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3 Harmonized Memory and Language Function in the Harmonized Cognitive Assessment Protocol (HCAP) Across the United States and Mexico
- Miguel Arce Rentería, Emily M Briceño, Diefei Chen, Joseph Saenz, Jet M. J. Vonk, Lindsay Kobayashi, Chris Gonzalez, Rich Jones, Rebeca Wong, Kenneth M Langa, David R Weir, Jennifer J Manly, Alden L Gross
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 87-88
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Objective:
Cross-national neuropsychological research is needed to understand the social, economic, and cultural factors associated with cognitive risk and resilience across global aging populations. Memory and language have been shown to be sensitive to age-related cognitive decline and pathological cognitive aging processes and may be more sensitive to subtle cognitive decline than measures of global cognitive function. Thus, we aimed to derive and validate harmonized cognitive domain scores for memory and language across population-based studies in the US and Mexico.
Participants and Methods:Data came from the Health and Retirement Study (HRS) Harmonized Cognitive Assessment Protocol (HCAP) and the Mexican Health and Aging Study (MHAS) Ancillary Study on Cognitive Aging (Mex-Cog). We used confirmatory factor analysis methodology to create statistically co-calibrated cognitive domains of memory and language. We performed differential item functioning (DIF) analysis to evaluate measurement differences across studies, using a cultural neuropsychological approach to identify comparable items across studies (i.e., cross-study anchors). We evaluated harmonized scores by examining their relationship to age and education in each study.
Results:We included 3347 participants from the HRS-HCAP study [Mage=76.6(7.5), 60% female] and 2042 participants from the Mex-Cog study [Mage=68.1(9.0), 59% female]. Education was classified according to the International Standard Classification of Education in the following categories (HRS-HCAP and Mex-Cog, respectively): none or early childhood education: (0.7%; 50.5%), primary education (4.1%; 22.3%), lower secondary education (7.1%; 15.7%), upper secondary education (41.1%; 3.0%), and any college (47.1%; 8.5%). DIF analyses revealed that 5 out of the 7 memory items and 1 out of the 12 language items demonstrated statistical evidence of measurement differences across studies, meaning that these items measured each underlying cognitive construct differently across studies. After adjusting for DIF by not allowing the items with DIF to be cross-study anchors, harmonized memory and language scores showed generally the expected associations with age and education in each study. Increasing age was associated with lower memory (r=-0.40 in HRS-HCAP; r=-0.44 in Mex-Cog) and language (r=-0.31 in HRS-HCAP and r=-0.67 in Mex-Cog) scores. Increasing years of education was associated with better memory and language scores, with mean scores ranging from z=-0.86 and z=-0.29 among those with a primary education or lower to z=0.33 and z=0.90 among those with any college, for HRS-HCAP and Mex-Cog, respectively.
Conclusions:A cultural neuropsychology approach to statistical harmonization facilitates the generation of harmonized measures of cognitive functioning in cross-national studies. Future work can utilize these harmonized cognitive scores to investigate determinants of late-life cognitive decline and dementia in the US and Mexico.
6 Code-switching, Language Attitudes, and Executive Function in Latinx Bilinguals
- Alice Gavarrete Olvera, Jet M. J. Vonk, Adam M. Brickman, Desiree Byrd, Miguel Arce Renteria
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 90-91
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Objective:
Code-switching is when bilingual individuals alternate between two languages in the same conversation. Some studies find that code-switching frequency is associated with executive functioning, while others do not. Individual attitudes towards bilingual language use and code-switching may explain the inconsistency in the literature. For instance, greater positive attitudes towards code-switching may be associated with more likelihood to engage in that practice and thus strengthen the cognitive benefit in executive function. Additionally, code-switching between English and Spanish has been stigmatized in the U.S., therefore it is unclear what sociocultural factors may predict positive attitudes. In this study, we assessed Latinx bilinguals’ attitudes on code-switching and investigated their relationship with code-switching frequency, sociodemographic and linguistic factors, and executive functioning.
Participants and Methods:Participants were 525 community-dwelling English-Spanish bilingual Latinx adults from the Offspring study (Mage= 55.38 (10.42); Meducation= 12.62 (3.34); 71% women; 41% tested in English, 75% immigrant). A language history questionnaire assessed for bilingualism and code-switching frequency. Participants completed 7 questions on code-switching attitudes on a 7-point Likert scale ranging from Strongly Disagree to Strongly Agree (e.g., “switching between languages in a conversation is an important part of my identity”), that were summed for a total score with higher scores indicating more positive attitudes. Executive functioning was assessed with the NIH Toolbox Cognition battery, verbal fluencies, and the digit span test. Sociodemographic and linguistic factors included age, sex, education, immigrant status, parental years of education, English and Spanish proficiency (average score on self-reported ratings on speaking, reading, writing, and understanding), and testing language. General linear models evaluated the association of code-switching attitudes on executive function, after adjusting for relevant covariates.
