The Clinical neuropsychologist最新文献

{"title":"Feigning or forgetfulness: The effect of memory impairment severity on word choice test performance.","authors":"Alec C Neale,&nbsp;Gabriel P Ovsiew,&nbsp;Zachary J Resch,&nbsp;Jason R Soble","doi":"10.1080/13854046.2020.1799076","DOIUrl":"https://doi.org/10.1080/13854046.2020.1799076","url":null,"abstract":"<p><strong>Objective: </strong>This study cross-validated the word choice test (WCT) in a diverse neuropsychiatric sample and examined the effect of increasing verbal memory impairment severity on WCT performance.</p><p><strong>Method: </strong>Data from 147 clinically referred patients (113 valid/34 invalid) who completed the WCT, Rey Auditory Verbal Learning Test (RAVLT), and four independent criterion PVTs were analyzed. RAVLT memory impairment bands used were: ≥37T (normal memory); 30T-36T (below average scores/mild impairment); and ≤29T (extremely low scores/severe impairment).</p><p><strong>Results: </strong>WCT and RAVLT were moderately correlated. The invalid group had significantly worse performance on the WCT and RAVLT. For the overall sample, the WCT yielded an area under the curve (AUC) = .79, with 62% sensitivity/93% specificity at a cut-score of ≤41. When the sample was subdivided by memory impairment severity, the severe impairment group had significantly lower WCT scores than the normal group. Moreover, the WCT retained moderate classification accuracy among the normal memory (AUC = .85) and mild memory impairment (AUC = .76) groups, with sensitivities of 65% and 62% (≥91% specificity) at their respective optimal cut-scores of ≤44 and ≤42. In contrast, the WCT had low classification accuracy among those with severe memory impairment (AUC = .66), with only 15% sensitivity/95% specificity at the optimal cut-score of ≤30.</p><p><strong>Conclusion: </strong>The WCT is generally useful for detecting invalid neuropsychological test performance, although, its classification accuracy was diminished among patients with severe memory impairment. Therefore, while the WCT remains a viable option for performance validity assessment, neuropsychologists should carefully consider its use when this level of severe memory impairment is known or suspected.</p>","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"584-599"},"PeriodicalIF":3.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13854046.2020.1799076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38202373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-intensive care syndrome in a cohort of infants & young children receiving integrated care via a pediatric critical care & neurotrauma recovery program: A pilot investigation.","authors":"Trevor A Hall,&nbsp;Skyler Leonard,&nbsp;Kathryn Bradbury,&nbsp;Emily Holding,&nbsp;Justin Lee,&nbsp;Amanda Wagner,&nbsp;Susanne Duvall,&nbsp;Cydni N Williams","doi":"10.1080/13854046.2020.1797176","DOIUrl":"https://doi.org/10.1080/13854046.2020.1797176","url":null,"abstract":"<p><strong>Objective: </strong>Children treated in the pediatric intensive care unit (PICU) often face difficulties with long-term morbidities associated with neurologic injuries and lifesaving PICU interventions termed Post-Intensive Care Syndrome (PICS). In an effort to identify and address critical issues related to PICS, we developed an integrated model of care whereby children and families participate in follow-up clinics with a neuropsychologist and a critical care physician. To demonstrate preliminary impact, we present pilot findings on the early identification and treatment of PICS in a cohort of infants and young children in our program through a combination of multi-professional direct assessment and parent proxy questionnaires.</p><p><strong>Method: </strong>Thirty-three infants and children, ages 3-72 months, participated in our initial follow-up clinic where issues related to physical health/recovery, development/cognition, mood/behavior, and quality of life were screened 1-3 months after discharge from the PICU.</p><p><strong>Results: </strong>In comparison to pre-hospitalization functioning, direct assessment revealed new neurological concerns identified by the critical care physician in 33.3% of participants and new neurocognitive concerns identified by the neuropsychologist in 36.4% of participants. Caregiver reported measures showed significant issues with patient cognitive functioning, emotional functioning, sleep, and impact on the family. Participants and families experienced significant difficulties related to changes in functioning and disability. Parents/caregivers and clinicians demonstrated agreement on functioning across a variety of indicators; however, important divergence in assessments were also found highlighting the importance of multiple assessments and perspectives.</p><p><strong>Conclusions: </strong>New PICS morbidities are common in the early phase of recovery after discharge in infants, young children and their families. Results demonstrate the benefits and need for timely PICU follow-up care that involves collaboration/integration of physicians, neuropsychologists, and families to identify and treat PICS issues.</p>","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"639-663"},"PeriodicalIF":3.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13854046.2020.1797176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38192881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent intracerebral hemorrhages due to central nervous system vasculitis: A neuropsychological case report.","authors":"Zachary J Resch,&nbsp;Gabriel P Ovsiew,&nbsp;Jason R Soble","doi":"10.1080/13854046.2020.1794044","DOIUrl":"https://doi.org/10.1080/13854046.2020.1794044","url":null,"abstract":"<p><strong>Objective: </strong>Primary angiitis of the central nervous system (PACNS) is a rare and devastating form of vasculitis that destroys the vessels of the brain and spinal cord, resulting in progressive and debilitating neurologic symptoms. The objective of the present study was to detail the diagnostic process of a case of a patient with PACNS who suffered from six intracerebral hemorrhages (ICHs).