Johnson Amanda Schafer, Flicker Lisa J, Lichtenberg Peter A
Institute of Gerontology, Wayne State University, Detroit, Michigan 48202, USA.
J Int Neuropsychol Soc. 2006 Jan;12(1):64-71. doi: 10.1017/S1355617706060073.
Neuropsychological test results are affected by multiple factors, but usually age and education are the only variables by which norms are stratified. Some authors have questioned whether these variables alone are sufficient (e.g., Marcopulos et al., 1997; Manly et al., 2002), since such norms have lead to problems, such as poor specificity for African Americans on dementia screening devices (Fillenbaum et al., 1990). Recent research has shown that reading ability, a measure of educational quality, attenuated racial differences in test performance (Manly et al., 2002). We specifically examined whether reading ability would account for a greater amount of variance than education in executive function tests in a population traditionally subject to poor educational quality. Results determined that reading ability accounted for a significantly greater amount of variance than years of education for Letter-Number Sequencing, Similarities, COWA, Trail Making Test, and Coloured Progressive Matrices. Reading ability was found to significantly mediate the relationship between each of these tests and education. Animal naming appears to be least affected by educational quality or quantity. These findings hold implications for the interpretation of neuropsychological test results, especially in those exposed to substandard educational quality, and for the way that test norms are constructed.
神经心理学测试结果受多种因素影响,但通常年龄和教育程度是仅有的用于划分常模的变量。一些作者质疑仅这些变量是否足够(例如,马尔科普洛斯等人,1997年;曼利等人,2002年),因为这样的常模已导致一些问题,比如在痴呆筛查工具上非裔美国人的特异性较差(菲伦鲍姆等人,1990年)。最近的研究表明,阅读能力作为教育质量的一项指标,减弱了测试表现中的种族差异(曼利等人,2002年)。我们专门研究了在一个传统上教育质量较差的人群中,在执行功能测试中阅读能力是否比教育程度能解释更多的方差。结果表明,对于字母数字排序、相似性、C - O - W 词流畅性、连线测验和彩色渐进矩阵测验,阅读能力比受教育年限能解释显著更多的方差。研究发现阅读能力显著介导了这些测试中的每一项与教育程度之间的关系。动物命名似乎受教育质量或数量的影响最小。这些发现对神经心理学测试结果的解释具有启示意义,尤其是在那些接受了不合格教育质量的人群中,并且对测试常模的构建方式也有启示意义。