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 #65 The Area Deprivation Index (ADI), Continuing to Re-Think Race Corrections in Neuropsychological Evaluations: Exploring the Relative Contribution of Race and Socioeconomic Disadvantage to Neuropsychological Test Performance Among a Racially Diverse Sample. Halle McCracken, University of Mississippi, Oxford, United States Brandon Baughman, Semmes Murphey Clinic, Memphis, United States Category: Inclusion and Diversity/Multiculturalism Keyword 1: demographic effects on test performance Keyword 2: mild cognitive impairment Objective: Neighborhood socioeconomic disadvantage is a risk factor for cardiovascular and neurologic morbidity and mortality. Independent of other demographic factors, greater socioeconomic disadvantage increases the risk for cognitive impairment and dementia, particularly for racially minoritized populations. Systemic racism and neighborhood segregation may partially explain the association between race and poor cognitive health, leading to disproportionality in cognitive impairment. Increasing our understanding of the role that neighborhood disadvantage plays in neurocognition may aid in the development and use of more sensitive normative data. Therefore, the aim of the present study is to explore the relative contributions of race and neighborhood disadvantage (as measured by the area deprivation index (ADI)) to neuropsychological test performance. Participants and Methods: The present study included retrospective review of 237 clinically referred patients who met criteria for a DSM-5-TR neurocognitive disorder. Subjects’ mean age was 69.1 (SD = 8.8), 74.7% were White, 23.6% were Black, and 1.7% were Asian, with a similar proportion of females to males (55.7% vs. 44.3%). The majority of subjects were married (63.3%) and average educational attainment was 14.3 (SD = 2.8) years. The mean ADI national percentile was 55.7 (Min = 4.0, Max = 100.00), with greater percentiles associated with increased disadvantage. 73.8% also had a comorbid psychiatric diagnosis. Hierarchical linear regression analyses were conducted to assess the relationship between race, ADI, and neuropsychological test performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results: Regression analyses revealed that ADI (∆R² = .026, p = .013) was significantly associated with performance on the Attention Index of the RBANS and race (∆R² = .021, p = .023) accounted for significant incremental variance in attention scores (overall model R² = .047, p = .004). Regarding the Visual Spatial Index, regression analyses revealed that ADI was not significantly associated with visuospatial performance (∆R² = .006, p = .227). However, race was significantly associated with visuospatial performance and accounted for significant incremental variance in test scores (∆R² = .046, p < .001; overall model R² = .053, p = .002). Finally, ADI and race were not significantly associated with performance on Immediate Memory, Language, or Delayed Memory indices. Conclusions: These results suggest that race and neighborhood disadvantage are not associated with neurocognitive test performance in the domains of memory and language in the current sample. However, race accounted for additional incremental variance in visuospatial performance, which is consistent with prior literature suggesting that visuospatial decline is more pronounced for Black individuals after adjusting for education. The significant associations between ADI, race, and attention suggest that race and neighborhood disadvantage account for more variability in subcortical functions, which are typically impacted by vascular pathology. As such, both racial and neighborhood disadvantage may place people at risk for poor vascular health, likely secondary to problems with healthcare access, education, food insecurity, etc. Future directions will be discussed regarding the use of neighborhood disadvantage as a neurocognitive performance interpretation variable and development of clinical recommendations.

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 #65

The Area Deprivation Index (ADI), Continuing to Re-Think Race Corrections in Neuropsychological Evaluations: Exploring the Relative Contribution of Race and Socioeconomic Disadvantage to Neuropsychological Test Performance Among a Racially Diverse Sample.

Halle McCracken, University of Mississippi, Oxford, United States
Brandon Baughman, Semmes Murphey Clinic, Memphis, United States

Category: Inclusion and Diversity/Multiculturalism

Keyword 1: demographic effects on test performance
Keyword 2: mild cognitive impairment

Objective:

Neighborhood socioeconomic disadvantage is a risk factor for cardiovascular and neurologic morbidity and mortality. Independent of other demographic factors, greater socioeconomic disadvantage increases the risk for cognitive impairment and dementia, particularly for racially minoritized populations. Systemic racism and neighborhood segregation may partially explain the association between race and poor cognitive health, leading to disproportionality in cognitive impairment. Increasing our understanding of the role that neighborhood disadvantage plays in neurocognition may aid in the development and use of more sensitive normative data. Therefore, the aim of the present study is to explore the relative contributions of race and neighborhood disadvantage (as measured by the area deprivation index (ADI)) to neuropsychological test performance.

Participants and Methods:

The present study included retrospective review of 237 clinically referred patients who met criteria for a DSM-5-TR neurocognitive disorder. Subjects’ mean age was 69.1 (SD = 8.8), 74.7% were White, 23.6% were Black, and 1.7% were Asian, with a similar proportion of females to males (55.7% vs. 44.3%). The majority of subjects were married (63.3%) and average educational attainment was 14.3 (SD = 2.8) years. The mean ADI national percentile was 55.7 (Min = 4.0, Max = 100.00), with greater percentiles associated with increased disadvantage. 73.8% also had a comorbid psychiatric diagnosis. Hierarchical linear regression analyses were conducted to assess the relationship between race, ADI, and neuropsychological test performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).

Results:

Regression analyses revealed that ADI (∆R² = .026, p = .013) was significantly associated with performance on the Attention Index of the RBANS and race (∆R² = .021, p = .023) accounted for significant incremental variance in attention scores (overall model R² = .047, p = .004). Regarding the Visual Spatial Index, regression analyses revealed that ADI was not significantly associated with visuospatial performance (∆R² = .006, p = .227). However, race was significantly associated with visuospatial performance and accounted for significant incremental variance in test scores (∆R² = .046, p < .001; overall model R² = .053, p = .002). Finally, ADI and race were not significantly associated with performance on Immediate Memory, Language, or Delayed Memory indices.

Conclusions:

These results suggest that race and neighborhood disadvantage are not associated with neurocognitive test performance in the domains of memory and language in the current sample. However, race accounted for additional incremental variance in visuospatial performance, which is consistent with prior literature suggesting that visuospatial decline is more pronounced for Black individuals after adjusting for education. The significant associations between ADI, race, and attention suggest that race and neighborhood disadvantage account for more variability in subcortical functions, which are typically impacted by vascular pathology. As such, both racial and neighborhood disadvantage may place people at risk for poor vascular health, likely secondary to problems with healthcare access, education, food insecurity, etc. Future directions will be discussed regarding the use of neighborhood disadvantage as a neurocognitive performance interpretation variable and development of clinical recommendations.