Results:Positive code-switching attitudes were correlated with greater code-switching, r(499)=.33, p<.001. Younger age r(499)=-.11, being born in the US t(493)=-2.05, greater English proficiency r(497)=.15, and English dominance t(499)=2.22, were associated with more positive code-switching attitudes (all p’s <.05). Sex, education, parental years of education, and Spanish proficiency were not associated with code-switching attitudes. Overall models of attitudes with executive function indicated that positive code-switching attitudes were associated with worse visual working memory (b = -0.08, t(169) = -2.75, 95% CI [0.14, -0.02]) after adjusting for age, sex, education, immigration status, parental years of education and testing language. Code-switching attitudes were not significantly associated with other executive function measures.
Conclusions:Among a community-based sample of bilingual middle-aged Latinx adults, positive attitudes towards code-switching were associated with greater likelihood of code-switching in conversations, higher English proficiency, being US born, younger age, and English language dominance but negatively associated with visual working memory. These findings indicate that code-switching attitudes are influenced by sociodemographic and linguistic factors. Additionally, the negative association between code-switching attitudes and visual working memory provides support for previous studies showing code-switching as a disadvantage to cognition. Results of this study suggest that detailed characterization of sociocultural factors and aspects of bilingualism can provide further clarity in determining if there is a potential bilingual cognitive advantage. Future research should examine the relationship of code-switching with other aspects of bilingualism (e.g., age of acquisition).
Longitudinal decline in semantic versus letter fluency, but not their ratio, marks incident Alzheimer’s disease in Latinx Spanish-speaking older individuals
- Kayri K. Fernández, Anton J. Kociolek, Patrick J. Lao, Yaakov Stern, Jennifer J. Manly, Jet M. J. Vonk
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue 8 / October 2023
- Published online by Cambridge University Press:
- 13 January 2023, pp. 775-782
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Objective:
To compare longitudinal verbal fluency performance among Latinx Spanish speakers who develop Alzheimer’s disease to those who do not develop dementia in absolute number of words produced on each task and their ratio to combine both scores.
Method:Participants included 833 Latinx Spanish-speaking older adults from a community-based prospective cohort in Manhattan. We performed growth curve modeling to investigate the trajectories of letter and semantic fluency, and their ratio (i.e., ‘semantic index’), between individuals who developed Alzheimer’s disease and those who did not (i.e., controls). The semantic index quantifies the proportion of words generated for semantic fluency in relation to the total verbal fluency performance.
Results:Letter fluency performance did not decline in controls; we observed a linear decline in those who developed Alzheimer’s disease. Semantic fluency declined in both groups and showed an increased rate of change over time in the incident Alzheimer’s disease group; in comparison, the control group had a linear and slower decline. There were no group differences in the longitudinal trajectory (intercept and slope) of the semantic index.
Conclusion:A decline in letter fluency and a more rapid and accelerating decline over time in semantic fluency distinguished people who developed Alzheimer’s disease from controls. Using the semantic index was not a superior marker of incident Alzheimer’s disease compared to examining the two fluency scores individually. Results suggest the differential decline in verbal fluency tasks, when evaluated appropriately, may be useful for early identification of Alzheimer’s disease in Latinx Spanish speakers, a historically understudied population.
Semantic and lexical features of words dissimilarly affected by non-fluent, logopenic, and semantic primary progressive aphasia
- Jet M. J. Vonk, Roel Jonkers, H. Isabel Hubbard, Maria Luisa Gorno-Tempini, Adam M. Brickman, Loraine K. Obler
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- Journal:
- Journal of the International Neuropsychological Society / Volume 25 / Issue 10 / November 2019
- Published online by Cambridge University Press:
- 12 September 2019, pp. 1011-1022
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Objective:
To determine the effect of three psycholinguistic variables—lexical frequency, age of acquisition (AoA), and neighborhood density (ND)—on lexical-semantic processing in individuals with non-fluent (nfvPPA), logopenic (lvPPA), and semantic primary progressive aphasia (svPPA). Identifying the scope and independence of these features can provide valuable information about the organization of words in our mind and brain.
Method:We administered a lexical decision task—with words carefully selected to permit distinguishing lexical frequency, AoA, and orthographic ND effects—to 41 individuals with PPA (13 nfvPPA, 14 lvPPA, 14 svPPA) and 25 controls.
Results:Of the psycholinguistic variables studied, lexical frequency had the largest influence on lexical-semantic processing, but AoA and ND also played an independent role. The results reflect a brain-language relationship with different proportional effects of frequency, AoA, and ND in the PPA variants, in a pattern that is consistent with the organization of the mental lexicon. Individuals with nfvPPA and lvPPA experienced an ND effect consistent with the role of inferior frontal and temporoparietal regions in lexical analysis and word form processing. By contrast, individuals with svPPA experienced an AoA effect consistent with the role of the anterior temporal lobe in semantic processing.
Conclusions:The findings are in line with a hierarchical mental lexicon structure with a conceptual (semantic) and a lexeme (word-form) level, such that a selective deficit at one of these levels of the mental lexicon manifests differently in lexical-semantic processing performance, consistent with the affected language-specific brain region in each PPA variant.