Open Access
Methodology for the generation of normative data for the U.S. adult Spanish-speaking population: a Bayesian approach
(SAGE, 2024-09-20) Rivera, Diego; Forte, Anabel; Olabarrieta Landa, Laiene; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Objective: To present the methodology for a study generating normative neuropsychological test data for healthy Spanish-speaking adults (18-80 years old) living in the U.S. using Bayesian inference as a novel approach. Method: The study sample consisted of 253 healthy adults from eight U.S. regions (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin), with individuals originating from a diverse array of Latin American countries. To participate in the study, individuals must have met the following criteria: were between 18 and 80 years of age, had lived in the U.S. for at least 1 year (12 continuous months), self-identified Spanish as their dominant language, had at least one year of formal education, were able to read and write in Spanish at the time of evaluation, scored ¿23 on the Mini-Mental State Examination, scored <10 on the Patient Health Questionnaire¿9, and scored <10 on the Generalized Anxiety Disorder scale. Participants completed 12 neuropsychological tests. Reliability statistics and norms were calculated for all tests. Conclusions: This was the first normative study for Spanish-speaking adults in the U.S. to implement demographic, acculturation, and bilingual dominance measures as possible controls. Additionally, it was the first study to use Bayesian linear or generalized linear regression models for generating normative data in neuropsychology.
Open Access
Normative data of neuropsychological tests of attention and executive functions in Ecuadorian adult population
(Routledge, 2021) Rodríguez Lorenzana, Alberto; Ramos Usuga, Daniela; Adana Díaz, Lila; Mascialino, Guido; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
Objective: The purpose of this study was to generate normative data for five tests of attention and executive functions (M-WCST, Stroop test, TMT, BTA, and SDMT), in a group of 322 Ecuadorian adults from Quito between the ages of 18 and 85. Method: Multiple regression analyzes taking into account age, education, and gender were used to generate the normative data. Results: Age and education were significantly related to test performance such that scores decreased with age and improved as a function of education. An online calculator is provided to generate normative test scores. Conclusions: This is the first study that presents normative data for tests of executive functions and attention in an Ecuadorian adult population. This data will improve the clinical practice of neuropsychology and help to develop the field in the country.
Open Access
Normative data for tests of attention and executive functions in a sample of European Portuguese adult population
(Routledge, 2021) Vicente, Selene G.; Rivera, Diego; Barbosa, Fernando; Gaspar, Nuno; Dores, Artemisa R.; Ciencias de la Salud; Osasun Zientziak
Objective: The main goal of this study was to produce normative data for the Portuguese population on five neuropsychological tests frequently used to assess executive functions and attention: the Modified Wisconsin Card Sorting Test (M-WCST), the Stroop Color and Word Test, the Trail Making Test (TMT), the Brief Test of Attention (BTA), and the Symbol Digit Modalities Test (SDMT). Method: The study included 300 individuals aged between 18 and 93 years, who had educational backgrounds ranging from 3 to 25 years. Results: The influence of age, education, and sex was explored for each measure, as well as their contribution to explain the performance variance. Conclusions: The normative data are presented as regression-based algorithms to adjust direct and derived test scores for sex, age, and education. This study provides a calculator of normative data, derived from the results of the regression models.
Open Access
Normative data study of verbal fluency and naming tests in elderly people in Costa Rica
(Oxford University Press, 2024) Mora-Villalobos, Lara; Brown-Mata, Gloriana; Smith-Castro, Vanessa; Ramos Usuga, Daniela; Rivera, Diego; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Objective: to generate normative data for the Verbal Fluency Test (VFT) and the Boston Naming Test (BNT) in the Costa Rican population. Method The sample consisted of 563 healthy older people (aged 59-90 years). Polynomial multiple regression analyses were run to evaluate the effects of the age, sex, and education variables on VFT and BNT scores.Results The results showed a significant linear effect of education on the four-letter VF scores and an effect of sex on the letter P score, with females performing better than males. The explained variance ranged from 20.9% to 28.3%. A linear effect of age and education was also found for the four semantic VF scores, with scores decreasing with increasing age and lower education. The sex variable was significant for all semantic categories, with females performing better than males except in the animal category. The explained variance ranged from 21.7% to 30.9%. In the BNT, a linear effect of education was found, so that the more education, the better the score. In addition, a sex effect was also found, with males having higher scores than females. The predictors of the model explained 9.6% of the variance. Conclusions: this is the first study that generates normative data for the VF and BNT in the Costa Rican population over 59 years of age based on demographic variables. The use of these normative data will help clinicians in Costa Rica to better understand language functioning in the elderly, allowing for better classification and diagnosis in the future.
