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Identifying Appropriate Neuropsychological Tests for Uneducated/Illiterate Older Individuals
Journal of the International Neuropsychological Society ( IF 2.6 ) Pub Date : 2021-08-31 , DOI: 10.1017/s1355617721001016
Maria-Aikaterini Mandyla 1 , Mary Yannakoulia 2 , Georgios Hadjigeorgiou 3, 4 , Efthimios Dardiotis 4 , Nikolaos Scarmeas 5, 6 , Mary H Kosmidis 1
Affiliation  

Objectives: We investigated the utility of traditional neuropsychological tests in older uneducated/illiterate individuals without dementia to determine the possibility that they are likely not appropriate for this group. Methods: We assessed the neuropsychological performance of 1122 older adults [≥65 years old; mean age: 74.03 (SD = 5.46); mean education: 4.76 (SD = 2.5) years; women: n = 714], in the context of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD), a population-based study conducted in Greece. Results: We based our analyses on three groups: high-functioning/cognitively healthy (i.e., without dementia) uneducated/illiterate individuals (n = 80), high-functioning/cognitively healthy educated/literate individuals (n = 932), and low-functioning/cognitively impaired educated/literate individuals (presumably with dementia; n = 110). We used binary regression analyses with Bonferroni correction to investigate whether test performance differentiated uneducated/illiterate from educated/literate individuals. Models were adjusted for age and sex; raw test scores were the predictor variables. The uneducated/illiterate cohort was at a disadvantage relative to the healthy educated/literate group on all variables but verbal memory recognition and consolidation, congruent motor responses, and phonological fluency clustering (p > .002). Moreover, only word list learning immediate and delayed free recall and delayed cued recall differentiated the high-functioning/cognitively healthy uneducated/illiterate from the low-functioning/cognitively impaired educated/literate group, favoring the former (p’s < .002). Conclusions: Our findings suggest that only particular verbal memory test variables are fair in determining whether older uneducated/illiterate individuals have functional/cognitive impairment suggestive of a neurodegenerative process. On all other neuropsychological variables, this cohort was at a disadvantage. Therefore, we highlight the need for identifying appropriate methods of assessment for older uneducated/illiterate individuals.

中文翻译:

为未受过教育/文盲的老年人确定适当的神经心理学测试

目的:我们调查了传统神经心理学测试在没有痴呆的未受过教育/文盲的老年个体中的效用,以确定他们可能不适合该群体的可能性。方法:我们评估了 1122 名老年人 [≥65 岁;平均年龄:74.03(标清= 5.46); 平均教育:4.76(标清= 2.5) 年;女性:n= 714],在希腊进行的一项基于人群的老龄化和饮食纵向调查 (HELIAD) 的背景下。结果:我们的分析基于三组:高功能/认知健康(即没有痴呆)未受过教育/文盲的个体(n= 80),高功能/认知健康受过教育/有文化的个体(n= 932),以及受过教育/识字的低功能/认知障碍个体(可能患有痴呆症;n= 110)。我们使用带有 Bonferroni 校正的二元回归分析来调查测试表现是否区分未受过教育/文盲与受过教育/有文化的个体。模型根据年龄和性别进行了调整;原始测试分数是预测变量。未受过教育/文盲的队列相对于健康受过教育/识字的组在所有变量上都处于劣势,但语言记忆识别和巩固、一致的运动反应和语音流畅性聚类除外。p> .002)。此外,只有学习立即和延迟自由回忆和延迟线索回忆的词表才能区分高功能/认知健康的未受过教育/文盲与低功能/认知受损的受过教育/识字组,有利于前者(p的< .002)。结论:我们的研究结果表明,只有特定的语言记忆测试变量才能公平地确定未受过教育/文盲的老年人是否存在暗示神经退行性过程的功能/认知障碍。在所有其他神经心理学变量上,这个队列处于劣势。因此,我们强调需要为未受过教育/文盲的老年人确定适当的评估方法。
更新日期:2021-08-31
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