</p><p><strong>Method: </strong>The patient was an African American woman with a history of recurrent ICHs of unclear etiology who received serial neuropsychological evaluations over the course of a 5-year period. Two comprehensive neuropsychological evaluations are included, as well as an overview of her clinical course, including differential diagnostic considerations and treatment planning.</p><p><strong>Results: </strong>Neuropsychological assessment revealed marked deficits in visuospatial abilities and processing speed associated with her underlying neuropathology. Integrated review of her medical records indicated a probable diagnosis of PACNS as the likely etiology of her recurrent ICHs.</p><p><strong>Conclusions: </strong>This study demonstrates the importance of differential diagnosis of low base-rate conditions, functional neuroanatomy and neurobehavioral phenomenology, serial assessment, and cognitive reserve in clinical neuropsychological practice.</p>","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"699-720"},"PeriodicalIF":3.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13854046.2020.1794044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38204102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous age-related changes of attention in unmedicated boys with attention deficit hyperactivity disorder.","authors":"Emel Erdogan Bakar,&nbsp;Sirel Karakaş","doi":"10.1080/13854046.2020.1801846","DOIUrl":"https://doi.org/10.1080/13854046.2020.1801846","url":null,"abstract":"<p><p><b>Objective</b> Neuropsychological, neuroanatomical, and electrophysiological studies have reported a steady increase in the different attention types until the age of 10 years. Moreover, differences between healthy control (HC) boys and those with attention deficit hyperactivity disorder (ADHD) become nonsignificant in late childhood. This cross-sectional study aimed to perform a comparative analysis of attentional processing in boys with ADHD and HC in the 6:00-10:11 years age range. <b>Methods:</b> Age-related changes in attentional processing were compared between Caucasian Turkic boys (72-131 months of age) with ADHD (n = 144) and HC (n = 112). Selective, focused, and inhibitory attention were measured using the Stroop Test (5 scores); sustained attention was measured using the Cancellation Test (3 scores); and attention span was measured using the Visual Aural Digit Span Test-Revised (6 scores). <b>Results:</b> At the age of 6 years, the ADHD group had a significantly lower performance for all attention types. By the age of 10 years, there were no significant between-group differences. However, the component structure of the neuropsychological test scores in the ADHD group differed from that in the HC group and previous studies. <b>Conclusions:</b> Attentional processing in boys with ADHD changes within the age-range of 6:00-10:00 years where it finally becomes similar to that in HC boys. This delayed maturation is consistent with the maturational lag model of ADHD. However, there was a between-group difference in the component structure of attentional processing, which is consistent with the maturational deviance model of ADHD.</p>","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"664-698"},"PeriodicalIF":3.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13854046.2020.1801846","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38401942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural neuropsychological assessment in Europe: Position statement of the European Consortium on Cross-Cultural Neuropsychology (ECCroN).","authors":"Sanne Franzen, Tam J Watermeyer, Simone Pomati, Janne M Papma, T Rune Nielsen, Pauline Narme, Naaheed Mukadam, Álvaro Lozano-Ruiz, Inmaculada Ibanez-Casas, Miriam Goudsmit, Ahmed Fasfous, Julia C Daugherty, Marco Canevelli, Clara Calia, Esther van den Berg, Peter Bekkhus-Wetterberg","doi":"10.1080/13854046.2021.1981456","DOIUrl":"10.1080/13854046.2021.1981456","url":null,"abstract":"<p><p>Over the past decades European societies have become increasingly diverse. This diversity in culture, education, and language significantly impacts neuropsychological assessment. Although several initiatives are under way to overcome these barriers - e.g. newly developed and validated test batteries - there is a need for more collaboration in the development and implementation of neuropsychological tests, such as in the domains of social cognition and language.</p><p><p>To address these gaps in cross-cultural neuropsychological assessment in Europe, the European Consortium on Cross-Cultural Neuropsychology (ECCroN) was established in 2019.</p><p><p>ECCroN recommends taking a broad range of variables into account, such as linguistic factors, literacy, education, migration history, acculturation and other cultural factors. We advocate against race-based norms as a solution to the challenging interpretation of group differences on neuropsychological tests, and instead support the development, validation, and standardization of more widely applicable/cross-culturally applicable tests that take into account interindividual variability. Last, ECCroN advocates for an improvement in the clinical training of neuropsychologists in culturally sensitive neuropsychological assessment, and the development and implementation of guidelines for interpreter-mediated neuropsychological assessment in diverse populations in Europe.</p><p><p>ECCroN may impact research and clinical practice by contributing to existing theoretical frameworks and by improving the assessment of diverse individuals across Europe through collaborations on test development, collection of normative data, cross-cultural clinical training, and interpreter-mediated assessment.