Socioeconomic disadvantage is a chronic stressor associated with several biological markers of health (e.g., inflammation) as well as early-onset cognitive aging. Studies examining socioeconomic status (SES) and its link with health outcomes exhibit no uniformity in the way in which SES is measured and defined. Also, studies have found that subjective socioeconomic status (SSES), defined by a subjective SES scale, was more consistently and strongly related to psychological functioning and health-related outcomes than objective socioeconomic status (OSES), defined by a composite score of education, household income, and occupation. The goal of the current study was to assess whether SSES mediates the relationship between OSES and neuropsychological test performance similarly across racial and ethnic groups.

Participants were 1,912 middle-aged older adults (13% non-Hispanic white, 17% non-Hispanic Black, 69% Hispanic/Latinx) from the Offspring study. Participants are the adult children of participants in the Washington Heights Inwood Columbia Aging Project, a community-based cohort study of aging and dementia representing the ethnic/racial diversity of upper Manhattan. Participants on average were 56.5 years of age and 67% were women. Measures of verbal learning and memory (SRT immediate and delayed recall), verbal fluency (animal and letter fluency), and attention/working memory (digit span forward and backward) were administered. OSES was characterized by years of formal education completed. SSES was measured by the MacArthur Scale of Subjective Social Status. The scale measures perceptions of one’s social standing relative to others. We conducted separate stratified mediation analyses for each neuropsychological outcome across each racial and ethnic group. All models were adjusted for age.

Participants with higher OSES demonstrated higher neuropsychological test scores (effect size associations ranged from .29 to .45) and reported higher SSES (b=.109 95% CI: .08, .14). Lower SSES was associated with lower neuropsychological test scores (effect-size range .06 to .13). In stratified analyses, the relationship between OSES and SSES was strongest for White participants (b=.13 [.01, .24]) compared with Latinx (b=.06 [.02, .11]) and Black (b=.06 [-.03, .16]) participants. Associations between SSES and neuropsychological outcomes were only reliable for White participants on SRT Immediate and Delayed Recall and Animal Fluency and for Black participants on Digit Span Forward. In mediation analyses, SSES mediated the relationship between OSES and Immediate Recall (indirect effect b=.18 [.001, .45]; 39% mediated), Delayed Recall (indirect effect b=.05 [.004, .09]; 44% mediated), and Animal Fluency (indirect effect b=.09 [.01, .20]; 22% mediated) for White participants. There was no evidence of mediation in Black or Latinx participants.

The relationship between OSES and SSES was strongest for White participants compared to Black and Latinx participants. Even though perception of social status predicted lower cognitive test scores among Black and Latinx adults, it is only a part of the indirect pathway linking OSES to cognitive function among White adults. It is likely that mechanisms related to tangible resources that benefit health (as opposed to perceived inequity) are in the pathway linking education to cognition among Black and Latinx, and thus intervening on systems of inequality throughout the life course has the most promise for improving brain health in those communities.

The MUNS is a screening scale developed in Cordoba, Argentina (2018). It is devised with multicultural stimuli that are easily translated into different languages. The scale consists of seven subtests evaluating five cognitive domains: attention, memory, executive functioning, constructional praxis, and language. Previous cross-cultural studies with this scale found significant differences in performance on the attention subtest. The authors have developed a new attention subtest called “Arrows Cancellation”, a short cancellation test designed to overcome its predecessor’s shortcomings. The minimum score of this subtest is 0, and the maximum score is 160. It takes between 3 to 5 minutes to administer. A pilot study of this subtest was performed in Argentina in 2021 (n=62, M=105.61 ± 15.06). The aim of this study is to present the first cross-cultural comparison for the Arrows Cancellation subtest of the MUNS.

Argentinian (n=25, 84% female) and U.S.A. (n=39, 87% female) samples were administered the Arrows Cancellation subtest. In both cases, individuals gave their consent to participate voluntarily in this study. Participants’ health backgrounds, explored through a set of questions, determined their inclusion in the study. Participants with any of the following diagnoses were excluded from this sample: stroke, loss of consciousness (at least 20 minutes), traumatic head injury, central nervous system disease, chronic renal insufficiency, hepatic encephalopathy, non-treated thyroid disease, epilepsy, non-treated high blood pressure, severe cardiac failure, severe sleep disorders, coma, diagnosed psychiatric disease, or illegal drug consumption. Argentinians were given the instructions in Spanish whilst Americans were instructed in English. The mean age for the Argentinian sample was 21.24 ± 2.44, and for the American sample it was 20.18 ± 1.89. The mean years of education was 13.44 ± 0.96 for the Argentinian group and 13.6 ± 1.55 for the American group. A t-test showed that there were no significant differences in age (p=.06), years of schooling (p=.67) between both samples.

The mean score of the Arrows Cancellation subtest for the Argentinian sample was 107.30 ± 14.51 and 108.95 ± 14.12 for the American sample. A t-test did not show significant differences in the Arrows Cancellation subtest score between samples (p=.65). In addition, there were no significant differences between males and females (p=.43).

The results of this study show that the new attention subtest of the MUNS did not show significant differences between two different cultural samples. Further studies are needed to confirm its utility in other cultural settings. Among the limitations of this study are the sample sizes and the restricted ranges of age and years of schooling.

This study examined false positive rates of performance validity test (PVT) failure in a group of monolingual (English-speaking) White non-Hispanic/Latinx (non-HL), monolingual (English-speaking) Hispanic/Latinx (HL), and bilingual (English- and Spanish-speaking) HL patients evaluated at an academic medical center. Research on classification accuracy of embedded performance validity tests (PVTs) is limited in HL and bilingual populations. Cultural test biases or language differences could inaccurately cause scores below PVT cutoff levels.

