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Cross-Cultural Validity of Cognitive Function Tests

认知功能测试的跨文化有效性

基本信息

批准号：
6937105
负责人：
VALORY N PAVLIK
金额：
$ 18.75万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-08-15 至 2007-07-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): The two largest racial/ethnic minorities in the U.S., African-Americans and Hispanics, are at higher risk for diabetes and certain diabetes complications than non-Hispanic whites. Recently, cognitive impairment and accelerated cognitive decline have been found to be higher in persons with type 2 diabetes than in nondiabetics. In population based studies these minority groups also appear to be greater risk for cognitive impairment and dementia. The relationship between race/ethnicity and cognitive impairment among persons with type 2 diabetes has not been studied. Before such studies can be undertaken, it is necessary to identify a set of cognitive function tests that is reliable and cross culturally valid in patient groups at greatest risk for type 2 diabetes. The purpose of this study is to test the hypothesis that a brief battery of culturally neutral cognitive function tests can yield reliable and valid measures of specific cognitive function domains in low literacy, bilingual, bi-cultural patient populations. The cognitive function tests included in the battery have been previously tested and normed in both English-speaking and Spanish-speaking groups, but their crosscultural validity is not known. A total of 480 patients with type 2 diabetes representing four ethnicity/language preference groups will be recruited from a large, urban, primary care clinic network (120 non-Hispanic whites, 120 non-Hispanic African-Americans, 120 Hispanics whose preferred language is English, and 120 Hispanics whose preferred language is Spanish). They will be tested at an initial time point and one month later. Patients will be compensated financially for their time so that at least 312 (65%) patients with complete test-retest data will be available for analysis. Sociodemographic and medical history data will be collected from the participants and their medical records. Height, weight, blood pressure, and waist circumference will be measured before the initial test session. In a 40% subsample (n=208), fasting plasma glucose and insulin, lipid profile, plasma homocysteine (with folate and vitamin B12), and c-reactive protein will be measured. The test-retest reliability of the individual tests in the battery will be calculated for each ethnic group, and the validity of the tests across the four defined racial/ethnic and linguistic groups will be tested using exploratory and confirmatory factor analysis. For those cognitive function measures found to be reliable and valid, multiple regression analysis will be used to test associations between test scores and specific clinical characteristics of the patients, such as age, duration of diabetes, glycemic level, diabetes treatment regimen, and each of the physical and biochemical variables will be examined.

描述（由申请人提供）：美国两个最大的种族/少数民族，非洲裔美国人和西班牙裔美国人患糖尿病和某些糖尿病并发症的风险高于非西班牙裔白人。最近，研究发现2型糖尿病患者的认知障碍和认知能力加速下降程度高于非糖尿病患者。在基于人口的研究中，这些少数群体似乎也有更大的认知障碍和痴呆症风险。2型糖尿病患者中种族/民族与认知障碍之间的关系尚未研究。在进行此类研究之前，有必要确定一套认知功能测试，该测试在2型糖尿病风险最高的患者群体中可靠且跨文化有效。本研究的目的是检验一个假设，即一个简短的电池文化中立的认知功能测试可以产生可靠和有效的措施，具体的认知功能领域的低识字率，双语，双文化患者人群。包括在电池的认知功能测试已被测试和规范在英语和西班牙语组，但其跨文化的有效性是未知的。将从一个大型城市初级保健诊所网络中招募代表4个种族/语言偏好组的共计480例2型糖尿病患者（120例非西班牙裔白人、120例非西班牙裔非洲裔美国人、120例首选语言为英语的西班牙裔美国人和120例首选语言为西班牙语的西班牙裔美国人）。将在初始时间点和一个月后对其进行检测。将对患者的时间进行经济补偿，以便至少312例（65%）具有完整的重测数据的患者可用于分析。将从受试者及其病历中收集社会人口统计学和病史数据。将在首次测试前测量身高、体重、血压和腰围。在40%的子样本（n=208）中，将测量空腹血糖和胰岛素、血脂谱、血浆同型半胱氨酸（含叶酸和维生素B12）和C反应蛋白。将计算每个种族组的组合中单个测试的重测信度，并将使用探索性和验证性因素分析测试四个定义的种族/种族和语言组的测试有效性。对于发现可靠和有效的认知功能测量，将使用多元回归分析来检验测试评分与患者的特定临床特征（例如年龄、糖尿病持续时间、血糖水平、糖尿病治疗方案）之间的关联，并将检查每个物理和生化变量。