Flores Ilse, Casaletto Kaitlin B, Marquine Maria J, Umlauf Anya, Moore David J, Mungas Dan, Gershon Richard C, Beaumont Jennifer L, Heaton Robert K
a Department of Psychology , San Diego State University , San Diego , CA , USA.
b SDSU/UCSD Joint Doctoral Program in Clinical Psychology , San Diego , CA , USA.
Clin Neuropsychol. 2017 May;31(4):783-797. doi: 10.1080/13854046.2016.1276216. Epub 2017 Jan 12.
This study examined the influence of Hispanic ethnicity and language/cultural background on performance on the NIH Toolbox Cognition Battery (NIHTB-CB).
Participants included healthy, primarily English-speaking Hispanic (n = 93; Hispanic-English), primarily Spanish-speaking Hispanic (n = 93; Hispanic-Spanish), and English speaking Non-Hispanic white (n = 93; NH white) adults matched on age, sex, and education levels. All participants were in the NIH Toolbox national norming project and completed the Fluid and Crystallized components of the NIHTB-CB. T-scores (demographically-unadjusted) were developed based on the current sample and were used in analyses.
Spanish-speaking Hispanics performed worse than English-speaking Hispanics and NH whites on demographically unadjusted NIHTB-CB Fluid Composite scores (ps < .01). Results on individual measures comprising the Fluid Composite showed significant group differences on tests of executive inhibitory control (p = .001), processing speed (p = .003), and working memory (p < .001), but not on tests of cognitive flexibility or episodic memory. Test performances were associated with language/cultural backgrounds in the Hispanic-Spanish group: better vocabularies and reading were predicted by being born outside the U.S., having Spanish as a first language, attending school outside the U.S., and speaking more Spanish at home. However, many of these same background factors were associated with worse Fluid Composites within the Hispanic-Spanish group.
On tests of Fluid cognition, the Hispanic-Spanish group performed the poorest of all groups. Socio-demographic and linguistic factors were associated with those differences. These findings highlight the importance of considering language/cultural backgrounds when interpreting neuropsychological test performances. Importantly, after applying previously published NIHTB-CB norms with demographic corrections, these language/ethnic group differences are eliminated.
本研究考察了西班牙裔种族以及语言/文化背景对美国国立卫生研究院工具箱认知电池（NIHTB-CB）测试表现的影响。
参与者包括健康的成年人，主要为讲英语的西班牙裔（n = 93；西班牙裔-英语组）、主要讲西班牙语的西班牙裔（n = 93；西班牙裔-西班牙语组）以及年龄、性别和教育水平相匹配的讲英语的非西班牙裔白人（n = 93；非西班牙裔白人组）。所有参与者均参与了美国国立卫生研究院工具箱全国常模项目，并完成了NIHTB-CB的流体和晶体成分测试。基于当前样本得出未根据人口统计学因素调整（即未经人口统计学调整）的T分数，并用于分析。
在未经人口统计学调整的NIHTB-CB流体综合得分方面，讲西班牙语的西班牙裔比讲英语的西班牙裔和非西班牙裔白人表现更差（p值 < 0.01）。构成流体综合测试的各项单独测试结果显示，在执行抑制控制测试（p = 0.001）、处理速度测试（p = 0.003）和工作记忆测试（p < 0.001）中存在显著的组间差异，但在认知灵活性测试或情景记忆测试中不存在显著差异。西班牙裔-西班牙语组的测试表现与语言/文化背景相关：在美国境外出生、以西班牙语为第一语言、在美国境外上学以及在家中更多地讲西班牙语，这些因素预示着词汇量和阅读能力更好。然而，在西班牙裔-西班牙语组中，许多相同的背景因素与较差的流体综合得分相关。
在流体认知测试中，西班牙裔-西班牙语组在所有组中表现最差。社会人口统计学和语言因素与这些差异相关。这些发现凸显了在解释神经心理学测试表现时考虑语言/文化背景的重要性。重要的是，在应用先前发表的经人口统计学校正的NIHTB-CB常模后，这些语言/种族群体差异得以消除。