The project involved secondary analysis of a deidentified dataset (N=391). Participants were included if they were between the ages of 18 and 64, had data from the initial visit, had an IQ greater than or equal to 70, were not diagnosed with dementia or major or mild cognitive impairment, and identified as either White non-HL or HL. Participants were required to have completed at least two PVTs. Participants who were not administered the Test of Memory Malingering (TOMM; n=95) or who scored below a highly sensitive Trial 1 cutoff (<46; n=86) were excluded. The final sample included 210 participants, which included monolingual non-HL participants (n=114), monolingual HL participants (n=44), and bilingual HL participants (n=52). Failure rates on eight PVTs were examined by participant group: Reliable Digit Span (RDS), Auditory Verbal Learning Test Recognition (AVLT), Logical Memory Recognition (LM), Visual Reproduction Recognition (VR), Trail Making Test Ratio (TMT rat), Rey Complex Figure Test Recognition (RCFT), Semantic Word Generation (animals; SWG), and Finger Tapping (TAP).

Groups were not significantly different in age. Monolingual non-HL participants had completed more years of education than monolingual and bilingual HL groups (13.7, 12.7, and 12.8 years respectively). In the whole sample, 8.6% (n=18) failed two or more PVTs. In the monolingual non-HL group, 8.8% (n=10) failed two or more PVTs, while 9.1% (n=4) of the monolingual HL group and 7.7% (n=4) of the bilingual HL group failed two or more PVTs (n.s.). Within the monolingual non-HL test set, failure rates were above 10% on SWG (12.73%) and TAP (17.7%). Failure rates above 10% in the monolingual HL set were found on SWG (11.6%). Failure rates above 10% in bilingual HL measures were observed on SWG (13.5%) and TAP (10.8%).

Total PVT failure rates did not significantly differ between groups. Across groups, performance was above a common false positive threshold of 10% on SWG. Monolingual non-HL and bilingual participants also had elevated failure rates on TAP.

Previous studies have found differences between monolingual and bilingual athletes on ImPACT, the most widely used sport-related concussion (SRC) assessment measure. Most recently, results suggest that monolingual English-Speaking athletes outperformed bilingual English- and Spanish-speaking athletes on Visual Motor Speed and Reaction Time composites. Before further investigation of these differences can occur, measurement invariance of ImPACT must be established to ensure that differences are not attributable to measurement error. The current study aimed to 1) replicate a recently identified four-factor model using cognitive subtest scores of ImPACT on baseline assessments in monolingual English-Speaking athletes and bilingual English- and Spanish-speaking athletes and 2) to establish measurement invariance across groups.

Participants included high school athletes who were administered the ImPACT as part of their standard pre-season athletic training protocol in English. Participants were excluded if they had a self-reported history of concussion, Autism, ADHD, learning disability or treatment history of epilepsy/seizures, brain surgery, meningitis, psychiatric disorders, or substance/alcohol use. The final sample included 7,948 monolingual English-speaking athletes and 7,938 bilingual English- and Spanish-speaking athletes with valid baseline assessments. Language variables were based on self-report. As the number of monolingual athletes was substantially larger than the number of bilingual athletes, monolingual athletes were randomly selected from a larger sample to match the bilingual athletes on age, sex, and sport. Confirmatory factor analysis (CFA) was used to test competing models, including one-factor, two-factor, and three-factor models to determine if a recently identified four-factor model (Visual Memory, Visual Reaction Time, Verbal Memory, Working Memory) provided the best fit of the data. Eighteen subtest scores from ImPACT were used in the CFAs. Through increasingly restrictive multigroup CFAs (MGCFA), configural, metric, scalar, and residual levels of invariance were assessed by language group.

CFA indicated that the four-factor model provided the best fit in the monolingual and bilingual samples compared to competing models. However, some goodness-of-fit-statistics were below recommended cutoffs, and thus, post-hoc model modifications were made on a theoretical basis and by examination of modification indices. The modified four-factor model had adequate to superior fit and met criteria for all goodness-of-fit indices and was retained as the configural model to test measurement invariance across language groups. MGCFA revealed that residual invariance, the strictest level of invariance, was achieved across groups.

This study provides support for a modified four-factor model as estimating the latent structure of ImPACT cognitive scores in monolingual English-speaking and bilingual English- and Spanish-speaking high school athletes at baseline assessment. Results further suggest that differences between monolingual English-speaking and bilingual English- and Spanish-speaking athletes reported in prior ImPACT studies are not caused by measurement error. The reason for these differences remains unclear but are consistent with other studies suggesting monolingual advantages. Given the increase in bilingual individuals in the United States, and among high school athletics, future research should investigate other sources of error such as item bias and predictive validity to further understand if group differences reflect real differences between these athletes.

Evaluate measures used to operationalize apathy in relation to cognitive impairment among Hispanic/Latin Americans and synthesize associations of apathy with cognitive impairment.

A systematic review of the available literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. This review covered studies on the relationship between apathy and cognitive impairment among Hispanic/Latin Americans across normal aging and neurocognitive disorders. The first stage of the review consisted of collecting all publications that contained (1) English or Spanish-speaking participants, (2) with measures for reported apathy, (3) assessment of cognitive functioning or diagnosis of neurocognitive disorder, (4) with Hispanic/Latin Americans represented in the sample. There was no limit regarding publication date. The required minimum of H/L participants in selected studies was determined based on a standard of representation in the United States general population, which is around 18.5%. In the second stage of the review, studies were screened excluding all studies that did not meet the criteria.

Thirteen, 37, and 17 studies were identified by APA PsychInfo, EMBASE, and PubMed, respectively. After removing 19 duplicate records, 48 reports were then assessed for eligibility. Thirty-five of those reports were missing apathy and cognition associations, were under-reported in information such as conference abstracts, or were missing adequate representation of H/L participants. This resulted in a total of 13 papers included in this review. Of the eleven cross-sectional studies, nine demonstrated significant differences or associations between apathy and cognitive status, one demonstrated a descriptive difference between apathy and cognitive status (i.e., no hypothesis test conducted), while one demonstrated null effects. All effects suggested that as apathy increased, cognitive impairment increased. These cross-sectional studies spanned across Säo Paulo, Brazil, Los Angeles, California, West Texas, Cuba, the Dominican Republic, Peru, Venezuela, Mexico, Puerto Rico, and Southwestern United States. This included community and clinic samples of participants. Of the two longitudinal studies, they both demonstrated non-significant associations of apathy and cognitive status. One study in Mexico suggested a risk ratio over 1 where apathy was non-significantly associated with dementia risk, while the other study in Texas, United States had hazard ratios below 1 where apathy was non-significantly associated with mild cognitive impairment risk.

