Rohit Mona, Levine Andrew, Hinkin Charles, Abramyan Shogik, Saxton Ernestine, Valdes-Sueiras Miguel, Singer Elyse
Department of Neurology, National Neurological AIDS Bank-University of California, Los Angeles, California 90025, USA.
J Int Neuropsychol Soc. 2007 May;13(3):462-70. doi: 10.1017/S1355617707070506.
Neuropsychological tests generally require adjustments for years of education when determining the presence of neurocognitive impairment. However, evidence indicates that educational quality, as assessed with reading tests, may be a better reflection of educational attainment among African Americans. Thus, African Americans with poor educational quality may be incorrectly classified with neurocognitive impairment based on neuropsychological tests. We compared the accuracy of neuropsychological test scores standardized using reading grade-equivalent versus years of education in predicting neurocognitive impairment among a sample of Whites and African-American adults who were HIV+. Participants were examined by a neurologist and classified with or without HIV-associated neurocognitive disorders according to accepted criteria. Participants were also classified as impaired versus not impaired based on their neuropsychological test scores standardized by 1) self-reported education or 2) WRAT-3 reading grade-level. Cross tabulation tables were used to determine agreement of the two methods in detecting impairment. Among African-Americans, standardized scores derived from reading scores had greater specificity than those derived from years of education (84.1% vs. 77.3). Among the Whites, correction based on years of education had both greater specificity and sensitivity. The results suggest that reading tests may be a useful alternative for determining NCI among African Americans.
在确定是否存在神经认知障碍时，神经心理学测试通常需要根据受教育年限进行调整。然而，有证据表明，通过阅读测试评估的教育质量，可能更能反映非裔美国人的教育水平。因此，教育质量较差的非裔美国人可能会基于神经心理学测试被错误地归类为患有神经认知障碍。我们比较了使用阅读年级当量与受教育年限标准化的神经心理学测试分数在预测一组感染艾滋病毒的白人和非裔美国成年人神经认知障碍方面的准确性。参与者由神经科医生进行检查，并根据公认标准被归类为患有或未患有与艾滋病毒相关的神经认知障碍。参与者还根据其神经心理学测试分数被归类为受损或未受损，这些分数通过以下两种方式标准化：1）自我报告的教育程度；2）WRAT-3阅读年级水平。交叉列表用于确定两种方法在检测损伤方面的一致性。在非裔美国人中，由阅读分数得出的标准化分数比由受教育年限得出的标准化分数具有更高的特异性（84.1%对77.3%）。在白人中，基于受教育年限的校正具有更高的特异性和敏感性。结果表明，阅读测试可能是确定非裔美国人神经认知障碍的一种有用替代方法。
