (1997). Neuropsychological (NP) assessment of African Americans [abstract]. Journal of the International Neuropsychological Society, 3, 49.Google Scholar
Norman, M.A., Evans, J.D., Miller, S.W., & Heaton, R.K. (2000). Demographically corrected norms for the California Verbal Learning Test. Journal of Clinical and Experimental Neuropsychology, 22, 80–94.Google Scholar
Patton, D., Duff, K., Schoenberg, M., Mold, J., Scott, J., & Adams, R. (2003). Performance of cognitively normal African Americans on the RBANS in community dwelling older adults. The Clinical Neuropsychologist, 17, 515–530Google Scholar
Richardson, J.L., Martin, E., Jimenez, N., Danley, K., Cohen, M., Carson, V., Sinclair, B., Racenstein, J., Reed, R., & Levine, A. (2002). Neuropsychological functioning in a cohort of HIV infected women: Importance of antiretroviral therapy. Journal of the International Neuropsychological Society, 8, 781–793.Google Scholar
Satz, P., Morgenstern, H., Miller, E.N., Selnes, O.A., McArthur, J.C., Cohen, B.A., Wesch, J., Becker, J.T., Jacobson, L., & D'Elia, L.F. (1993). Low education as a possible risk factor for cognitive abnormalities in HIV-1: Findings from the Multicenter AIDS Cohort Study (MACS). Acquired Immune Deficiency Syndrome, 6(5), 503–511.Google Scholar
Stern, R.A., Silva, G., Chaisson, N., & Evans, L. (1996). Influence of cognitive reserve on neuropsychological functioning in asymptomatic human immunodeficiency virus-1 infection. Archives of Neurology, 53, 148–153.Google Scholar
Stern, Y., Andrews, H., Pittman, J., Sano, M., Tatemichi, T., Lantigua, R., & Mayeux, R. (1992). Diagnosis of dementia of in a heterogeneous population. Development of a neuropsychological paradigm-based diagnosis of dementia and quantified correction for the effects of education. Archives of Neurology, 49, 453–460.Google Scholar
Tang, M.X., Cross, P., Andrews, H., Jacobs, D.M., Small, S., Bell, K., Merchant, C., Lantigua, R., Costa, R., Stern, Y., & Mayeux, R. (2001). Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan. Neurology, 56, 49–56.Google Scholar
Tulsky, D. & Price, L. (2003). Cross-validation of the joint factor structure of the WAIS-III and WMS-III: Examination of the structure by ethnic and age groups. In D. Tulsky, D. Saklofske, R.K. Heaton, G. Chelune, R. Ivnik, R.A. Bornstein, A. Prifitera, & M. Ledbetter (Eds.), Clinical interpretation of the WAIS-III and WMS-III. San Diego, CA: Academic Press.
U.S.Department of Education. (2000). NEAP 1999 trends in academic progress: Three decades of student performance (NCES 2000-439). Washington, DC: Office of Educational Research and Improvement, National Center for Education Statistics.
Wechsler, D. (1997). Wechsler Adult Intelligence Scale–Third edition: Administration and scoring manual. San Antonio, TX: Harcourt Brace.
Welsh, K.A., Fillenbaum, G., Wilkinson, W., Heyman, A., Mohs, R.C., Stern, Y., Harrell, L., Edland, S.D., & Beekly, D. (1995). Neuropsychological test performance in African-American and white patients with Alzheimer's disease. Neurology, 45, 2207–2211.Google Scholar
Wilkinson, G. (1993). Wide Range Achievement Test (3rd ed.) administration manual. Wilmington, DE: Wide Range Inc.
Woods, S.P., Rippeth, J.D., Frol, A.B., Levy, J.K., Ryan, E., Soukup, V.M., Hinkin, C.H., Lazzaretto, D., Cherner, M., Marcotte, T.D., Gelman, B.B., Morgello, S., Singer, E.J., Grant, I., & Heaton, R.K. (2004). Interrater reliability of clinical ratings and neurocognitive diagnoses in HIV. Journal of Clinical and Experimental Neuropsychology, 26, 759–778.Google Scholar