The Neuropsychiatric Inventory (NPI) apathy subscale was the most used measure for apathy in this review (81.8% of included studies). However, a recent systematic review on apathy measurement in older adults and people with dementia specifically stated that the apathy dimension commonly used in the NPI should not be employed outside of screening for apathy. This suggests potential bias and poor evidence in the current literature consisting of apathy research with H/Ls. Longitudinal studies evaluating the utility of examining apathy in relation to cognitive impairment with diverse ethnoracial groups, in addition to Hispanic/Latin Americans, are warranted. Assessing construct equivalence of apathy across demographic characteristics such as language, education, and informant characteristics should be conducted to elucidate potential biases in measurement.

Evidence has shown that the environment is an often overlooked social determinant of health (SDoH) of emotional, neural, and cognitive development. Aspects of the built environment relate to health factors and equity in living conditions, and may contribute to racial, ethnic, or economic health disparities. For example, urbanicity is linked with negative factors including less access to green space (i.e. gray space), increase in air pollution, temperatures, and socio-economic inequalities. While there is existing research on access to green space on some mental health and cognitive outcomes, there is limited research on the presence of gray space linked with cognitive functioning in youth. While some studies have shown that aspects of the neighborhood environment (e.g. access to healthy food, air pollution, heat exposure, and walkability) can impact neural and cognitive functioning, few to date have disentangled unique contributions of these factors in a large, national cohort. Therefore, the aim of the present study was to identify the best fitting model testing multiple SDoHs related to gray space on overall cognitive functioning in youth enrolled in the Adolescent Brain Cognitive Development (ABCD) Study.

Using baseline data (n = 8,802) from ABCD 4.0 data, this study used environmental measures and linked external databases to characterize SDoH variables predicting youths’ cognitive functioning via the NIH Toolbox (e.g. total cognitive composite score). This study used geospatial mapping to estimate exposure to air pollutants and heat. Additionally, the National Walkability Index was linked to assess walkability of neighborhood. Exposure to gray space (e.g. impervious surfaces) and access to healthy food were assessed via the Child Opportunity Index 2.0. An exhaustive search for the best subsets of these variables (gray space, access to healthy food, walkability, air pollution, and heat exposure) predicting cognitive performance was run to examine the best fitting model based on adjusted R2, using the 'leaps’ package in R. Then, a multiple linear mixed effects regression model, using the lmer package in R, was fitted adjusting for various and relevant demographic factors.

The results of the regression indicated that walkability index (F(1, 1322.4) = 11.07, p < 0.001) and heat exposure (F(1, 81.1) = 5.54, p < 0.001) explained a significant amount of the variance (Adjusted R2 = 20%) predicting total cognitive performance while controlling for sex, age, household income, parent education, marital status, family relatedness, and site.

Findings suggest that walkability of the neighborhood and heat exposure may play a role in cognitive development over and above other SDoHs and demographic factors. However, this study was limited to baseline assessment and a single measurement of total composite cognitive score, thus it is crucial for future research to investigate relationships over the life course across cognitive domains to further clarify these findings. The present study can help inform future public policy on improving lived and built environments, which may aid in supporting cognitive development in youth. These findings identify key factors, walkability and heat exposure, to consider when investigating the interaction between poverty, health, and environmental justice.

Socioeconomic factors, spanning from childhood to mid-adulthood, were examined in an older adult Black cohort to better understand their influence on the ability to complete instrumental activities of daily living. Previous research with socioeconomic factors has primarily focused on cognitive changes rather than everyday functioning. Additionally, research that has been conducted examining functioning has been with predominantly White samples.

Data on Black participants were obtained from Rush University’s Memory and Aging Project (MAP), Minority Aging Research Study (MARS), and the Latino CORE study (CORE). Participants (n = 1,273) were predominately female (79.9%) and ranged in age from 54 - 97 years (M = 73 years old). Participants were stratified into two groups based on their consensus diagnosis: no cognitive impairment (NCI; 76.1%) and mild cognitive impairment (MCI). Linear regression analyses were utilized on each group to examine predictors of decreased functioning in instrumental activities of daily living. Predictors included income levels during childhood, at age 40, and current income level. Additionally, sex, education level, and parental education levels were included in the models.

Impairment of functioning in instrumental activities of daily living was predicted by the age of the participants at the time of their visit in both NCI and MCI groups (p < 0.001). Current income levels for the NCI participants significantly predicted functioning in IADLs (p < 0.001). This relationship was not present for the MCI group, rather, total family income at age 40 better predicted functioning (p = 0.043).

Previous research has found that early and mid-life socioeconomic circumstances have cascading and complex effects on late life cognition. These same associations may be applicable to functioning with instrumental activities of daily living as they are with cognition. In the present study, current income levels were influential on the functioning of participants without cognitive impairment. Although, when examining those with mild cognitive impairment, mid-life economic circumstances were more impactful on everyday functioning. While the economic status of both groups were predictors of functioning, these findings highlight the importance of better understanding socioeconomic factors across the lifespan and all levels of cognition.

Neuropsychological test norms are developed as a reference point for assessing normal and abnormal test performance (Manly & Echemendia, 2007; Mitrushina et al., 2005). However, these norms are often created without considering the cultural experiences that influence neuropsychological test performance in ethnically diverse individuals. Since the Soviet Union’s collapse, approximately 2.66 million people migrated to different countries, with one of the most popular destinations being the United States (Tishkov, Zayinchkovskaya, & Vitkovskaya, 2005). The objective of this study was to examine whether specific cultural factors can significantly influence Former Soviet Union’s neuropsychological test performance on the California Verbal Learning Test-Second Edition Short Form (CVLT-II-SF).

A total of 66 fluent, English-speaking first- or second-generation healthy immigrants from the Former Soviet Union participants were recruited from the greater Los Angeles area for this study. Participants ranged in age from 18 to 75 years old. Participants were administered the CVLT-II-SF as part of a larger battery. This shorter version of the CVLT-II requires participants to learn 9 words that fall into 3 different categories over 4 learning trials. This is followed by distractor task, free recall of the 9 items and free recall of the items again after 10 minutes, followed by recall with cuing of the categories. A questionnaire designed to assess the participants’ various cultural experiences was given and include the amount of education that was obtained outside of the U.S. as well as the percentage of time they spoke English growing up. Finally, all participants completed an acculturation measure.

