The Impact of Education and Acculturation on Nonverbal Neuropsychological Test Performance Among Latino/a Patients with Epilepsy

Abstract

The present study examined the relationship between various sociocultural factors (e.g., acculturation, education), neurological variables (e.g., epilepsy duration and seizure frequency) and nonverbal neuropsychological (NP) test performance in a sample of 305 Latino/a and Non-Latino/a White adults with and without epilepsy. All participants completed nonverbal NP measures of visuospatial skills, memory, executive functioning, and psychomotor speed. An acculturation scale was administered to Spanish-speaking epilepsy patients and controls. Education was strongly correlated with performance on all but one of the nonverbal measures across the entire sample. Among Spanish-speaking Latino/a patients with epilepsy, level of acculturation to U.S. culture was associated with a measure of behavioral inflexibility (p < .05) and with a composite measure of nonverbal NP test performance (p < .05). Finally, the results of hierarchical regression models showed that sociocultural factors accounted for a greater proportion of variance in nonverbal NP test performance than did neurological factors. These results provide further evidence that sociocultural factors are strong predictors of NP test performance in clinical populations, even on nonverbal tests. Assessment of acculturation may be as critical as assessment of disease factors in interpreting cognitive performance in Latino/a individuals.

Key words:

• cross-cultural
• Hispanic Americans
• tests

Notes

SSHCs = Spanish-speaking healthy controls; NLEPs = Non-Latino/a epilepsy patients; ESLEPs = English-speaking Latino/a epilepsy patients; SSLEPs = Spanish-speaking Latino/a epilepsy patients.

Seizure Frequency = self-reported seizures per month; EPs = epilepsy patients; NLEPs = Non-Latino/a epilepsy patients; ESLEPs = English-speaking Latino/a epilepsy patients; SSLEPs = Spanish-speaking Latino/a epilepsy patients; AED = antiepileptic drug.

^a Significant group differences observed between SSLEP < ESLEP (p < .05), and SSLEP < NLEP (p < .01).

^b Significant group differences observed between SSLEP < ESLEP (p < .05), and ESLEP < NLEP (p < .05).

Composite NP = Composite Nonverbal Neuropsychological Measure; ROCFT (CT, DR) = Rey-Osterrieth Complex Figure Test (Copy Trial, Delayed Recall); WCST-64 (TC, PE) = Wisconsin Card-Sorting Test–64-Card Version (Total Categories, Perseverative Errors); GPT (DH, NDH) = Grooved Pegboard Test (Dominant Hand, Nondominant Hand); RFFT (TD, PE) = Ruff Figural Fluency Test-Short Form (Total Designs, Perseverative Errors); BVMT-R (TR, DR) = Brief Visuospatial Memory Test-Revised (Total Recall, Delayed Recall).

*p < .05 (two-tailed). **p < .01 (two-tailed).

^a Point biserial correlation calculated.

BAS = Bidimensional Acculturation Scale; Composite NP = Composite Nonverbal Neuropsychological Measure; ROCFT (CT, DR) = Rey-Osterrieth Complex Figure Test (Copy Trial, Delayed Recall); WCST-64 (TC, PE) = Wisconsin Card-Sorting Test–64-Card Version (Total Categories, Perseverative Errors); GPT (DH, NDH) = nbsp;Grooved Pegboard Test (Dominant Hand, Nondominant Hand); RFFT (TD, PE) = Ruff Figural Fluency Test-Short Form (Total Designs, Perseverative Errors); BVMT-R (TR, DR) = Brief Visuospatial Memory Test-Revised (Total Recall, Delayed Recall).

*p < .05 (two-tailed). **p < .01 (two-tailed).

BAS = Bidimensional Acculturation Scale.