Individuals tend to overestimate their abilities in areas where they are less competent. This cognitive bias is known as the Dunning-Krueger effect. Research shows that Dunning-Krueger effect occurs in persons with traumatic brain injury and healthy comparison participants. It was suggested by Walker and colleagues (2017) that the deficits in cognitive awareness may be due to brain injury. Confrontational naming tasks (e.g., Boston Naming Test) are used to evaluate language abilities. The Cordoba Naming Test (CNT) is a 30-item confrontational naming task developed to be administered in multiple languages. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the NASA Task Load Index (NASA-TLX). They found that workload ratings on the NASA-TLX increased with increased task demands on a cognitive task. The purpose of the present study was to determine whether the Dunning-Kruger effect occurs in a Latinx population and possible factors driving individuals to overestimate their abilities on the CNT. We predicted the low-performance group would report better CNT performance, but underperform on the CNT compared to the high-performance group.

The sample consisted of 129 Latinx participants with a mean age of 21.07 (SD = 4.57). Participants were neurologically and psychologically healthy. Our sample was divided into two groups: the low-performance group and the high-performance group. Participants completed the CNT and the NASA-TLX in English. The NASA-TLX examines perceived workload (e.g., performance) and it was used in the present study to evaluate possible factors driving individuals to overestimate their abilities on the CNT. Participants completed the NASA-TLX after completing the CNT. Moreover, the CNT raw scores were averaged to create the following two groups: low-performance (CNT raw score <17) and high-performance (CNT raw score 18+). A series of ANCOVA's, controlling for gender and years of education completed were used to evaluate CNT performance and CNT perceived workloads.

We found the low-performance group reported better performance on the CNT compared to the high-performance, p = .021, np2 = .04. However, the high-performance group outperformed the low-performance group on the CNT, p = .000, np2 = .53. Additionally, results revealed the low-performance group reported higher temporal demand and effort levels on the CNT compared to the high-performance group, p's < .05, nps2 = .05.

As we predicted, the low-performance group overestimated their CNT performance compared to the high-performance group. The current data suggest that the Dunning-Kruger effect occurs in healthy Latinx participants. We also found that temporal demand and effort may be influencing awareness in the low-performance group CNT performance compared to the high-performance group. The present study suggests subjective features on what may be influencing confrontational naming task performance in low-performance individuals more than highperformance individuals on the CNT. Current literature shows that bilingual speakers underperformed on confrontational naming tasks compared to monolingual speakers. Future studies should investigate if the Dunning-Kruger effects Latinx English monolingual speakers compared to Spanish-English bilingual speakers on the CNT.

There is a well-established relationship in the literature between cognitive impairment and functional disability, such that, increased cognitive impairment is associated with diminished capacity to perform daily activities independently. However, there has been limited research on the relationship between cognitive impairment and daily functioning in older adults from an Indian population, or differences between Indian and U.S samples. The relationship may differ across these two populations due to their unique cultures. For example, India and the United States have significantly different social systems and family structures, with different emphases placed on the community as compared to the individual. Therefore, the role that older adults play or the support they receive within the family and society differs between the two countries and could significantly impact the relationship between cognitive ability and functional disability. The primary objective of this study is to further explore the similarities and differences in this relationship across cross-cultural populations. We hypothesized that individuals across both samples with lower cognitive functioning will have increased disability. Furthermore, we propose that the relationship between cognitive functioning and functional disability will be stronger in the U.S sample as compared to the Indian sample.

Community-dwelling older adults were sampled through local senior centers and by convenience sampling in the United State and India, respectively (N = 40 and 36, respectively). All participants were administered the Montreal Cognitive Assessment (MoCA) to evaluate cognitive ability. Functional status was assessed using the Activities of Daily Living section of the OARS multidimensional functional questionnaire and the World Health Organization Disability Assessment Schedule (WHODAS).

A significant association between cognitive functioning and functional disability was demonstrated in the combined sample, i.e., the MoCA was correlated with OARS (r[70] = .42, p < .001) and the WHODAS (r[59] = -.32, p = .009). However, when comparing samples, significant differences in associations between the MoCA and functional measures were noted in the Indian and U.S. samples: In the Indian sample, the MoCA was not significantly correlated with either the WHODAS (r[38] = -.28, p = .09) or the OARS (r[39] = .17, p = .31). Comparatively, in the United States, the MoCA was correlated with the OARS (r[32] = .51, p = .002) and the WHODAS (r[26] = -.40, p = .04).

