INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Majestic Complex (Posters 61-120) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #63 Race Moderates the Relationship Between Trails-B Scores and IADL Disability Among Black and White Americans: The Health and Retirement Study Madison Maynard, University of Central Florida, Orlando, United States Daniel Paulson, University of Central Florida, Orlando, United States Quinn Allen, University of Central Florida, Orlando, United States Category: Assessment/Psychometrics/Methods (Adult) Keyword 1: ecological validity Keyword 2: aging (normal) Keyword 3: assessment Objective: Use of race-based normative data in clinical neuropsychological assessment requires careful consideration of assessment goals and definition of clinical populations. While varying conceptualizations of validity warrant application to neuropsychology, prediction of variance in key ecological correlates, such as disability, is a principal goal of clinical assessment. Executive performance tasks should predict variance in cognitively-associated disability, regardless of the examinee's racial group; however, mean differences in test scores been racial groups variably relate to ecological correlates. The goal of this study was to examine whether scores on the Trails-B account for equal variance in instrumental activities of daily living (IADLs) among Black and White older adults. Participants and Methods: Participants were drawn from the 2016 wave of the Health and Retirement Study (HRS). Included participants were 65 years and older and were self-described as either White or Black race. Health burden was based on endorsement of arthritis, cancer, hypertension, diabetes, pulmonary disorders, cardiac disorders, stroke, and mental health diagnoses. Depressive symptoms were measured using the 8-item Center for Epidemiological Studies-Depression (CES-D) scale. The Trail Making Test was administered as part of the HRS Harmonized Cognitive Assessment Protocol (HCAP). A three-step linear regression model was conducted to evaluate primary hypotheses. Results: The final sample of 2,929 respondents was 60.0% female, 84.1% White, and 8.0% Hispanic. Average age was 75.60 (SD = 7.32) and average education was 13.00 (SD = 2.94). Control variables entered in the first step included age, gender, ethnicity, years of education, wealth, health burden, CES-D score, and the dichotomously coded race variable. Cumulatively, variables in this step accounted for 16.1% of variance in IADL score. In step two, the addition of the Trails-B score augmented variance accounted for to 17.4%, (p < .001). In the third step, the interaction between the Trails-B and race was added, further increasing variance accounted for to 17.6% (p < .009). The zero-order correlation between Trails-B and IADL score was .242 for White participants and .151 for Black participants. Conclusions: Primarily, findings indicate that Trails-B scores predict variance in IADL disability over and above that accounted for by demographic factors and overall health burden. Secondly, accounting for these variables, race moderates the relationship between Trails-B score and IADL deficits such that this neuropsychological test is a better predictor of ecological deficits for White older adults than for Black. These findings may serve as support for the use of race-based norms in interpreting Trails-B scores for older Black participants; however, these clinical decisions must be made within the broader context of care and goals of clinical decision making. One limitation of this study is that HRS data does not permit for accounting for the impact of reading level, which may partially mitigate apparent racial discrepancies as older Black Americans were disproportionally impacted by discrepancies in educational access by comparison to their White peers. A second limitation to these findings is that attrition in the HRS sample is impacted by disability, thus, more clinically affected older adults may not be well-represented.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #63

Race Moderates the Relationship Between Trails-B Scores and IADL Disability Among Black and White Americans: The Health and Retirement Study

Madison Maynard, University of Central Florida, Orlando, United States
Daniel Paulson, University of Central Florida, Orlando, United States
Quinn Allen, University of Central Florida, Orlando, United States

Category: Assessment/Psychometrics/Methods (Adult)

Keyword 1: ecological validity
Keyword 2: aging (normal)
Keyword 3: assessment

Objective:

Use of race-based normative data in clinical neuropsychological assessment requires careful consideration of assessment goals and definition of clinical populations. While varying conceptualizations of validity warrant application to neuropsychology, prediction of variance in key ecological correlates, such as disability, is a principal goal of clinical assessment. Executive performance tasks should predict variance in cognitively-associated disability, regardless of the examinee's racial group; however, mean differences in test scores been racial groups variably relate to ecological correlates. The goal of this study was to examine whether scores on the Trails-B account for equal variance in instrumental activities of daily living (IADLs) among Black and White older adults.

Participants and Methods:

Participants were drawn from the 2016 wave of the Health and Retirement Study (HRS). Included participants were 65 years and older and were self-described as either White or Black race. Health burden was based on endorsement of arthritis, cancer, hypertension, diabetes, pulmonary disorders, cardiac disorders, stroke, and mental health diagnoses. Depressive symptoms were measured using the 8-item Center for Epidemiological Studies-Depression (CES-D) scale. The Trail Making Test was administered as part of the HRS Harmonized Cognitive Assessment Protocol (HCAP). A three-step linear regression model was conducted to evaluate primary hypotheses.

Results:

The final sample of 2,929 respondents was 60.0% female, 84.1% White, and 8.0% Hispanic. Average age was 75.60 (SD = 7.32) and average education was 13.00 (SD = 2.94). Control variables entered in the first step included age, gender, ethnicity, years of education, wealth, health burden, CES-D score, and the dichotomously coded race variable. Cumulatively, variables in this step accounted for 16.1% of variance in IADL score. In step two, the addition of the Trails-B score augmented variance accounted for to 17.4%, (p < .001). In the third step, the interaction between the Trails-B and race was added, further increasing variance accounted for to 17.6% (p < .009). The zero-order correlation between Trails-B and IADL score was .242 for White participants and .151 for Black participants.

Conclusions:

Primarily, findings indicate that Trails-B scores predict variance in IADL disability over and above that accounted for by demographic factors and overall health burden. Secondly, accounting for these variables, race moderates the relationship between Trails-B score and IADL deficits such that this neuropsychological test is a better predictor of ecological deficits for White older adults than for Black. These findings may serve as support for the use of race-based norms in interpreting Trails-B scores for older Black participants; however, these clinical decisions must be made within the broader context of care and goals of clinical decision making. One limitation of this study is that HRS data does not permit for accounting for the impact of reading level, which may partially mitigate apparent racial discrepancies as older Black Americans were disproportionally impacted by discrepancies in educational access by comparison to their White peers. A second limitation to these findings is that attrition in the HRS sample is impacted by disability, thus, more clinically affected older adults may not be well-represented.