Culture Bias in Testing Expressive Ability In Dementia

描述（由申请人提供）： 非洲裔美国人和西班牙裔美国人的老年人提出了他们的关注， 在研究中的充分代表性和目前的适当性 评估和干预。这对那些 患上痴呆症，伴随着难以表达他们的想法， 感情本研究的目的是：1）检查现有的和新的 创造了表达语言和情绪的文化偏见的措施， 老年非裔美国人和西班牙裔美国人，2）完善和修改这些 不具备足够可靠性和有效性的工具， 达到了令人满意的水平。600名受试者，100名非裔美国人， 100名西班牙裔美国人和100名欧洲裔美国老年痴呆症患者， 将从社区招募相同数量的正常对照， 机构网站。受试者的年龄、性别、社会经济地位， 教育，种族群体，文化适应和心理状态将获得。 主要评定者将在种族组上匹配;相同的评定者的可靠性 不同的种族群体将使用测试的录像带进行检查 sessions.两个新的工具，迈阿密测验和阿尔茨海默氏情绪量表 将被评估为众所周知的波士顿呼吸测试，动物流畅性， 劳顿观察情感量表、康奈尔痴呆抑郁量表和 痴呆情绪评估量表。每项措施的内部一致性将是 评估。使用概化理论作为分析框架，所有 将评估评估者间的可靠性和随时间推移的稳定性。 受试者和评定者之间的文化匹配/不匹配也将在 情绪量表迈阿密测验对认知障碍的鉴别能力 和未受损的动物将与波士顿试验进行比较， 熟练掌握其他类别（水果，蔬菜，服装）。同样，能力 新的阿尔茨海默氏症情绪量表来区分精神病患者 将来自非苦恼受试者的情绪量表与其他情绪量表进行比较。 差异项目功能分析将指导修订， 修改.作为外联工作， 对记忆障碍的评估扩大了， 治疗进行时，对文化上适当的测试的需求是一个 紧急1临床医生和研究人员都需要知道哪些测试是 适当的，在何种程度上，审查员的种族影响， 结果以及如何解释在新开发的两个项目上获得的分数 广泛使用的测试。

DESCRIPTION (provided by applicant): The dramatically increasing numbers of African American and Hispanic American older adults raises concerns about their adequate representation in research and the appropriateness of current assessments and interventions. This is especially important for those who develop dementia with concomitant difficult expressing their thoughts and feelings. The purpose of this study is to: 1) examine existing and newly created measures of expressive language and mood for culture bias in use with older African Americans and Hispanic Americans, and 2) refine and modify those instruments that do not demonstrate adequate reliability and validity until satisfactory levels are achieved. Six hundred subjects, 100 African American, 100 Hispanic American and 100 European American older adults with dementia and equal number of normal controls, will be recruited from community and institutional sites. Data on subjects' age, gender, socioeconomic status, education, ethnic group, acculturation and mental status will be obtained. Primary raters will be matched on ethnic group; reliability of raters of same and different ethnic group will be examined using videotapes of the testing sessions. Two new instruments, the Miami Naming Test and Alzheimer's Mood Scale will be evaluated as will the well known Boston Naming Test, Animal Fluency, Lawton Observed Affect Scale, Cornell Scale for Depression in Dementia and Dementia Mood Assessment Scale. Internal consistency of each measure will be evaluated. Using generalizability theory as a framework for analysis, all measures will be evaluated for interrater reliability and stability over time. Cultural match/mismatch between subject and rater will also be evaluated on the mood scales. Ability of Miami Naming Test to discriminate cognitively impaired and unimpaired will be compared with the Boston Naming Test as will the Animal Fluency with other categories (fruit, vegetable, clothing). Likewise, ability of the new Alzheimer's Mood Scale to discriminate psychiatrically distressed from nondistressed subjects will be compared with the other mood scales. Differential item functioning analysis will guide the revisions and modifications. As outreach efforts to bring minority individuals in for assessment of memory disorders expands and research on the efficacy of treatment is conducted, the demand for culturally appropriate tests is an urgent one. Both clinicians and researchers need to know which tests are appropriate, the extent to which the ethnicity of the examiner affects the results and how to interpret the scores obtained on both the newly developed and widely used tests.