These results, in keeping with most previous studies done in the U.S. point to a robust relationship between cognition and functional disability in the U.S sample. However, this association is substantially diminished in the Indian sample. One possible reason maybe, greater support available to older Indians may mitigate the negative effect of cognitive impairment on adaptive function. A major limitation of this study is the small sample size. Additionally, due to vast cultural differences that exist across India, the sample collected from an urban well-education population will likely not generalize to the larger country. Future research from larger and more diverse samples across the country will likely provide more valuable insight.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder commonly associated with relative impairments on processing speed, working memory, and/or executive functioning. Anxiety commonly co-occurs with ADHD and may also adversely affect these cognitive functions. Additionally, language status (i.e., monolingualism vs bilingualism) has been shown to affect select cognitive domains across an individual’s lifespan. Yet, few studies have examined the potential effects of the interaction between anxiety and language status on various cognitive domains among people with ADHD. Thus, the current study investigated the effects of the interaction of anxiety and language status on processing speed, working memory, and executive functioning among monolingual and bilingual individuals with ADHD.

The sample comprised of 407 consecutive adult patients diagnosed with ADHD. When asked about their language status, 67% reported to be monolingual (English). The Mean age of individuals was 27.93 (SD = 6.83), mean education of 15.8 years (SD = 2.10), 60% female, racially diverse with 49% Non-Hispanic White, 22% Non-Hispanic Black, 13% Hispanic/Latinx, 9% Asian/Pacific Islander, and 6% other race/ethnicity. Processing speed, working memory, and executive function were measured via the Wechsler Adult Intelligence Scale-Fourth Edition Processing Speed Index, Working Memory Index, and Trail Making Test B, respectively. Anxiety was measured via the Beck Anxiety Inventory (BAI). Three separate linear regression models examined the interaction between anxiety (moderator) and cognition (processing speed, working memory, and executive function) on language. Models included sex/gender and education as covariates with Processing Speed Index and Working Memory Index as the outcomes. Age, sex/gender, and education were used as covariates when Trail Making Test B was the outcome.

Monolingual and bilingual patients differed in mean age (p < .05) but did not differ in level of anxiety, education, or sex/gender. Overall, anxiety was not associated with processing speed, working memory, and executive function. However, the interaction between anxiety and language status was significantly associated with processing speed (ß = -0.37, p < .05), and executive functioning (ß = 0.82, p < .05). No associations were found when anxiety was added as a moderator for the associations between language and working memory.

This study found that anxiety moderated the relationship between language status and select cognitive domains (i.e., processing speed and executive functioning) among individuals with ADHD. Specifically, anxiety had a greater association on processing speed and executive functioning performance for bilinguals rather than monolinguals. Future detailed studies are needed to better understand how anxiety modifies the relationship between language and cognitive performance outcomes over time amongst a linguistically diverse sample.

Japanese-Americans are the sixth largest Asian ethnicity in the United States. They represent a highly heterogeneous population due to their history of immigration dating back to the late 19th century. In comparison to the total Japanese-American population, there are very few neuropsychologists of Japanese descent who are familiar with the culture. The Asian Neuropsychological Association lists 16 licensed members of Japanese descent, and only 7 practice outside of Hawaii or California. These numbers suggest that unless non-Japanese neuropsychologists are knowledgeable of the culture, test translations, and appropriate norms, it would be challenging for many Japanese-Americans to receive culturally and linguistically competent neuropsychological services. The aim of the present study is to provide guidance for conducting neuropsychological assessments with Japanese-Americans with the goal of facilitating competent culturally-informed services to this population.

Pertinent facets of Japanese culture as identified in the ECLECTIC framework and demographics of the U.S. Japanese-American population, and the available literature on neuropsychological tests that are translated into Japanese and normed with Japanese samples, was reviewed by authors with knowledge of Japanese language and culture. Literature published in both English and Japanese were included for review.

Psychological testing is a Western technology fraught with the behavioral expectations and values of the culture in which it was developed. Thus, these tests may be biased against persons coming from cultures that differ from the West. Recommendations for providing neuropsychological services to Japanese-Americans are presented with an aim of maximizing test fairness by addressing the following issues: comfort with the testing situation, test biases, accessibility, and validity. Given the emphasis on education, Japanese-Americans should be familiar and comfortable with cognitive testing, although they may experience undue pressure to perform well to avoid shame. Japanese-Americans may experience discomfort disclosing personal information during the interview, particularly if the evaluation is perceived to be psychiatric in nature, as there is a strong stigma associated with mental illness that could bring shame to the family. Japanese communication styles are indirect in nature, where the message is implied and what is “not said” is just as important as what is directly conveyed. Accessibility issues will primarily impact first generation Japanese-Americans who are native Japanese speakers. Another characteristic that may impact responding is hesitancy for guessing when unsure. Recommendations for providing culturally competent neuropsychological assessment given these considerations will be presented and expanded upon in detail. Finally, an online database of translated and normed neuropsychological tests by cognitive domain has been created and will be presented.

