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Should Ethnicity be Considered in the Determination of Cognitive Change? Results from Health & Aging Brain Study – Health Disparities

Kevin Duff, Oregon Health & Science University, Portland, United States
Justin Miller, Cleveland Clinic, Las Vegas, United States
Kimberly Cobos, Cleveland Clinic, Las Vegas, United States
Sid O'Bryant, University of North Texas Health Science Center, Forth Worth, United States



Objective:
Whereas the impact of ethnicity and race has been well-established on baseline neuropsychological tests, the impact of these factors on cognitive change has not. The current study sought to examine if ethnicity (Mexican American vs. Non-Hispanic Whites) influenced the determination of reliable change.
Participants and Methods:
Using one-year follow-up data from HABS-HD, standardized regression-based (SRB) change scores were calculated on 799 older (50 – 87 years old) cognitively intact Mexican American (n=352) and Non-Hispanic White (n=447) participants on 13 neuropsychological test scores. Linear regression models included baseline cognitive scores, age, sex, education, and ethnicity as predictors of follow-up cognitive scores.
Results:
As expected, baseline neuropsychological scores were the best predictor of follow-up scores, and this occurred in all 13 of the models. Age, sex, and education intermittently contributed to some of the models. Ethnicity statistically contributed to 9 of the 13 models (69%), occurring on models tapping global cognition, learning and memory, attention and processing speed, and executive functioning. Using standardized beta weights, a ³9% drop in a standard deviation of change scores on tests of attention and memory were predicted for the Mexican American participants compared to their Non-Hispanic White counterparts.
Conclusions:
These results suggest ethnicity makes a significant contribution when predicting change over time for multiple neuropsychological test scores assessing memory, attention, and executive functioning. Gaining a better understanding of the clinical meaningfulness of these findings is essential, and replication is needed in diverse ethnic and racial populations.
Category: Cross Cultural Neuropsychology/ Clinical Cultural Neuroscience

Keyword 1: ethnicity
Keyword 2: cognitive course
Keyword 3: aging (normal)