Open Access
Normative data for executive function tests in an Ecuadorian Waranka minority population
(Taylor & Francis, 2024-07-01) Fierro Bósquez, María José; Olabarrieta Landa, Laiene; Christ, Bryan R.; Arjol, David; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Objective: To generate normative data (ND) for executive functions tests in the Waranka minority population of Ecuador. Method: Four-hundred participants aged 6–17 completed the Symbol-Digit Modalities Test (SDMT), Trail-Making Test (TMT), Modified-Wisconsin Card Sorting Test (M-WCST), and Test of Colors-Words (STROOP). Scores were normed using multiple linear regressions, including age, age2, natural logarithm of mean parent education (MPE), sex, bilingualism, and two-way interactions as predictors. Results: Age by MPE and Age2 by MPE interactions arose for SDMT, so that children with illiterate parents scored lower than those with literate parents. Girls scored higher in SDMT. All TMT and M-WCST scores were influenced by age2. Age by MPE interaction was found for TMT–A, so that children with higher MPE went faster; and age by bilingualism interaction for TMT–B, so that more bilingual children needed less time. Stroop-Word and Color were influenced by age2 by MPE interaction, so that children, while older, scored higher, especially those with higher MPE. Also, age2 by sex interaction arose, so that girls increased scores curvilinearly while boys linearly. Word-Color was influenced by age, while Stroop-interference by age2. Age by MPE interaction was found for MCST-Categories and Perseveration, so that perseverations decreased to then increased, especially in those with illiterate parents. M-WCST-Category scores increased to then decrease later on age in children with illiterate parents. Z-scores calculated through indigenous ND were significantly lower than generated through non-indigenous norms. Conclusions: ND for minority populations are critical since Waranka sample performed worse when using non-indigenous norms for z-score calculation.
Open Access
Normative data for verbal fluency and naming tests in Spanish-speaking adults in the United States
(SAGE, 2024-08-22) Olabarrieta Landa, Laiene; Rivera, Diego; Xia, Bridget; Moreno, Oswaldo; Ramos Usuga, Daniela; Morel Valdés, Gloria M.; López, Enrique; Rodríguez, Miriam J.; Carrión, Carmen I.; Lequerica, Anthony H.; Drago, Christin I.; García, Patricia; Rivera, Patricia M.; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Background: The Rey-Osterrieth Complex Figure Test (ROCFT) and the Clock Drawing Test (CDT) are commonly used in clinical practice. The ROCFT measures constructional praxis, visual perception, and visuospatial learning and memory and the CDT assesses for visuospatial, constructional, and executive difficulties. Several neurological disorders are associated with visuospatial and visuoconstructional impairments, yet reliable normative data accounting for sociodemographic aspects of identity and acculturative variables are scarce for Hispanics living in the U.S. Objective: To generate normative data for the ROCF and CDT in a Spanish-speaking adult population living in the U.S. Methods: The sample consisted of 245 participants¿ cognitively normal adults, recruited from several states in the U.S. Each participant was administered the ROCFT and CDT as part of a larger cognitive battery. The ROCFT and CDT were normed using a Bayesian approach. Age, age2, education, sex, acculturation, and language competence, were included as predictors in the analyses. Results: ROCFT was associated with education and age, particularly as they interact with Spanish language competency, and time spent in the U.S. Education was significantly associated with recall abilities and a lower memory recall on the ROCFT. Age was found to vary depending on a person¿s bilingual abilities. Sex did not emerge as a predictor of performance, and it was not moderated by other variables. Conclusions: This is the first study to include acculturation and language proficiency variables in the creation of norms for the assessment of visuoconstruction abilities. This study will have a large impact on the practice of neuropsychology in the U.S.
Open Access
Normative data estimation in neuropsychological tests: a systematic review
(Oxford University Press, 2024) Del Cacho Tena, Ana María; Christ, Bryan R.; Arango Lasprilla, Juan Carlos; Perrin, Paul B.; Rivera, Diego; Olabarrieta Landa, Laiene; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Objective: To quantify the evolution, impact, and importance of normative data (ND) calculation by identifying trends in the research literature and what approaches need improvement. Methods: A PRISMA-guideline systematic review was performed on literature from 2000 to 2022 in PubMed, Pub-Psych, and Web of Science. Inclusion criteria included scientific articles about ND in neuropsychological tests with clear data analysis, published in any country, and written in English or Spanish. Cross-sectional and longitudinal studies were included. Bibliometric analysis was used to examine the growth, productivity, journal dispersion, and impact of the topic. VOSViewer compared keyword co-occurrence networks between 1952¿1999 and 2000¿2022. Results: Four hundred twelve articles met inclusion and exclusion criteria. The most studied predictors were age, education, and sex. There were a greater number of studies/projects focusing on adults than children. The Verbal Fluency Test (12.7%) was the most studied test, and the most frequently used variable selection strategy was linear regression (49.5%). Regression-based approaches were widely used, whereas the traditional approach was still used. ND were presented mostly in percentiles (44.2%). Bibliometrics showed exponential growth in publications. Three journals (2.41%) were in the Core Zone. VOSViewer results showed small nodes, long distances, and four ND-related topics from 1952 to 1999, and there were larger nodes with short connections from 2000 to 2022, indicating topic spread. Conclusions: Future studies should be conducted on children¿s ND, and alternative statistical methods should be used over the widely used regression approaches to address limitations and support growth of the field.