Providing neuropsychological services to Japanese-Americans can be challenging as Japanese culture is significantly different from western culture. In addition, Japanese-Americans are heterogenous with salient issues of English proficiency and acculturation. Information to individualize a conceptual understanding of Japanese-Americans, translated and normed tests, and recommendations to maximize fairness in testing are presented to assist clinical neuropsychologists provide competent services to Japanese-Americans.

The Immigrant Health Paradox (IHP) suggests that immigrants have better health upon arrival in comparison to their U.S.-born Latinx counterparts, indicating that immigrants’ unique experiences may buffer against negative health outcomes, including cognition. Some studies indicate that IHP-related cognitive health benefits diminish with increased time spent in the U.S., while others suggest that this relationship may be age-dependent such that compared to migration during earlier or later life, migration during young/middle adulthood may be related to better cognition-potentially due to higher simultaneous cognitive demands associated with this age epoch (e.g., language acquisition, acculturation). However, this literature is equivocal and has methodological limitations (e.g., cognition typically assessed with cognitive screeners, lack of clinical populations) Thus, this study aimed to examine the role of age related to IHP and cognition within a well-characterized sample of HIV+ Latinx adults. It was hypothesized that compared to U.S.-born Latinx adults and those who immigrated earlier or later in life, the Latinx immigrant subgroup who migrated during young/middle adulthood would demonstrate better cognitive functioning.

This cross-sectional study included a HIV+ sample (A/=105) of 34 Latinx immigrants (Mage=45.56, SD=6.99) and 71 U.S.-born Latinx individuals (Mage=46.03, SD=7.63), who completed a comprehensive sociocultural questionnaire and cognitive battery. Demographically-adjusted average T-scores were computed for each cognitive test and domain (e.g., learning, memory). A series of Welch’s-corrected ANOVAS with post hoc Games-Howell tests for multiple comparisons were conducted to compare cognitive function across three groups: Latinx immigrants who migrated during earlier (<19 yrs) or later adulthood (>50 yrs), young/middle adulthood (20-49 yrs), and U.S.-born Latinx adults.

Compared to the other Latinx subgroups, Latinx immigrants who migrated during middle adulthood performed worse in Verbal Fluency (F(2,98)=8.04, p<.001), Attention/Working Memory (f(2,96)=6.10, p<.01), Executive Function (f(2,99)=5.11, p<.01), and Processing Speed (F(2,101)=3.36, p<.05). Posthoc Games-Howell tests showed that the mean Verbal Fluency (p<.01, 95% C.I.=[-21.37, -2.66]), Attention/Working Memory (p<.05, 95% C.I.=[-16.82, -1.59]), Executive Function (p<.01, 95% C.I.=[-14.66, -2.49]) and Processing Speed (p<.05, 95% C.I.=[-13.60, -1.31]) T-scores were significantly lower in Latinx immigrants who migrated in young/middle adulthood compared to the U.S.-born Latinx sample. Further, there were no differences between the U.S.-born Latinx group compared to the Latinx immigrant group who migrated earlier or later in life (ps>.05).

This preliminary study is the first to examine whether the potential protective cognitive effects of the IHP vary across the lifespan among Latinx immigrants with HIV, using a comprehensive neuropsychological battery. Age-related IHP benefits were not observed in this study. Moreover, Latinx immigrants who migrated during young/middle adulthood had worse cognitive functioning compared to their U.S.-born Latinx counterparts and those that migrated earlier or later in life. A possible explanation for this study’s unexpected findings is that the IHP is outdated due to the current sociopolitical climate immigrants experience compared to the 1980s when the theory was developed. Future studies, with larger samples, longitudinal designs, and greater sociocultural characterization (e.g., immigration reason/s, country of origin, discrimination), are needed to better understand the role of IHP in cognition.

Although the majority of Japanese speakers live in Japan, there are also large populations of Japanese speakers in the United States of America and Brazil, with more than a million Japanese speakers across the two countries. Only 53% of foreign-born Japanese individuals in the United States report proficiency in English. Although there has been increasing attention to the neuropsychological assessment of linguistically diverse patients broadly in recent years, there are specific considerations unique to Japanese that clinicians and researchers should be aware of when working with Japanese speakers outside of Japan. The aim of the present study is to present considerations and appropriately normed assessments of verbal abilities for Japanese patients.

