Executive function tests: Normative data for Spanish-speaking adults in the United States

Area of Science:

• Neuropsychology
• Cognitive Science
• Cultural Psychiatry

Background:

• Normative data for executive function tests is scarce for Spanish-speaking populations, especially U.S. Hispanics.
• Accurate assessment tools are vital for this demographic to avoid misdiagnosis.

Purpose of the Study:

• To establish normative data for executive function tests (Modified Wisconsin Card Sorting Test and Stroop Color and Word Test) in U.S. Spanish-speaking Hispanics.
• To investigate the influence of sociodemographic factors on cognitive performance in this population.

Main Methods:

• Assessed 245 individuals aged 18-80 across eight U.S. states.
• Utilized Bayesian regression to estimate norms, accounting for age, education, sex, acculturation, and language proficiency.
• Administered the Modified Wisconsin Card Sorting Test (M-WCST) and Stroop Color and Word Test (SCWT).

Main Results:

• Older age was associated with greater decline in SCWT performance, particularly for those highly proficient in Spanish.
• Longer U.S. residency correlated with stronger age effects on M-WCST performance.
• Higher educational attainment positively impacted M-WCST outcomes, while lower education increased errors.
• Interactions were found between education and Spanish proficiency (SCWT), and sex and acculturation (SCWT).

Conclusions:

• Culturally sensitive normative data is essential for accurate identification of executive dysfunction in diverse populations.
• Sociocultural factors like acculturation and language proficiency significantly influence neuropsychological assessment results.
• Considering these factors improves diagnostic accuracy and reduces misdiagnosis risks for U.S. Hispanics.