Correlation analysis was performed in order to assess which cultural factors significantly correlated with the CVLT-II-SF variables. The results revealed that two of the cultural factors (percentage of education that was obtained outside of the U.S. and the acculturation score) are significantly correlated with several neuropsychological variables. Stepwise regression analysis was then used to further examine the best cultural predictors of CVLT-II-SF variables. This analysis revealed that the percent of education obtained outside of the U.S. significantly predicted the total learning trial scores, the long free recall trial, and the long-cued recall trials, while the acculturation scores significantly predicted the short free recall trial.

The results of this study indicate that specific cultural factors should be taken into account when interpreting the test results of immigrants of former Soviet Union individuals. More specifically, acculturation and the amount of education obtained outside of the U.S. are important factors to consider.

Given that African American older adults are disproportionately at risk for the development of dementia, identifications of sensitive risk and protective factors are of high importance. Subjective decline in cognition is a potentially easy to assess clinical marker, as it has been previously associated with increased risk of converting to MCI and/or dementia. Subjective decline in cognition is complex though, in that it has also been associated with psychosocial factors. Given this, and the fact that the bulk of research on subjective decline in cognition has been conducted in older white adults, research in diverse samples is needed. The present study sought to address these gaps by examining interactions between race and psychosocial risk (dysphoria) and protective (social activity) factors in the prediction of subjective cognition.

Older white (n = 350) and African American (n = 478) participants completed questionnaires via Qualtrics Panels (m age = 65.9). Subjective decline in cognition was assessed via the Multifactorial Memory Questionnaire (MMQ). Dysphoria was assessed via the Inventory of Depression and Anxiety Symptoms-II Dysphoria subscale (IDAS). Frequency of late life social activity was assessed via a validated series of questions used by the Rush Alzheimer’s Disease Center. Race, dysphoria, late life social activity, and interactions between race and dysphoria and race and social activity were analyzed as predictors of subjective decline in cognition via linear regression.

The overall model accounted for a significant portion of the variance in subjective decline in cognition, F(6, 713) = 38.38, p < .01, with an R2 of .24. The interaction between race and dysphoria was significant, such that the relationship between dysphoria and subjective decline in cognition was stronger for older adults who are African American. Race, dysphoria, social activity, and the interaction between race and social activity were not significant predictors.

While dysphoria and related negative affect variables have been previously associated with subjective cognition, interactions with race are rarely analyzed. Our results show that the relationship between dysphoria and subjective decline in cognition were stronger for African American older adults. This result is of clinical importance, as dysphoria is central to many internalizing disorders, which have been associated with subjective cognition and the development of MCI and dementia. Future research should seek to analyze drivers for this associations and if interventions for dysphoria may reduce subjective decline in cognition for African American older adults.

Stephenson (2000) suggested that acculturation is a phenomenon that immigrants and refugees ubiquitously experience. The level of acculturation is impacted by a person’s choice to allow how much of their cultural traits they decide to keep while adapting to the dominant society cultural traits. Depending on what immigrants find to be important or unimportant, it can influence future generations (i.e., their children) in how they will be developed and adapt into a dominant society. Hispanic-Americans are individuals that were born and reside in the United States and have a family background that extends to one of the Spanish speaking countries in Latin America or Spain. The typical language spoken by Hispanic families other than English is Spanish. It has been reported that Hispanics that are capable of speaking English may be afforded better and greater opportunities to resources. Research shows that a person level of acculturation can influence their cognition. In fact, in one study using a Mexican-American sample that was divided into two groups: high and low. Researchers found that highly acculturated Mexican-Americans outperformed lower acculturated Mexican-Americans on the Wisconsin Card Sorting Test. We evaluated the influence of acculturation in Hispanic-Americans neuropsychological test performance. It was predicted that highly acculturated Hispanic-Americans to American culture would demonstrate better cognitive abilities compared to lower acculturated Hispanic-Americans.

The present study sample consisted of 75 neurologically and psychologically healthy Hispanic-American undergraduate students with a mean age of 19.44 (SD = 1.37). Participants were divided into two acculturation groups: high (n = 39) and low (n = 36). In addition, all the participants completed a comprehensive neuropsychological battery and background questionnaire in English. The Acculturation Rating Scale for Hispanic/Latino Americans is a 20-item scale that was utilized to create our acculturation groups. ANOVAs were used to evaluate cognitive differences between our acculturation groups.

Results revealed that the highly acculturated group outperformed the lower acculturated group on the Weschler Adult Intelligence Scale-Third Edition vocabulary task and the Boston Naming Test, p’s<.05, n.p’s2=.06. Furthermore, results revealed that the lower acculturated group outperformed the highly acculturated group on the Trail Making Test part A and B, and Comalli Stroop part A, p’s<.05, np’s2=.06-.07.

As expected, the highly acculturated group demonstrated better language abilities compared to the lower acculturated group. However, in the opposite direction, the lower acculturated group outperformed the highly acculturated group on several speed attention tasks and one executive functioning task. A possible explanation why the highly acculturated participants demonstrated better language abilities may be attributed that their dominant language is English or they only spoke English. Meanwhile, the opposite could be said for lower acculturated participants that English was not their dominant language or they were bilingual speakers, for that reason they demonstrated better processing speed and executive functioning abilities. Research shows that monolinguals demonstrate better language abilities compared to bilinguals, but the opposite is found on processing speed and executive functioning tasks. Future research should investigate the relationship between bilingualism and acculturation in neuropsychological testing performance of Hispanic-Americans.

