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Scientific Summary UC Davis / SENAS (Spanish and English Neuropsychological Assessment Scales)

Scientific Summary UC Davis / SENAS (Spanish and English Neuropsychological Assessment Scales). Acknowledgements. Funded in part by Grant R13AG030995-01A1 from the National Institute on Aging

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Scientific Summary UC Davis / SENAS (Spanish and English Neuropsychological Assessment Scales)

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  1. Scientific SummaryUC Davis / SENAS (Spanish and English Neuropsychological Assessment Scales) Friday Harbor Psychometrics 2012

  2. Acknowledgements • Funded in part by Grant R13AG030995-01A1 from the National Institute on Aging • The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. Government. Friday Harbor Psychometrics Workshop 2011

  3. Overview • SENAS Overview • Demographic variables and longitudinal change • Ethnicity, clinical diagnosis, and cognitive change • Age, education, and relationship to brain • Decomposing demographic and brain effects • Intracranial volume and cognition • Factorial invariance • Final thoughts Friday Harbor Psychometrics 2012

  4. SENAS Overview Friday Harbor Psychometrics 2012

  5. Purpose of SENAS Project (circa 1992) • Create matched English and Spanish language neuropsychological tests for ages 60+ • New scales based upon neuropsychological model of cognitive functioning • Scales psychometrically matched • Within English and Spanish language versions • Between English and Spanish language versions • Distribution of item difficulty appropriate to elderly population Friday Harbor Psychometrics 2012

  6. Approach • Concept of item and test bias central to project • Development and validation based on modern psychometric methods • Item response theory (IRT) • Latent variable modeling • Empirically based • Data based approach to making decisions about item selection and scale construction • Empirical evaluation of reliability and validity Friday Harbor Psychometrics 2012

  7. Guiding PrinciplesInitial Scale Development • Scales targeted to assess neuropsychologically relevant cognitive domains • Verbal and non-verbal measures • Non-timed • New scales, not translations of existing scales • Examiner administered • Item generation • New items • Broad range of difficulty Friday Harbor Psychometrics 2012

  8. SENAS Scales and Abilities Measured Friday Harbor Psychometrics 2012

  9. Model for Item Selection Friday Harbor Psychometrics 2012

  10. Test Information for 3MS and SENAS Object Naming Friday Harbor Psychometrics 2012 Mungas et al., 2004

  11. Scientific Applications Friday Harbor Psychometrics 2012

  12. Summary Conclusions / Challenge for Conference • Demographic variables have robust effects on baseline test scores • Especially ethnicity and education • Demographic variables have minimal effects on longitudinal change • Brain and disease variables account for change Friday Harbor Psychometrics 2012

  13. Community Clinic Morphometric Cognition Clinical MRI English N ≈ 350 African American N ≈ 140 African American N ≈ 425 Hispanic Spanish N ≈ 900 Hispanic English N ≈ 450 Caucasian N ≈ 700 Caucasian N ≈ 235 Hispanic N ≈ 130 Longitudinal N ≈ 175 Life Experience Measures Hispanic Friday Harbor Psychometrics 2012

  14. Ethnicity, education, and cognitive change Friday Harbor Psychometrics 2012

  15. Purpose of this study • Understand how demographic variables relate to cognitive change • Demographic variables of interest • Race/Ethnicity • Education • Language of test administration Friday Harbor Psychometrics 2012

  16. Independent Variables • Model 1 • Verbal Memory Form • Previous Evaluation • Spanish Administration • PrevEval by Spanish Interaction • Model 3 • Age & Education • Gender • Model 2 • Race/Ethnicity • Model 4 • Recruitment Source • Clinical Diagnosis • APOE Genotype Friday Harbor Psychometrics 2012

  17. Language, Ethnicity, Education Effects Episodic Memory Friday Harbor Psychometrics 2012

  18. Language, Ethnicity, Education Effects Executive Function Friday Harbor Psychometrics 2012

  19. Executive Function Trajectories by Education Friday Harbor Psychometrics 2012

  20. Average Ethnic Group Performance by Model – Episodic Memory Friday Harbor Psychometrics 2012

  21. Ethnicity, clinical diagnosis, and cognitive change Friday Harbor Psychometrics 2012

  22. Episodic Memory by Diagnosis Change Friday Harbor Psychometrics 2012 Mungas et al., 2010

  23. Episodic Memory by Diagnosis ChangeAfrican American Friday Harbor Psychometrics 2012

  24. Episodic Memory by Diagnosis ChangeHispanic Friday Harbor Psychometrics 2012

  25. Episodic Memory by Diagnosis ChangeCaucasian Friday Harbor Psychometrics 2012

  26. Age, education, and relationship to brain Friday Harbor Psychometrics 2012

  27. MRI Effect Sizes and Age and Education Adjustment - Episodic Memory Friday Harbor Psychometrics 2012 Mungas et al., 2009

