Performance of middle-aged and elderly European minority and majority populations on a Cross-Cultural Neuropsychological Test Battery (CNTB)

Abstract

Objective: The aim of this study was to examine test performance on a cross-cultural neuropsychological test battery for assessment of middle-aged and elderly ethnic minority and majority populations in western Europe, and to present preliminary normative data. Method: The study was a cross-sectional multi-center study. Tests in the European Cross-Cultural Neuropsychological Test Battery (CNTB) cover several cognitive domains, including global cognitive function, memory, executive functions, and visuospatial functions. Results: A total of 330 participants were included: 14 Moroccan, 45 Pakistani/Indian Punjabi, 41 Polish, 66 Turkish, and 19 former Yugoslavian minority participants, and 145 western European majority participants. Significant differences between ethnic groups were found on most CNTB measures. However, ethnic groups differed greatly in demographic characteristics and differences in test scores were mainly related to educational differences, explaining an average of 15% of the variance. Preliminary multicultural CNTB normative data dichotomized by education and age were constructed using overlapping cells. Applying this normative data across the whole sample resulted in an acceptable number of participants scoring in the impaired range across all ethnic groups. Factor analyses found the CNTB to have a stable and clinically meaningful factor structure. Conclusions: The CNTB represents the first European joint effort to establish neuropsychological measures appropriate for ethnic minority populations in western Europe. The CNTB can be applied in approximately 60 min, covers several cognitive domains, and appears appropriate for assessment of the targeted populations. However, due to the small sample size in some ethnic groups further studies are needed replicate and support this.

Keywords:

• Neuropsychological tests
• cognitive assessment
• cross-cultural comparison
• ethnic groups
• dementia

Acknowledgments

This work was supported by the European Union funded Interreg IV A program. The authors thank the research assistants Anne Julie Storheil, Chanden Dihram, Claudia Lohman Tassone, Dilek Pinar Atici Secilmis, Fatime Zeka, Fozia Qureshi, Ivana Babic, Katrine Schneekloth Friis Nielsen, Lidia Morawska Nielsen, Mustafa Olgun, Nafeesa Akhtar, Naserana Sarwar, Natasa Bela, and Nurten Aykac for their invaluable help in recruiting and assessing study participants. Also, we thank neuropsychologist Kasper Jørgensen for his constructive comments and feedback on the initial draft of the manuscript. The authors report no conflicts of interest.