Verbal fluency tasks evaluate executive functioning by requiring a person to provide words within a certain time period that start with a certain letter (phonemic fluency) or category (semantic fluency). Research shows that age impacts test takers’ phonemic and semantic verbal fluency performance. In fact, it has been suggested that phonemic verbal fluency peaks around age 30 to 39 and begins to decline at older ages. In contrast to phonemic fluency, research suggests that semantic fluency increases steadily between test takers until age 12 and begins declining around age 20. A generation is a cohort of people born within a certain period who share age and experiences. Studies show that Generation X individuals (persons born between 1965-1980) outperform Generation Y (persons born between 19811995) and Generation Z individuals (persons born between 1965-1980) on the Cordoba Naming Test. To our knowledge, no study has investigated verbal fluency performance across generational groups. We predicted that Generation X individuals would outperform individuals from Generation Y and Z on both verbal fluency measures.

The sample of the present study consisted of 107 participants with a mean age of 27.39 (SD = 9.16). Participants were divided into three groups: Generation X (n = 19), Generation Y (n = 52), and Generation Z (n = 36). The phonemic verbal fluency task consisted of three trials and the semantic verbal fluency task consisted of one trial, one minute each. A series of ANCOVAs with Bonferroni post-hoc tests were used to evaluate verbal fluency performance between generational groups. All participants passed performance validity testing.

We found significant differences between our generational groups on both verbal fluency tasks. Post-hoc tests revealed that the Generation Y group outperformed both Generation X and Z groups on both verbal fluency tasks, p’s <.05, np2 =.11 -.16. No significant differences were found on either verbal fluency task between the Generation X and Z groups.

Contrary to our hypothesis, Generation Y individuals possessed better phonemic and semantic fluency than both Generation X and Z individuals. Meanwhile, Generation X individuals did not significantly differ on any of the verbal fluency tasks compared to Generation Z individuals. Speaking multiple languages has been shown to impact verbal fluency performance. In our sample, the Generation X and Z groups consisted primarily of bilingual speakers compared to the Generation Y group. Examining generational differences is essential to understand the unique characteristics and impact of the times in which various individuals have grown up. Future research, for instance, should evaluate the influence of bilingualism across generational groups on verbal fluency performance.

Technological advances allow for increased international collaboration within the medical community (e.g., internet, e-mail, instant messaging, video-teleconferencing [VTC]). Partnering with clinicians and researchers across the globe allows for shared resources, particularly beneficial for underserved populations and communities with poor access to specialty resources, including neuropsychology. Along with the potential benefits of such collaborations comes challenges including language, cultural, and physical barriers. The presented findings detail important lessons learned from an ongoing research collaboration between the Einstein team (Bronx, NY) and a research group in Kerala, India, called the Kerala Einstein Study (KES), a study evaluating pre-dementia syndromes in Indian older adults. Here we highlight the training process of research assistants administering neuropsychological measures to older adults in India, by neuropsychologists in the USA.

One study manager and several research assistants (collectively referred to as RAs) based in India were trained by the first author, a neuropsychology postdoctoral fellow (MS) based in the US via VTC (i.e., Zoom), under supervision of a clinical neuropsychologist. RAs were trained in test administration and scoring for a variety of neuropsychological measures. RAs speak Malayalam and English; training occurred in English. Following training, VTC meetings were held to process testing experience and channels were created for ongoing administration/scoring questions and concerns (i.e., email, WhatsApp). RAs scanned and uploaded scored protocols to a protected web-based platform. MS double-scored several protocols and additional VTC meetings were held to discuss/update scoring procedures.

Physical challenges included time difference between sites, internet connectivity, language barriers (i.e., varying English dialects) cultural considerations (e.g., some test/task directions were changed based on RAs knowledge of more appropriate wording). Test administration challenges included cultural factors (i.e., allowing for continuation of some tasks beyond time limits for rapport) and RA comfort level with administration of some tasks (e.g., trail making test). Scoring challenges included RAs tendency to score too strictly or leniently and confusion regarding specific scoring criteria. At an initial VTC meeting, MS modeled test administration. Then RAs practiced the tests together. To reduce challenges including time difference, connectivity problems, language barriers, and comfort with testing/scoring, VTC training sessions were scheduled individually between MS and each RA. During these sessions, the RA 'tested’ MS and received immediate feedback. Most sessions lasted approximately 90 minutes with one RA requiring a second session (i.e., sessions were tailored for individuals to obtain level of testing comfortability and competency). After each RA was 'cleared’ by MS to start testing, RAs began testing and scoring. Following MS’s review of several scored protocols, meetings took place in groups in order to improve scoring skills and increase consistency between RAs. Given the continued high degree in scoring variability, a third RA was hired with one of his main responsibilities being to double score all protocols.

Findings highlight important challenges and considerations for remotely training study personnel to administer neuropsychological measures (i.e., RAs in India and neuropsychologists in the USA). Important steps to reduce identified barriers included individualized training sessions, specific training in scoring, and open/ongoing communication channels.

Bilingualism has shown to have significant implications for neuropsychological assessment, namely, the Digit Span task. Moreover, bilingual individuals have been shown to exhibit both advantages and disadvantages on Digit Span; however, the relationship between bilingualism and performance on this subtest is poorly understood. This research aims to better understand how Hispanic Spanish-English bilinguals perform on this commonly administered working memory subtest.

Participants included 82 Hispanic Spanish-English bilinguals [Age: M=29.11 (SD=6.369); Education: M=15.68 (SD=2.255); 53.7% female]. The participants completed the Language and Social Background Questionnaire (LSBQ; composite factor scores) and the Wechsler Adult Intelligence Scale -Fourth Edition (WAIS-IV) Digit Span (raw scores) subtest via Zoom, an online video conferencing platform. A hierarchical multiple regression analysis was utilized to predict participants’ Digit Span performance based on their LSBQ composite factor scores. Hierarchical multiple regression analyses were conducted using SPSS Version 27.

LSBQ composite factor scores significantly predicted Digit Span Forward, F (3, 78) = 1.835, p < 0.43 (R2 = .030) and Longest Digit Span Forward, F (1, 78) = 4.02, p < 0.48 (R2 = .041) scores. LSBQ composite factor scores did not significantly predict Digit Span Backward, F (3, 78) = .344, p = .941, Digit Span Sequencing, F (3, 78) = .598, p = .731, Digit Span Total, F (3, 78) = .440, p = 0.296, Longest Digit Span Backward, F (3, 78) = .510, p = .666, or Longest Digit Span sequencing F (3, 78) = .200, p = .751 scores.

