Jones Richard N, Gallo Joseph J
Hebrew Rehabilitation Center for Aged Research and Training Institute, Boston, Massachusetts
J Gerontol B Psychol Sci Soc Sci. 2002 Nov;57(6):P548-58. doi: 10.1093/geronb/57.6.p548.
Years of completed education is a powerful correlate of performance on mental status assessment. This analysis evaluates differences in cognitive performance attributable to level of education and sex. We analyzed Mini-Mental State Examination responses from a large community sample (Epidemiologic Catchment Area study, N = 8,556), using a structural equation analytic framework grounded in item response theory. Significant sex and education group differential item functioning (DIF) were detected. Those with low education were more likely to err on the first serial subtraction, spell world backwards, repeat phrase, write, name season, and copy design tasks. Women were more likely to err on all serial subtractions, men on spelling and other language tasks. The magnitude of detected DIF was small. Our analyses show that failing to account for DIF results in an approximately 1.6% overestimation of the magnitude of difference in assessed cognition between high- and low-education groups. In contrast, nearly all (95%) of apparent sex differences underlying cognitive impairment are due to DIF. Therefore, item bias does not appear to be a major source of observed differences in cognitive status by educational attainment. Adjustments of total scores that eliminate education group differences are not supported by these results. Our results have implications for future research concerning education and risk for dementia.
完成学业的年限与精神状态评估表现密切相关。本分析评估了因教育水平和性别导致的认知表现差异。我们使用基于项目反应理论的结构方程分析框架，分析了来自大型社区样本（流行病学集水区研究，N = 8556）的简易精神状态检查表的回答。检测到显著的性别和教育组差异项目功能（DIF）。受教育程度低的人在首项连续减法、倒拼单词、重复短语、书写、说出季节以及复制设计任务上更容易出错。女性在所有连续减法上更容易出错，男性在拼写和其他语言任务上更容易出错。检测到的DIF幅度较小。我们的分析表明，不考虑DIF会导致对高学历和低学历群体评估认知差异幅度的高估约1.6%。相比之下，认知障碍背后几乎所有（95%）明显的性别差异都归因于DIF。因此，项目偏差似乎不是观察到的认知状态因教育程度不同而产生差异的主要来源。这些结果不支持消除教育组差异的总分调整。我们的结果对未来关于教育和痴呆风险的研究具有启示意义。
