Dementia-Related Neuropsychological Testing Considerations in Non-Hispanic White and Latino/Hispanic Populations.

Abstract

Hispanic individuals are at greater risk for health disparities, less than optimal health care, and are diagnosed at later stages of cognitive impairment than white non-Hispanics. Acculturation and different attitudes toward test-taking may result in decrements in performance, especially on unfamiliar measures that emphasize speed and accuracy. Non-Hispanic individuals often outperform Hispanic individuals on cognitive and neuropsychological measures in community and clinical populations. Current neuropsychological testing may not provide accurate data related to monolingual and bilingual individuals of Hispanic descent. Testing instruments were identified by searching academic databases using combinations of relevant search terms. Neuropsychological instruments were included if they were designed to detect cognitive impairment, had an administration time of less than 45 minutes, and were available in English. Validity studies were required to employ gold standard comparison diagnostic criteria. Twenty-nine instruments were evaluated in dementia staging, global cognition, memory, memory and visual abilities, working memory and attention, verbal learning and memory, recall, language, premorbid intelligence, literacy/cognitive reserve, visuospatial, attention, problem-solving, problem solving and perception, functional assessment, and mood/daily functioning domains. Spanish-language neuropsychological instruments need to be made widely available and existing instruments to be normed in Spanish to best serve and assess diverse populations. Psychometric data were reported for neuropsychological instruments, which may be administered to Hispanic older adults presenting for evaluation related to dementia-spectrum disorders. This is one of the few reviews to provide an overview of the sensitivity and specificity of available Spanish translated neuropsychological instruments.