Results suggest that Hispanic Spanish-English bilinguals perform worse on Digit Span Forward and Longest Digit Span Forward as their bilingual experiences increase. However, bilingual experiences did not significantly predict Digit Span Backward, Digit Span Sequencing, Digit Span Total, Longest Digit Span Backward, or Longest Digit Span Sequencing scores. The contrasts in Digit Span performance may be attributed to the different ways in which each condition of the subtest is cognitively processed. Therefore, clinicians and researchers should use caution when interpreting test data for Digit Span with Hispanic Spanish-English bilinguals.

The apolipoprotein E (APOE) gene has been identified as a major risk factor for the development of Alzheimer’s disease in late life. Research has shown that APOE e4 allele carriers demonstrate poorer memory performance and accelerated cognitive decline relative to non-carriers, and there is a need to identify potential factors of resiliency against the negative effects of e4 on cognition. Social support may represent one potential mechanism given that higher levels of social support have been linked to better cognitive and functional outcomes in older adults. Thus, the current study sought to examine whether social support moderates the relationship between APOE e4 status and subjective and objective memory performance in a large community-based sample of Hispanic/Latino (H/L) and Non-Hispanic White (NHW) older adults residing in Texas.

Participants included 1,564 (H/L = 808, NHW = 756) older adults (mean age = 66.36±8.68) without dementia that had enrolled in the Health and Aging Brain Study-Health Disparities. Participants completed study questionnaires and a comprehensive neuropsychological battery. Apolipoprotein e4 status (e4 carriers vs. non-carriers) was determined by possession of at least one e4 allele. Perceived social support was measured using the total score from the abbreviated 12-item version of the Interpersonal Support Evaluation List. Objective memory performance was assessed using a z-score composite of Story A and B from the Weschler Memory Scale (WMS)-III and immediate and delayed recall trials from the Spanish-English Verbal Learning Test. Subjective memory was assessed using the total score from the Subject Memory Complaints Questionnaire. Race stratified multiple linear regression models, controlling for age, sex, and years of education, examined APOE e4 positivity x social support interactions on subjective and objective memory performance.

There was a significant APOE e4 genotype x social support interaction on objective memory performance (ß = -1.10, p = 0.003) in H/Ls such that higher levels of social support were associated with better memory performance in non-e4 carriers (ß = 0.14, p < .001), but not in e4 carriers (ß = -0.13, p = 0.9). In contrast, no significant APOE e4 status x social support interaction was observed on subjective memory (ß = -0.39, p = 0.35) in H/Ls. Finally, results revealed no significant APOE e4 genotype x social support interactions on subjective memory (ß = 0.14 p = 0.77) or objective memory (ß = 0.67, p = 0.11) performance in NHWs. Conclusions: Findings revealed that social support did not mitigate against the negative effects of e4 on subjective and objective memory performance in H/Ls or NHWs. However, results demonstrate that higher levels of social support are associated with better objective, but not subjective memory performance in H/Ls without the e4 genotype. These findings suggest that social support may protect against cognitive decline and enhance cognitive reserve in non-e4 carriers. Future studies should explore other potential factors of resiliency (e.g., diet, exercise) and examine the association between genetic risk and social support on neural markers (e.g., cortical thinning, hippocampal atrophy).

Injection drug use is a significant public health crisis with adverse health outcomes, including increased risk of human immunodeficiency virus (HIV) infection. Comorbidity of HIV and injection drug use is highly prevalent in the United States and disproportionately elevated in surrounding territories such as Puerto Rico. While both HIV status and injection drug use are independently known to be associated with cognitive deficits, the interaction of these effects remains largely unknown. The aim of this study was to determine how HIV status and injection drug use are related to cognitive functioning in a group of Puerto Rican participants. Additionally, we investigated the degree to which type and frequency of substance use predict cognitive abilities.

96 Puerto Rican adults completed the Neuropsi Attention and Memory-3rd Edition battery for Spanish-speaking participants. Injection substance use over the previous 12 months was also obtained via clinical interview. Participants were categorized into four groups based on HIV status and injection substance use in the last 30 days (HIV+/injector, HIV+/non-injector, HIV/injector, HIV-/non-injector). One-way analysis of variance (ANOVA) was conducted to determine differences between groups on each index of the Neuropsi battery (Attention and Executive Function; Memory; Attention and Memory). Multiple linear regression was used to determine whether type and frequency of substance use predicted performance on these indices while considering HIV status.

The one-way ANOVAs revealed significant differences (p’s < 0.01) between the healthy control group and all other groups across all indices. No significant differences were observed between the other groups. Injection drug use, regardless of the substance, was associated with lower combined attention and memory performance compared to those who inject less than monthly (Monthly: p = 0.04; 2-3x daily: p < 0.01; 4-7x daily: p = 0.02; 8+ times daily: p < 0.01). Both minimal and heavy daily use predicted poorer memory performance (p = 0.02 and p = 0.01, respectively). Heavy heroin use predicted poorer attention and executive functioning (p = 0.04). Heroin use also predicted lower performance on tests of memory when used monthly (p = 0.049), and daily or almost daily (2-6x weekly: p = 0.04; 4-7x daily: p = 0.04). Finally, moderate injection of heroin predicted lower scores on attention and memory (Weekly: p = 0.04; 2-6x weekly: p = 0.048). Heavy combined heroin and cocaine use predicted worse memory performance (p = 0.03) and combined attention and memory (p = 0.046). HIV status was not a moderating factor in any circumstance.

As predicted, residents of Puerto Rico who do not inject substances and are HIVnegative performed better in domains of memory, attention, and executive function than those living with HIV and/or inject substances. There was no significant difference among the affected groups in cognitive ability. As expected, daily injection of substances predicted worse performance on tasks of memory. Heavy heroin use predicted worse performance on executive function and memory tasks, while heroin-only and combined heroin and cocaine use predicted worse memory performance. Overall, the type and frequency of substance is more predictive of cognitive functioning than HIV status.

