Executive function tests: Normative data for Spanish-speaking adults in the United States

Issue title: Newly Developed Neuropsychological Norms for the Evaluation of Spanish-Speaking Adults in the United States

Guest editors: Juan Carlos Arango-Lasprilla and Diego Rivera

Article type: Research Article

Authors: Ramos Usuga, Daniela^a | Rivera, Diego^{b; c} | Xia, Bridget^d | Carrión, Carmen I.^e | Morel Valdés, Gloria M.^f | Moreno, Oswaldo^g | Rodriguez, Miriam J.^{h; i} | Krch, Denise^{j; k} | Wongserbchart, Wongthipa^l | Drago, Christin I.^m | García, Patricia^{n; o} | Rivera, Patricia M.^p | Olabarrieta-Landa, Laiene^{b; c} | Perrin, Paul B.^{d; q} | Arango-Lasprilla, Juan Carlos^{g; *}

Affiliations: [a] Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain | [b] Department of Health Science, Public University of Navarre, Pamplona, Spain | [c] Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain | [d] School of Data Science, University of Virginia, Charlottesville, VA, USA | [e] Department of Neurology, Yale University, School of Medicine, New Haven, CT, USA | [f] Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA | [g] Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA | [h] Clinical Psychology Program, Carlos Albizu University, Miami Campus, Miami, FL, USA | [i] Department of Health, and Wellness Design, School of Public Health, Indiana University, Bloomington, IN, USA | [j] Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA | [k] Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA | [l] The Chicago School, Los Angeles, CA, USA | [m] Global Wellness LLC, Miami, FL, USA | [n] Department of Neurology, School of Medicine, Indiana University, Indianapolis, IN, USA | [o] Department of Physical Medicine and Rehabilitation, School of Medicine, Indiana University, Indianapolis, IN, USA | [p] Mental Health Department – Neuropsychology, Kaiser Permanente Northwest, Portland, OR, USA | [q] Department of Psychology, University of Virginia, Charlottesville, VA, USA

Correspondence: [*] Address for correspondence: Juan Carlos Arango-Lasprilla, Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA. E-mail: [email protected].

Abstract: BACKGROUND:Normative data for Spanish-speaking populations, particularly Hispanics in the U.S., is notably scarce. OBJECTIVE:This study aims to establish normative data for executive function tests (Modified Wisconsin Card Sorting Test and Stroop Color and Word Test) among Spanish-speaking Hispanics in the U.S. METHODS:We assessed 245 individuals aged 18–80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin) and employed Bayesian regression to estimate norms, considering various sociodemographic factors influencing performance. RESULTS:The posterior distribution suggests a high probability that age impacts SCWT performance, with older adults likely to show greater declines, particularly among those with high proficiency in Spanish. The posterior distribution suggests a stronger effect of age on M-WCST performance among individuals with longer U.S. residency. Educational attainment demonstrates a robust positive impact on M-WCST outcomes, with lower levels of education associated with a higher probability of increased errors. An interaction between education and Spanish proficiency was observed, influencing SCWT scores differently across proficiency levels. Sex and acculturation levels interact to affect SCWT performance, with distinct patterns observed between men and women. This suggests that the impact of acculturation on cognitive test performance may vary by gender. CONCLUSION:Establishing culturally sensitive normative data can enhance accurate identification of executive dysfunction and reduce misdiagnosis risks. This study underscores the importance of considering sociocultural factors including acculturation and language proficiency in neuropsychological assessments to better serve diverse populations.

Keywords: Acculturation, cultural diversity, hispanic or latino, executive function, wisconsin card sorting test, neuropsychological tests

DOI: 10.3233/NRE-240088

Journal: NeuroRehabilitation, vol. 55, no. 2, pp. 209-221, 2024