Demographically corrected norms for African Americans and Caucasians on the Hopkins Verbal Learning Test–Revised, Brief Visuospatial Memory Test–Revised, Stroop Color and Word Test, and Wisconsin Card Sorting Test 64-Card Version

Abstract

Memory and executive functioning are two important components of clinical neuropsychological (NP) practice and research. Multiple demographic factors are known to affect performance differentially on most NP tests, but adequate normative corrections, inclusive of race/ethnicity, are not available for many widely used instruments. This study compared demographic contributions for widely used tests of verbal and visual learning and memory (Brief Visual Memory Test–Revised, Hopkins Verbal Memory Test–Revised) and executive functioning (Stroop Color and Word Test, Wisconsin Card Sorting Test–64) in groups of healthy Caucasians (n = 143) and African Americans (n = 103). Demographic factors of age, education, gender, and race/ethnicity were found to be significant factors on some indices of all four tests. The magnitude of demographic contributions (especially age) was greater for African Americans than for Caucasians on most measures. New, demographically corrected T-score formulas were calculated for each race/ethnicity. The rates of NP impairment using previously published normative standards significantly overestimated NP impairment in African Americans. Utilizing the new demographic corrections developed and presented herein, NP impairment rates were comparable between the two race/ethnicities and were unrelated to the other demographic characteristics (age, education, gender) in either race/ethnicity group. Findings support the need to consider extended demographic contributions to neuropsychological test performance in clinical and research settings.

Keywords:

• Neuropsychology
• Executive functioning
• Memory
• Cognition
• African American

Acknowledgments

Funded by a Developmental Grant award from the HIV Neurobehavioral Research Center (HNRC).

The HNRC is supported by Center Award MH 62512 from the National Institute of Mental Health (NIMH). The San Diego HNRC group is affiliated with the University of California, San Diego, the Naval Medical Center, San Diego, and the Veterans Affairs San Diego Healthcare System, and it includes: Director: Igor Grant; Co-Directors: J. Hampton Atkinson, Ronald J. Ellis, and J. Allen McCutchan; Center Manager: Thomas D. Marcotte; Jennifer Marquie-Beck; Melanie Sherman; Neuromedical Component: Ronald J. Ellis, J. Allen McCutchan, Scott Letendre, Edmund Capparelli, Rachel Schrier, Terry Alexander, Debra Rosario, Shannon LeBlanc; Neurobehavioral Component: Robert K. Heaton, Steven Paul Woods, Mariana Cherner, David J. Moore; Matthew Dawson; Neuroimaging Component: Terry Jernigan, Christine Fennema-Notestine, Sarah L. Archibald, John Hesselink, Jacopo Annese, Michael J. Taylor; Neurobiology Component: Eliezer Masliah, Ian Everall, Cristian Achim; Neurovirology Component: Douglas Richman, David M. Smith; International Component: J. Allen McCutchan; Developmental Component: Ian Everall, Stuart Lipton; Participant Accrual and Retention Unit: J. Hampton Atkinson, Rodney von Jaeger; Data Management Unit: Anthony C. Gamst, Clint Cushman (Data Systems Manager); Statistics Unit: Ian Abramson, Florin Vaida, Reena Deutsch, Tanya Wolfson. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.