Open Access
15-item version of the Boston naming test: normative data for the Latin American spanish-speaking adult population.
(American Psychological Association, 2023) Del Cacho Tena, Ana María; Merced, Kritzia; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Olabarrieta Landa, Laiene; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
Objective: Naming is commonly impaired in people with neurodegenerative diseases and brain injury, and as a result, its accurate assessment is essential. The aim of this study was to provide normative data for the 15-item Spanish version of the Boston Naming Test (BNT) for an adult population from eight Latin American countries/regions. Method: The total sample consisted of 2,828 participants from Argentina, Chile, Cuba, El Salvador, Mexico, Honduras, Paraguay, and Puerto Rico. Multiple regressions were used to generate normative data following a four-step process. Results: Regression models showed a linear effect of age on the 15-item BNT total score for Argentina, Chile, Mexico, and Puerto Rico. In contrast, Paraguay showed a quadratic age effect. Almost all countries showed a positive linear effect of education, except Cuba which had a quadratic effect. Sex was a significant predictor in Argentina, Chile, Cuba, and Mexico, where in women scored lower than men. Conclusions: This study generates normative data for the 15-item Spanish version of the BNT and offers a free open-source calculator that will assist in the efficacious use of this neuropsychological test in clinical practice and research.
Open Access
Normative data for ten neuropsychological tests for the Guatemalan pediatric population updated to account for vulnerability
(MDPI, 2021) Ibáñez Alfonso, Joaquín A.; Company-Córdoba, Rosalba; Cadena, Claudia de la; Simpson, Ian C.; Rivera, Diego; Sianes, Antonio; Ciencias de la Salud; Osasun Zientziak
The Guatemalan pediatric population is affected by a high incidence of poverty and violence. The previous literature showed that these experiences may ultimately impact cognitive performance. The aim of this article is to update the standardized scores for ten neuropsychological tests commonly used in Guatemala considering vulnerability. A total of 347 healthy children and adolescents from 6 to 17 years of age (M = 10.83, SD = 3) were assessed, controlling for intelligence, mental health and neuropsychological history. The standard scores were created using multiple linear regression and standard deviations from residual values. The predictors included were the following: Age, age squared (age2), mean parental education (MPE), mean parental education squared (MPE2), gender, and vulnerability, as well as their interaction. The vulnerability status was significant in the scores for language, attention and executive functions. To the best of our knowledge, this is the first study that includes the condition of vulnerability in the calculation of neuropsychological standard scores. The utility of this update is to help in the early detection of special needs in this disadvantaged population, promoting more accurate interventions in order to alleviate the negative effects that living in vulnerable conditions has on children and adolescents.
Open Access
Normative data for test of learning and memory in an Ecuadorian adult population
(Routledge, 2020) Rodríguez Lorenzana, Alberto; Núñez Fernández, Silvia; Adana Díaz, Lila; Mascialino, Guido; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
Objective: The objective of this study was to develop norms for two neuropsychological tests of learning and memory in an Ecuadorian adult population. Method: 322 healthy individuals, ages between 18 and 84, were enrolled in the Metropolitan District of Quito. Participants were administered a comprehensive neuropsychological evaluation that included tests of learning and memory (Rey-Osterrieth Complex Figure Test [ROCF] and Hopkins Verbal Learning Test-Revised [HVLT-R]). Backward stepwise multiple linear regression analyses were used to examine the influence of demographic variables age, education, and gender on test performance. Normative data were developed adjusting for demographic variables found to be significant in the final regression models. Results: The final multiple linear models revealed performance on tests of learning and memory worsened with age and improved as a function of education. A user-friendly Excel-based calculator is presented to calculate the z score and percentile automatically based on raw score and sociodemographic information. Conclusion: This is the first study that presents normative data for tests of learning and memory for an adult population in Ecuador. It is expected that these norms will help to improve the clinical practice of neuropsychology in Ecuador by limiting erroneous raw score interpretation and incrementing diagnostic accuracy.