UDSNB 3.0 Neuropsychological Test Norms in Older Adults from a Diverse Community: Results from the Einstein Aging Study (EAS)

Article type: Research Article

Authors: Wang, Cuiling^{a; b; *} | Katz, Mindy J.^b | Chang, Katherine H.^{c; d} | Qin, Jiyue^a | Lipton, Richard B.^{a; b; e} | Zwerling, Jessica L.^b | Sliwinski, Martin J.^g | Derby, Carol A.^{a; b} | Rabin, Laura A.^{b; d; f}

Affiliations: [a] Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA | [b] Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA | [c] Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, USA | [d] Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, USA | [e] Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, USA | [f] Department of Psychology, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, USA | [g] Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA

Correspondence: [*] Correspondence to: Cuiling Wang, PhD, 1300 Morris Park Avenue, Block Bldg. Rm. 318, Bronx, NY 10461, USA. Tel.: +1 718 430 2006; E-mail: cuiling.wang@einsteinmed.org.

Abstract: Background: The Uniform Data Set, Version 3 Neuropsychological Battery (UDSNB3.0), from the database of the University of Washington’s National Alzheimer’s Coordinating Center (NACC), is widely used to characterize cognitive performance in clinical and research settings; however, norms for underrepresented community-based samples are scarce. Objective: We compared UDSNB 3.0 test scores between the Einstein Aging Study (EAS), composed of racially/ethnically diverse, community-dwelling older adults aged≥70 and the NACC, and report normative data from the EAS. Methods: Analyses included 225 cognitively normal EAS participants and comparable data from 5,031 NACC database participants. Linear regression models compared performance between the samples, adjusting for demographics (sex, age, education, race/ethnicity), depressive symptoms, and whether English was the first language. Linear regression models to examine demographic factors including age, sex, education and race/ethnicity as predictors for the neuropsychological tests were applied in EAS and NACC separately and were used to create a demographically adjusted z-score calculator. Results: Cognitive performance across all domains was worse in the EAS than in the NACC, adjusting for age, sex, education, race/ethnicity, and depression, and the differences remained in visuo-construction, visuospatial memory, confrontation naming, visual attention/processing speed, and executive functioning after further adjusting for whether English was the first language. In both samples, non-Hispanic Whites outperformed non-Hispanic Blacks and more education was associated with better cognitive performance. Conclusion: Differences observed in demographic, clinical, and cognitive characteristics between the community-based EAS sample and the nationwide NACC sample suggest that separate normative data that more accurately reflect non-clinic, community-based populations should be established.

Keywords: Aging, cognitive test norms, community sample, mild cognitive impairment, neuropsychology, racial/ethnic diversity

DOI: 10.3233/JAD-210538

Journal: Journal of Alzheimer's Disease, vol. 83, no. 4, pp. 1665-1678, 2021