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Clinical Manifestations.

Kate Ruiz1, Melanie L Johnson2,3, Diane M Jacobs1,4,5,6,7

  • 1University of California, San Diego, La Jolla, CA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Adjusting cognitive test scores using grade equivalency, rather than years of education, may underestimate cognitive impairment in Spanish-speaking U.S. Latinos. This highlights the need for careful interpretation of neuropsychological test results in this population.

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Area of Science:

  • Neuropsychology
  • Cognitive Science
  • Latino Health

Background:

  • Neuropsychological test norms often adjust for years of education.
  • Educational quality and attainment vary, making years of education an inadequate measure.
  • Grade-equivalency scores offer a more nuanced view of educational experience.

Purpose of the Study:

  • To investigate the impact of adjusting cognitive test results using grade equivalency versus years of education.
  • To compare the interpretation of cognitive test results in Spanish-speaking U.S. Latinos using two different educational adjustment methods.

Main Methods:

  • 140 Spanish-speaking Latinos with subjective cognitive decline underwent cognitive testing.
  • The Woodcock-Muñoz Letter-Word Identification Test estimated grade-equivalency.
  • Cognitive test scores were standardized (Z-scores) adjusting for age, sex, language, and either years of education or grade-equivalency.

Main Results:

  • Grade equivalency scores were significantly higher than self-reported years of education.
  • Cognitive test Z-scores adjusted for grade equivalency were significantly lower than those adjusted for years of education.
  • A greater percentage of participants fell below cognitive impairment cutoffs when adjusting for grade equivalency.

Conclusions:

  • Adjusting for grade equivalency may underestimate cognitive impairment in Spanish-speaking U.S. Latinos.
  • Self-reported years of education may not fully capture the educational experiences of this diverse group.
  • Caution is advised when interpreting education-adjusted neuropsychological test scores for this population.