Abstract
It is essential to use culturally appropriate, sensitive and specific tests that reflect true cognitive performance. However, several factors including age, education and gender can influence neuropsychological test performance.ObjectiveTo examine the effects of age, education and gender on neuropsychological function in older adults using measures of global cognitive screening, attention, working memory, executive functions, memory, construction, language and parietal focal signs.MethodsThis is a cross sectional normative study of 180 community-dwelling normal older adults. All participants were screened with the Hindi Mental Status Examination (HMSE), Everyday Activities Scale for India (EASI), Edinburgh handedness inventory (EDI) and MINI Screen, and followed by a detailed neuropsychological assessment.ResultsStepwise regression analysis revealed that education was associated with better performance on all the neuropsychological tests. Females performed significantly better on measures of memory. Further, most of the illiterate subjects, including low educated participants, refused to cooperate on measures of executive functioning.ConclusionEducation was found to be the strongest determinant of neuropsychological test performance followed by age and gender. Our study demonstrates that Indian healthy normal older adults with low education perform poorly on measures of planning and working memory. Traditional measures of planning and working memory should be avoided or used cautiously in the presence of low education. There is an urgent need to develop tasks for measuring executive functions, especially in low educated Indian older adults.
Highlights
Neuropsychological assessment plays a crucial role in identifying cognitive impairment associated with aging and dementia
All participants were screened with the Edinburgh handedness inventory, Hindi Mental Status Examination (HMSE), Everyday Activities Scale for India (EASI) and Modified MINI Screen and followed by a detailed neuropsychological assessment
The main purpose of the present study was to examine the relative contribution of age, education and gender on neuropsychological functions
Summary
Neuropsychological assessment plays a crucial role in identifying cognitive impairment associated with aging and dementia. Cross-cultural neuropsychology as an emerging field of neuropsychology focuses more on cultural experience that could lead to performance differences unrelated to brain functioning.[1] culturally-appropriate, sensitive and specific tests have been recommended to reflect true cognitive performance, when assessing the elderly population.[2,3,4,5] Recently, there has been growing concern to develop culturally-specific norms for Asian populations, including India.[1,2,3,4]. It has been observed that females perform better on verbal tasks while males outperform females on visuo-spatial tasks.[12,13,14] It has been observed that while age-related cognitive decline is more pronounced in speed of processing, working memory and long-term memory,[14,15] implicit memory and knowledge storage are relatively resistant to cognitive aging.[16,17]
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