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Background: The Cognitive Abilities Screening Instrument (CASI) was designed for use in cross-cultural studies of Japanese and Japanese-American elderly in Japan and the U.S.A. The measurement equivalence in Japanese and English had not been confirmed in prior studies.
Methods: We analyzed the 40 CASI items for differential item functioning (DIF) related to test language, as well as self-reported proficiency with written Japanese, age, and educational attainment in two large epidemiologic studies of Japanese-American elderly: the Kame Project (n=1708) and the Honolulu-Asia Aging Study (HAAS; n = 3148). DIF was present if the demographic groups differed in the probability of success on an item, after controlling for their underlying cognitive functioning ability.
Results: While seven CASI items had DIF related to language of testing in Kame (registration of one item; recall of one item; similes; judgment; repeating a phrase; reading and performing a command; and following a three-step instruction), the impact of DIF on participants' scores was minimal. Mean scores for Japanese and English speakers in Kame changed by <0.1 SD after accounting for DIF related to test language. In HAAS, insufficient numbers of participants were tested in Japanese to assess DIF related to test language. In both studies, DIF related to written Japanese proficiency, age, and educational attainment had minimal impact.
Conclusions: To the extent that DIF could be assessed, the CASI appeared to meet the goal of measuring cognitive function equivalently in Japanese and English. Stratified data collection would be needed to confirm this conclusion. DIF assessment should be used in other studies with multiple language groups to confirm that measures function equivalently or, if not, form scores that account for DIF.
Background: Recent data demonstrate that moderate consumption of alcohol (13–52 grams of ethanol per day) may be beneficial to cognitive functioning among older adults.
Methods: Longitudinal growth curve analyses controlling for baseline age, body mass index (BMI), education/income, migrant status, smoking, history of diagnosed stroke, hypertension, coronary heart disease (CHD), depression, diabetes and stroke (time-varying) were used to examine the relationship between alcohol consumption, gender and cognitive performance over an 8-year follow-up period. The sample included 1624 Japanese American community-dwelling adults aged 65 and older who were cognitively intact at baseline and participated in at least one follow-up examination. Cognitive performance was measured using the Cognitive Abilities Screening Instrument (CASI; 0–100 point scale), a global test of cognitive function.
Results: Current consumers (n=480) scored significantly (p<0.05) higher on CASI (mean rate of change−1.22 CASI units) over the 8-year follow-up period than past consumers or abstainers (n=1144; mean rate of change−3.77 CASI units). There was no significant main effect for gender, or an alcohol and gender interaction.
Conclusions: This study provides further support regarding the beneficial effects of moderate alcohol consumption on cognitive performance over time. Observed benefits were not modified by gender. Future studies need to determine whether alcohol preserves cognition directly or whether other factors such as physiology or cultural drinking practices are driving the observed association.
Norms for cognitive measures used to assess dementia are scant for
minority groups, in particular for older Japanese Americans. Using the
Consortium to Establish a Registry for Alzheimer's Disease (CERAD)
Neuropsychology Battery, we compared the baseline performance of demented
and nondemented Japanese Americans. Participants came from two harmonized
epidemiological studies of dementia which were examined separately: the
Kame Project, Seattle (350 men and women; 201 nondemented), age 65 and
older; Honolulu-Asia Aging Study (HAAS), Hawaii (418 men; 120
nondemented), age 71 and older. The measures examined were Verbal Fluency;
abbreviated Boston Naming; constructional praxis; and Word List Learning,
Recall, and Recognition. Within each study, the CERAD measures
distinguished between nondemented participants and those with mild
cognitive impairment. Among persons with dementia, average level of
performance decreased as severity of dementia increased. Determinants of
score (age, education, language of administration, stage of dementia)
varied between the two studies. Among Japanese Americans, the CERAD
Neuropsychology Battery distinguished nondemented persons from those with
dementia, but was less consistent in distinguishing levels of severity of
dementia. This battery is useful for comparative epidemiological studies
of dementia in minority populations. (JINS, 2005, 11,
We used a rational-empirical approach in the construction and
validation of a cognitive activity scale for use with elderly
populations. The scale development effort produced a 25-item scale with
a reasonably high level of internal consistency in a sample of 200
elderly individuals. Scale scores were positively correlated with years
of education and measures of various domains of cognitive ability. In a
separate cross-validation sample, a similar pattern of reliability and
validity coefficients was obtained. The full scale score was found to
contribute significantly to the prediction of cognitive ability after
controlling for the effects of age, education, and gender. Two
subscales (Higher Cognitive Abilities and Frequent Cognitive Abilities)
and a measure of self-reported maintenance of cognitive activity were
also developed. In a separate study, the maintenance score was found to
differ significantly between the validation sample and a sample of
individuals with a history of neurological disorder, with a moderate
effect size (d approximately = .7). Further cross-validation
studies in minority groups and groups of varying socioeconomic status
will be critical in establishing the research and clinical value of the
scale and subscales. (JINS, 2005, 11,
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