Executive function tests: normative data for Spanish-speaking adults in the United States

Background: normative data for Spanish-speaking populations, particularly Hispanics in the U.S., is notably scarce.
Objective: This study aims to establish normative data for executive function tests (M-WCST, SCWT) among Spanish-speaking Hispanics in the U.S.
Methods: we assessed 245 individuals aged 18-80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin) and employed Bayesian regression to estimate norms, considering various sociodemographic factors influencing performance.
Results: age impacts SCWT scores negatively, especially in older individuals, with stronger effects among those proficient in Spanish. Age also affects M-WCST performance more in individuals with longer U.S. residency. Education correlates with M-WCST outcomes, with lower attainment linked to more errors. Education interacts with Spanish proficiency, influencing SCWT scores differently based on proficiency levels. Sex and acculturation levels interact, affecting SCWT performance differently between men and women.
Conclusions: establishing culturally sensitive normative data can enhance accurate identification of executive dysfunction and reduce misdiagnosis risks. This underscores the importance of considering sociocultural factors including acculturation and language proficiency in neuropsychological assessments to better serve diverse populations.