Objectives:Vision and hearing impairments affect 55% of people aged 60+ years and are associated with lower cognitive test performance; however, tests rely on vision, hearing, or both. We hypothesized that scores on tests that depend on vision or hearing are different among those with vision or hearing impairments, respectively, controlling for underlying cognition.Methods:Leveraging cross-sectional data from the Baltimore Longitudinal Study of Aging (BLSA) and the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), we used item response theory to test for differential item functioning (DIF) by vision impairment (better eye presenting visual acuity worse than 20/40) and hearing impairment (better ear .5–4 kHz pure-tone average > 25 decibels).Results:We identified DIF by vision impairment for tests whose administrations do not rely on vision [e.g., Delayed Word Recall both in ARIC-NCS: .50 logit difference between impaired and unimpaired (p = .04) and in BLSA: .62 logits (p = .02)] and DIF by hearing impairment for tests whose administrations do not rely on hearing [Digit Symbol Substitution test in BLSA: 1.25 logits (p = .001) and Incidental Learning test in ARIC-NCS: .35 logits (p = .001)]. However, no individuals had differences between unadjusted and DIF-adjusted measures of greater than the standard error of measurement.Conclusions:DIF by sensory impairment in cognitive tests was independent of administration characteristics, which could indicate that elevated cognitive load among persons with sensory impairment plays a larger role in test performance than previously acknowledged. While these results were unexpected, neither of these samples are nationally representative and each has unique selection factors; thus, replication is critical.

中文翻译：

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评估感觉障碍老年人认知测试中的偏差：巴尔的摩老龄化纵向研究 (BLSA) 和社区神经认知研究 (ARIC-NCS) 中动脉粥样硬化风险的差异项目功能分析

目标：55% 60 岁以上的人患有视力和听力障碍，并且与较低的认知测试成绩相关；然而，测试依赖于视力、听力或两者。我们假设，在控制潜在认知的情况下，视力或听力障碍患者的视力或听力测试分数分别不同。方法：利用巴尔的摩老龄化纵向研究 (BLSA) 和社区神经认知研究中的动脉粥样硬化风险 (ARIC-NCS) 的横断面数据，我们使用项目反应理论来测试视力障碍（更好的眼睛呈现）的差异项目功能 (DIF)视力低于 20/40）和听力障碍（较好的耳朵 0.5–4 kHz 纯音平均值 > 25 分贝）。结果：我们通过视力障碍来识别 DIF，以进行不依赖于视力的测试[例如，ARIC-NCS 中的延迟单词回忆：受损和未受损之间的 0.50 logit 差异（p= .04)，在 BLSA 中：0.62 logits (p= .02)] 和 DIF 通过听力障碍进行测试，其管理机构不依赖于听力 [BLSA 中的数字符号替换测试：1.25 logits (p= .001) 和 ARIC-NCS 中的附带学习测试：.35 logits (p=.001)]。然而，没有人发现未经调整和 DIF 调整的测量值之间的差异大于测量的标准误差。结论：认知测试中感觉障碍的 DIF 与管理特征无关，这可能表明感觉障碍患者中认知负荷的升高对测试表现的影响比之前承认的更大。虽然这些结果出乎意料，但这些样本都不具有全国代表性，并且每个样本都有独特的选择因素；因此，复制至关重要。