A 30-item confrontation naming test was developed in Argentina for Spanish speakers, The Cordoba Naming Test (CNT). The Boston Naming Test is an established confrontation naming task in the United States. Researchers have used the Boston Naming Test to identify individuals with different clinical pathologies (e.g., Alzheimer’s disease). The current literature on how Spanish speakers across various countries perform on confrontational naming tasks is limited. To our knowledge, one study investigated CNT performance across three Spanish-speaking countries (i.e., Argentina, Mexico, and Guatemala). Investigators found that the Guatemalan group underperformed on the CNT compared to the Argentine and Mexican groups. The purpose of this study was to extend the current literature and investigate CNT performance across five Spanish-speaking countries (i.e., Argentina, Mexico, Guatemala, Colombia, United States). We predicted that the Argentine group would outperform the other Spanish-speaking countries.

The present study sample consisted of 502 neurologically and psychologically healthy participants with a mean age of 29.06 (SD = 13.41) with 14.75 years of education completed (SD = 3.01). Participants were divided into five different groups based on their country of birth and current country residency (i.e., United States, Mexico, Guatemala, Argentina, & Colombia). All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in Spanish. The CNT consisted of 30 black and white line drawings, ranging from easy to hard in difficulty. An ANCOVA, controlling for gender, education, and age, was used to evaluate CNT performance between the five Spanish-speaking country groups. Meanwhile, a Bonferroni post-hoc test was utilized to evaluate the significant differences between Spanish-speaking groups. We used a threshold of p < .05 for statistical significance.

Results revealed significant group differences between the five Spanish speaking groups on the CNT, p = .000, np2 = .48. Bonferroni post-hoc test revealed that the United States group significantly underperformed on the CNT compared to all the Spanish-speaking groups. Next, we found the Guatemalan group underperformed on the CNT compared to the Argentinian, Mexican, and Colombian groups. Additionally, we found the Argentinian group outperformed the Mexican, Guatemalan, and United States groups on the CNT. No significant differences were found between the Argentinian group and Colombian group or the Mexican group and Colombian group on the CNT.

As predicted, the Argentinian group outperformed all the Spanish-speaking groups on the CNT except the Colombian group. Additionally, we found that the United States group underperformed on the CNT compared to all the Spanish-speaking groups. A possible explanation is that Spanish is not the official language in the United States compared to the rest of the Spanish-speaking groups. Meanwhile, a possible reason why the Argentinian and Colombian groups demonstrated better CNT performances might have been that it was less culturally sensitive than the United States, Mexican, and Guatemalan groups. Further analysis is needed with bigger sample sizes across other Spanish-speaking countries (e.g., Costa Rica, Chile) to evaluate what variables, if any, are influencing CNT performance.

Converging evidence across languages suggests that the word length effect (WLE; rate of number of syllables, phonemes, or pronunciation times per word) significantly contributes to estimates of verbal working memory (WM) capacity limits in the storage phase, but not in the manipulation phase (i.e., word length effect decay), of WM. Direct examination of the WLE on verbal WM performance within monolingual Spanish-speakers has not been reported. We investigated the psychophysical mechanisms of capacity consumption in Spanish-speakers across three syllabic word length rates to clarify the relative contributions of the WLE to storage (digit span forward) versus manipulation (digit span backward) memory phases within one language of monolingual speakers.

Monolingual Spanish-speaking adults (N = 84) born in Latin American countries and age 18-65 completed testing over Zoom. Inclusion criteria required proficiency in the Spanish-language; exclusion criteria were bilingualism, multilingualism, TONI-4 IQ < 85, or history of head injury/LOC. A within-group design measured the WLE across three cognitive load conditions in the forward and backward directions of the digit span test varying in Spanish syllabic word length: the Mexican WAIS-IV Digit Span Test (“Standard Load”), and two modified measures with either a ∼20% decrease (“Low Load”) or ∼20% increase (“High Load”) in total syllables/digit relative to the Standard Load.

A reverse WLE was observed on syllable accuracy percentage task performance (p < 0.01), such that longer word length led to higher capacity limits during storage WM. A WLE, not decay, was found on both raw score (p < .001) and syllable accuracy percentage (p < 0.01) task performances during manipulation WM, where longer word length led to lower capacity limits.

The reverse WLE was attributed to higher-order, executive-function cognitive strategies (such as chunking) that superseded negative word length effects. A larger syllabic discrepancy during manipulation WM could have superseded executive-function strategies, rendering a traditional WLE. Our study contributed more precise capacity estimates and clearer understanding of successful WM performance within monolingual, Latin American-born Spanish-speakers, helping to reduce cultural disparities in neurocognitive and neuropsychological research. Future studies may extend these findings to examine how WM capacity resources can be harnessed to improve memory strategies in clinically-applied settings with Spanish-speaking populations.

In South Africa, most of the cognitive tests employed for neuropsychological evaluation are those developed in educationally advantaged settings such as the US, but the normative data accompanying the tests are unsuitable for use with South African examinees who have a disadvantaged quality of education, and/or whose primary language is other than English. A recently completed collation of Africa-based normative data (Shuttleworth-Edwards & Truter, 2022) includes a chapter on Performance Validity Tests (PVTs) with proposed cut-off points to assist in the identification of noncredible performance. The aim of this study was to compare the cut-off points established using educationally disadvantaged South African nonclinical normative samples for which only specificity percentages are available, with those established using clinical samples with designated valid and invalid performers for which both specificity and sensitivity data are available. A further aim was to compare the Africa-based cut-off points with age-equivalent cut-off points where available for US-based data on the targeted tests.

The collation of Africa-based studies delineates cut-off scores for invalid test performance based on both nonclinical as well as clinical populations for three stand-alone PVTs especially developed to identify invalid performance including the Dot Counting Test (DCT), the Rey Fifteen Item Test (FIT), and the Test of Memory Malingering (TOMM); and three commonly employed cognitive tests for which there are embedded validity indicators including the Digit Span Age-Corrected Scaled Score (ACSS) and Reliable Digit Span (RDS), the Rey Auditory Verbal Learning Test (RAVLT), and the Trail Making Test A and B (TMT A and B). For studies using nonclinical norming data alone, specificity percentages to derive the cut-off points were set at a minimum of 90%. For studies using clinical samples specificity was set at a minimum of 90%, and the associated sensitivity percentages were reported indicating each test’s ability to correctly identify those with an invalid performance. The studies included participants stratified for both child and adult age groups (age 8 to 79 years) from South African educationally disadvantaged backgrounds. The data were tabled together for descriptive comparison purposes, including a column for the US-base cut-off points for equivalent age stages where available.

