Cognitive Test Performance of African American Elders

描述(申请人提供)：神经心理测试在少数族裔人群中的特异性很差，因此与非西班牙裔白人相比，认知正常的非裔美国人更有可能被误诊为痴呆症。在之前的资助期间，这项研究通过衡量种族群体内部和之间不同的文化和教育因素，然后利用这些数据来了解种族和文化对认知测试成绩的作用，直接解决了非裔美国老年人认知障碍和痴呆症的误诊问题。我们的工作确定了可以明确测量的文化和教育体验的各个方面，并将这些变量与横向和纵向测试表现联系起来。我们发现，在计入识字水平(对教育质量的估计)后，非洲裔美国人和白人长辈在考试成绩上的差异基本上消失了。无论种族，识字水平是语言和非语言能力的最强预测指标，也是未来记忆力衰退的最佳预测指标。尽管识字对认知有广泛的影响，但一些研究人员提出，识字的主要影响是特定缓冲或短期存储系统的功能，即语音环路。然而，这一理论的提出并没有充分评估视觉空间短时记忆或工作记忆的特征任务。到目前为止，这个项目已经产生了关于文化和教育经验对认知测试成绩的作用以及随着时间的推移认知能力下降的风险的重大见解。目前的提案将使用这些见解来指导对文化、识字和认知之间关系的新研究。这项研究的三个目的是：1)使用资源特征和广泛的识字技能来确定阅读识别的衡量标准是否真实地反映了教育质量；2)确定学校资源变量是否是认知衰退和痴呆症发展的最佳预测因子，而不分种族；以及3)检验识字通过执行特定和特征良好的语言和视觉空间信息的存储和操纵任务，影响视觉空间材料的存储和中央执行或工作记忆的功能的假设。

DESCRIPTION (provided by applicant): Neuropsychological tests have poor specificity among minority populations and thus misdiagnosis of dementia is more likely among cognitively normal African Americans as compared to non-Hispanic Whites. During the prior funding period, this study directly addressed the problem of misdiagnosis of cognitive impairment and dementia among African American elders by measuring cultural and educational factors that differ within and between racial groups, and then using these data to understand of the role of race and culture on cognitive test performance. Our work identified aspects of cultural and educational experience that could be explicitly measured and related these variables to test performance both cross-sectionally and longitudinally. We found that after accounting for literacy level (an estimate of quality of education), differences in the test performance of education matched African American and White elders largely disappeared. Regardless of race, literacy level was the strongest predictor of performance on measures of verbal and nonverbal ability and the best predictor of future memory decline. Despite this wide-ranging effect of literacy on cognition, several researchers have suggested that the primary influence of literacy is on the functioning of a specific buffer or short-term storage system, the phonological loop. However, this theory has been put forth without adequately assessing visuospatial short-term memory or well-characterized tasks of working memory. To date, this project has generated major insights into the role of cultural and educational experience on cognitive test performance and the risk of cognitive decline over time. The current proposal will use these insights to guide new studies of the relationship between culture, literacy, and cognition. The three aims of the study are to: 1) use resource characteristics and a broad measure of literacy skill to determine if a measure of reading recognition is a true reflection of quality of education; 2) determine whether school resource variables are the best predictors of cognitive decline and development of dementia regardless of race; and 3) test the hypotheses that literacy affects storage of visuospatial material and the functioning of the central executive or working memory, by administering specific and well characterized tasks of storage and manipulation of verbal and visuospatial information.