  28. Executive Function, MRI, Age & EducationAfrican Americans -.24 -.55 .00 Education Age BM .36 -.03 .32 -.26 .39 Executive Function Friday Harbor Psychometrics 2012 Mungas et al., 2009

  29. Executive Function, MRI, Age & EducationHispanics .01 -.60 .00 Education Age BM .30 -.17 .46 -.40 .44 Executive Function Friday Harbor Psychometrics 2012 Mungas et al., 2009

  30. Executive Function, MRI, Age & EducationCaucasians -.07 -.53 .00 Education Age BM .29 -.10 .29 -.36 .28 Executive Function Friday Harbor Psychometrics 2012 Mungas et al., 2009

  31. Age and Education Influences onMRI - Cognition Relationships • It is possible to separate disease effects from extraneous influences • MRI effects on cognition can obscured by demographic effects on test performance, especially when • Demographic relationship with test score is larger than relationship with disease • Substantial heterogeneity of demographic variable in population of interest Friday Harbor Psychometrics 2012

  32. Decomposing demographic and brain effects Friday Harbor Psychometrics 2012 Reed et al., 2010

  33. Friday Harbor Psychometrics 2012

  34. Data • 288 subjects. 158 normal, 92 MCI, 38 demented • 96 African Americans, 74 Hispanics (32 tested in English, 42 tested in Spanish), and 118 Caucasians. • Education M = 12.7 yrs (range 0-25) • Age M = 74.7 yrs (range 60-93) • Mean evaluations = 3.5; 74% had 3 or more evaluations. N of evaluations truncated at 5. Friday Harbor Psychometrics 2012 Reed et al., 2010

  35. Mem-D ~ 20% of episodic memory variance • Mem-B ~ 20% of episodic memory variance • Mem-R ~ 50% of episodic memory variance Friday Harbor Psychometrics 2012 Reed et al., 2010

  36. Relationships of memory components with global cognitive function (CDR sum of boxes) Friday Harbor Psychometrics 2012 Reed et al., 2010

  37. Relationships of memory components with clinical progression (conversion to MCI or dementia) Friday Harbor Psychometrics 2012 Reed et al., 2010

  38. Relationships of memory components with longitudinal change in cognition (executive function) Friday Harbor Psychometrics 2012 Reed et al., 2010

  39. Effects of Mem-D? • Substantial variance in Episodic Memory was uniquely related to demographic variables (ethnicity and education especially) • Greater amount for other cognitive domains • Mem-D was minimally related to clinical outcomes • Especially longitudinal decline and conversion • Challenge in clinical neuropsychological assessment is to separate demographic from brain influences on test scores Friday Harbor Psychometrics 2012 Reed et al., 2010

  40. Intracranial volume and cognition Friday Harbor Psychometrics 2012 Farias et al., 2012

  41. Model of joint effects of intracranial volume and brain structure Friday Harbor Psychometrics 2012 Farias et al., 2012

  42. Semantic Memory by ICV Friday Harbor Psychometrics 2012 Farias et al., 2012

  43. Cognition and ICV • ICV related to Semantic Memory and Executive Function • ICV not related to Episodic Memory • Early development might have impact on cortical development Friday Harbor Psychometrics 2012 Farias et al., 2012

  44. Factorial invariance Friday Harbor Psychometrics 2012

  45. Sample • Community dwelling recruited using cognitive screening protocol and clinic referrals • Whites - n=678 • Blacks - n=352 • Hispanics, English Speaking n=434 • Hispanics, Spanish Speaking n=877 • Broad range of cognitive function • Normal to demented Friday Harbor Psychometrics 2012 Mungas et al., 2011

  46. Object Naming Spatial Localization Spatial Verbal Picture Association Pattern Recognition Verbal Abstraction NonVerbal Reasoning Verbal Expression Visual Attention Attention Verbal Comprehension Verbal Attention Memory Word List Learning 1 Working Memory Word List Learning 2 Category Fluency Fluency Spatial Config Learning Phonemic Fluency Best Factor Structure Friday Harbor Psychometrics 2012 Mungas et al., 2011

  47. Invariance of Dimensional Structure Across Ethnic and Language Groups • Same number of dimensions • Invariant Factor Loadings • Observed test scores have same relationship to latent dimensions • Some differences in Intercepts for tests • Spanish speaker has to have greater latent attention ability to achieve a given Verbal Attention score Friday Harbor Psychometrics 2012 Mungas et al., 2011

  48. Verbal Attention by Attention/Working Memory Friday Harbor Psychometrics 2012 Mungas et al., 2011

  49. Final Thoughts Friday Harbor Psychometrics 2012

  50. Longitudinal Trajectories Friday Harbor Psychometrics 2012

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