There was a high level of compatibility between the proposed cut-off points established for the South African nonclinical normative samples compared with those using clinical samples of designated valid and invalid performers. There was a trend for more lenient cut-offs for younger children and older adults compared to older children and younger adults. Compared with US-based data where available, adjustments towards leniency were called-for on all indicators.

Cut-off scores for invalid cognitive test performance can be verified by perusing data derived from nonclinical norming samples as well as those from clinical samples, although the latter have the advantage of providing the sensitivity data to demonstrate the efficacy of a proposed cut-off score for identifying noncredible test performance. Adjustments towards leniency need to be made for cut-off scores for young children and older adults within an educationally disadvantaged population, and for disadvantaged adult populations compared with US-based educationally advantaged populations.

Despite the rise in literacy, 773 million of the global population is estimated to be illiterate. The rate of illiteracy is even higher among women and older adults (OA). Literacy has been well documented to impact cognitive skills, and most neuropsychological tests developed are for individuals with higher education. Moreover, there is sparse research on cognitive process and performance of illiterate individuals across cognitive domains.

Per a 2011 census, the illiteracy rate in the Indian older adult population was as high as 56%, and within this group, women and older adults in rural regions were especially vulnerable. Thus, it is important to understand cognitive performance of illiterate Indian older adult population, especially when they are being assessed for neurodegenerative disorders.

This study used subset of data from Harmonized Longitudinal Aging Study of India, Diagnostic Assessment of Dementia (LASI DAD), which was developed by the Gateway to Global Aging Data. A sample of cognitive healthy OA (n = 715) was selected based on Hindi Mental Status Exam score of >19 and a Clinical Dementia Rating Scale of 0 (literate = 419, illiterate = 296). Given the heterogeneity of the population, adapted cognitive instruments were used. This study compared memory performances, using word list and constructional praxis with delayed recall tasks, of OA based on their literacy status (illiterate vs. literate).

Literate cognitive healthy OA (M = 15.27, SD = 3.9) learned more words over three trials than illiterate OA (M = 12.17, SD = 3.7) on a world list task, a statistically significant difference (M = 3.1, 95% CI [2.5, 3.6], t (713) = 10.62, p<0.05. Literate OA (M = 8.7, SD = 2.2) had higher scores on task of copy of simple geometrical figures than illiterate OA (M = 5.3, SD = 2.8), a statistically significant difference (M = 3.3, 95% CI [2.9, 3.7], t (713) = 7.1, p<0.05. Literate OA (M = 4.5, SD = 1.8) also recalled more words than illiterate OA (M = 3.6, SD = 2.1) after a delay. Recall of geometric figures after a delay was higher for literate OA (M = 5, SD = 2.9) as well compared to illiterate OA (M = 2.4, SD = 2.5).

Conclusion: In a sample of cognitively healthy Indian older adults, literate OA consistently performed better than illiterate OA on both verbal and nonverbal memory measures. This is consistent with past literature which shows that illiterate individuals take longer to learn verbal information and have lower recall. Additionally, use of geometric figure may be complicated for these individuals. These are important considerations when assessing an OA for memory problems with low or no education. Next steps would be to look at differences across other cognitive domains and also examining if cognitive differences exist in illiterate OA based on gender.

The research examining the influence of bilingualism on cognition continues to grow. Past research shows that monolingual speakers outperformed bilingual speakers on language, memory, and attention and processing speed tasks. However, the opposite has been found favoring bilingual speakers, when comparing executive functioning abilities. Furthermore, researchers have reported that no differences in executive functioning abilities exist between young adult monolingual speakers compared to young adult bilingual speakers. Moreover, limited research exists examining cognition abilities between monolinguals, bilinguals that learn a language (e.g., English) first, and bilinguals that learn the same language (e.g., English) second. We examined young adult monolinguals cognition abilities (e.g., memory) compared to young adult bilinguals that learned English as a first or second language. It was expected that the monolingual group would outperform both bilingual groups on memory, language, and attention and processing tasks, but no differences would be found on executive functioning tasks.

The sample consisted of 149 right-handed undergraduate students with a mean age of 19.58 (SD = 1.90). Participants were neurologically and psychologically healthy and divided into three language groups: English first language (EFL) monolingual speakers, EFL bilingual speakers, and English second language (ESL) bilingual speakers. All the participants completed a background questionnaire and comprehensive neuropsychological battery that included memory, language, executive functioning, and attention and processing speed tasks in English. A series of ANOVA’s were used to evaluate cognitive tasks (e.g., Boston Naming Test, Trail Making Test) between the language groups. Participants demonstrated adequate effort on one performance validity test.

Language groups were well demographically matched. We found the EFL monolingual group outperformed the ESL bilingual group on the Wide Range Achievement Test, fourth edition task and the Controlled Oral Word Association Test (COWAT) phonemic task, p’s < .05, np’s2 = .04-.05. Additionally, results revealed both monolingual groups outperformed the ESL bilingual group on the Wechsler Adult Intelligence Scale, Third edition vocabulary task and the Boston Naming Test, p’s < .05, np’s2 = .06-.15. No significant differences were found on any of the cognitive tasks between the EFL monolingual group and the EFL bilingual group.

As expected, the ESL bilingual group performed worse on language tasks compared to both monolingual groups, specifically the EFL monolingual group. However, in the opposite direction, we found the EFL monolingual demonstrated better phonemic verbal fluency abilities on the COWAT compared to the ESL bilingual group. The current data suggest that bilingualism influences cognitive abilities (e.g., language, executive functioning) more ESL bilingual speakers compared to EFL monolingual speakers. A possible explanation may be due to the type of interaction that ESL bilingual speakers may prefer to have (i.e., mix language conversations) compared to EFL speaking groups. Future studies with a larger bilingual speaking sample should investigate if the Adaptive Control Hypothesis which suggest that different types of conversations may be placing different demands of language control influences cognitive abilities.