A systematic review of cognitive screeners and assessments of verbal fluency, verbal memory, and verbal academic skills that have been translated and normed for use with Japanese speaking populations was conducted. Studies published in both English and Japanese were reviewed. Test content modifications, administration modifications, and relevant cultural and linguistic considerations were synthesized and summarized.

One consideration in translation is the use of words that are linguistically and culturally comparable across the two languages. Multiple cognitive screeners and verbal learning/memory tasks have been translated with cultural equivalency considerations (e.g., for the Montreal Cognitive Assessment, velvet, church, and daisy were changed to silk, shrine, and lily). In Japanese, there is a one-to-one correspondence between sound (syllable) and graphemes (kana script), compared to one-to-many associations in alphabet-based languages like English. This impacts normative expectations on letter fluency tasks. The hiragana letters, A, Ka, and Shi (fc, fr, L) are recommended because there are relatively large number of words that start with these letters and the number of words generated with these letters showed close to normal distributions in previous research. Unlike letter fluency, semantic fluency is believed to be relatively culture-free and independent of language systems. The Japanese writing system utilizes both phonographic systems where written symbols map onto sounds, and logographic systems, where written symbols map onto concepts. This is in contrast to English, which has a solely phonographic written system. These two separate writing systems complicate the assessment of reading among Japanese-speaking individuals, as there may be a dissociation between abilities in reading in the phonographic versus logographic systems. Acculturation has been shown to impact performance on certain verbal task performances, along with demographic variables such as immigration generation status and bilingualism.

Neuropsychologists should be familiar with linguistic differences between English and Japanese such as the one-to-one correspondence between sound and grapheme in Japanese and the use of both phonographic and logographic systems in written Japanese. Neuropsychologists should also be careful to use tests that are translated for cultural equivalence rather than direct translations, and that have been normed for use with Japanese speakers. Finally, general cross-cultural considerations in assessment such as the evaluation of bilingualism, familiarity with the testing environment, and other factors remain essential.

When assessing individuals from diverse backgrounds, APA ethical principles emphasize the consideration of language and culture when selecting appropriate measures. Research among hearing, English-speaking individuals has shown the effects in identifying cognitive deficits when language, culture, and educational background are not considered in the selection and administration of measures (Ardilla, 2007). Among the Deaf community in the US, a minority group with a unique culture and language (American Sign Language: ASL), there have been few attempts to adapt existing English cognitive measures. Factors complicating this include research resources given the limited number of neuropsychologists and researchers who understand both the complexities of the measures as well as the linguistic and cultural factors within the Deaf population. The goal of the current project is to develop a culturally informed interpretation of a cognitive screening tool for appropriate use with older Deaf adults.

Item selection was informed by MMSE data from Dean et al. (2009) and methods utilized by Atkinson et al. (2015). Items selection occurred through consultation with three neuropsychologists and graduate peers with either native signing abilities or demonstrated ASL fluency, as well as Deaf identities, cultural affiliation and or community engagement. Selection considered the potential for translation errors, particularly related to equivalence of translation from a spoken modality to a signed. Items were categorized into the following domains: Orientation, Attention, Memory, Language, Executive Functioning, Visuospatial, and Performance Validity. Two native signers (Deaf interpreters) provided formal translation of the items. The measure was piloted with 20 deaf and hard of hearing (DHH) adult signers (ages M=41.10, SD=5.50, Range=31-48). Items were prerecorded to standardize the administration, which was shown to participants through the screenshare function of Zoom software.

The average performance was 100.80 (SD=3.91)/ 105 possible points. Within the memory domain, some errors, especially for word selection on delayed recall, were noted which may be related to sign choice and dialect. Additionally, with culture-specific episodic memory items, participants 35% of participants were unable to provide a correct answer with qualitative responses indicating this information may be more familiar to a subset of the Deaf community that had attended Gallaudet University in Washington, D.C. There was a significant positive relationship between ASL fluency, determined by the ASL-Comprehension Test, and performance on the cognitive screener (r(18)=.54, p=.01) while age of onset of deafness (r(18)=-.16, p=.51) and age of ASL acquisition (r(18)= .21, p=.37), were not significant.

Results of this preliminary project yielded a measure that benefited from inclusion of content experts in the field during the process of interpretation and translation. It appears appropriate for Deaf signers who are proficient in ASL. The pattern of correlations suggests the measure may be appropriate for use with fluent signers with experience in ASL acquisition. Further development of the measure should focus on appropriate items that address the diversity of the Deaf experience as well as continue to explore inclusive translation approaches.

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.