</p>","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"546-557"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39488698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychological functioning in survivors of childhood medulloblastoma/CNS-PNET: The role of secondary medical complications.","authors":"Kristine Stadskleiv,&nbsp;Einar Stensvold,&nbsp;Kjersti Stokka,&nbsp;Anne Grete Bechensteen,&nbsp;Petter Brandal","doi":"10.1080/13854046.2020.1794045","DOIUrl":"https://doi.org/10.1080/13854046.2020.1794045","url":null,"abstract":"<p><p><b>Objective</b> To investigate the long-term cognitive consequences of malignant pediatric brain tumor and its treatment, and factors explaining variability in cognitive functioning among survivors. <b>Method:</b> A geographical cohort of survivors of pediatric medulloblastoma (MB) and supratentorial primitive neuroectodermal tumor (CNS-PNET), treated between 1974 and 2013, was invited to participate. Of the 63 surviving patients, 50 (79%) consented to participation. The participants were tested with a battery of neuropsychological tests covering a wide age range. Verbal cognition, nonverbal cognition, processing speed, attention, memory, executive functioning, and manual dexterity were assessed. The participants were between 5:5 and 51:11 years of age at time of assessment. Assessments took place on average 19 years after primary tumor resective surgery. <b>Results:</b> One participant had a severe intellectual disability. For the rest, IQ varied from 52 to 125, with a mean score of 88.0 (<i>SD</i> 19.7). Twenty-eight (56%) of the participants had full-scale IQ scores in the age-average range or above. Gender, age at operation, time since operation, the presence of secondary medical complications, and treatment variables explained 46% of the variability in IQ scores, <i>F</i>(4,44) =  9.5, <i>p</i><.001. The presence of endocrine insufficiency in combination with either epilepsy and/or hydrocephalus was associated with lowered IQ, lowered processing speed, and memory impairments. <b>Conclusion:</b> Patients treated for childhood MB and CNS-PNET have a lifelong risk of medical sequelae, including impaired cognitive functioning. This study adds to the literature by demonstrating the importance of following neuropsychological functioning closely, especially processing speed, learning, and memory, in survivors who have multiple secondary medical complications.</p>","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"600-625"},"PeriodicalIF":3.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13854046.2020.1794045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38208842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"20th Annual AACN Conference and Workshops of the American Academy of Clinical Neuropsychology (AACN), June 22-25, 2022","authors":"T. Vannorsdall","doi":"10.1080/13854046.2022.2054361","DOIUrl":"https://doi.org/10.1080/13854046.2022.2054361","url":null,"abstract":"and H. Stricker, Ph.D., ABPP Biomarkers have changed the landscape of alzheimer’s disease (aD) research and now have direct relevance for who may be eligible for current and forthcoming aD therapeutics. This workshop will review alzheimer’s disease (aD) biomarkers, with a focus on traditional imaging and CsF biomarkers and the projected impact of plasma biomarkers on clinical trials and practice. Mri classification of amyloid-related imaging abnormalities (aria) will also be reviewed. The status of disease-modifying therapies for aD will be discussed, including drugs that were approved and those that may be on the verge of being approved. aD biomarkers and emerging aD therapeutics will also impact neuropsychology. We will highlight considerations for normative data, the use of composite scores in the clinic, how we think about the diagnostic accuracy of neuropsychological measures, and how digital cognitive measures are needed to help with increased demand for and equitable access to cognitive screening and monitoring. ABSTRACT This workshop will focus on typical and atypical neurodevelopment in infants and young children, first examined through the results and challenges faced by developmental neuroimaging researchers, and then by an exploration of the myriad socio-contextual factors that impact developmental and pediatric assessment in the united states and globally. our understanding of what is known about early cortical organization and hemispheric specialization will be discussed. The speakers will then focus on current practice and challenges in assessing typical and atypical development in the united states and in low and lower middle-income countries (lMiCs). The workshop will address the impact of socio-demographic and socio-cultural factors in pediatric assessment. We will discuss the need for population-based assessment methods in global health, and common neurodevelopmental insults and their impact on young children living in poverty. preliminary findings from: (1) a longitudinal, multisite study of a new early childhood development measure, pediaTrac; (2) a large cohort of infants and young children who have sustained inflicted traumatic brain injuries; and (3) assessment of neurodevelopment in a large cohort of infants and young children in rural guatemala will be discussed. evaluate examinees with claims of posttraumatic disorder (pTsD) and traumatic brain injury (TBi) arising from a single precipitating (e.g. motor vehicle accident, participation in combat). in the current workshop, clinical neuropsychologist and clinical integrated overview of the various complexities that accompany these “combined” claims. The presenters will provide a review of contemporary diagnostic criteria for pTsD and TBi and highlight certain parallels and differences that exist with regard to the abnormalities in serum studies can be associated with changes in mental status and cognition. some relationships have been clearly demonstrated, such as some el","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126514712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Black lives matter to clinical neuropsychologists? An introduction to a special issue.","authors":"Steven Paul Woods,&nbsp;Marc A Norman","doi":"10.1080/13854046.2021.2020906","DOIUrl":"https://doi.org/10.1080/13854046.2021.2020906","url":null,"abstract":"The racial strife that was exacerbated by the murder of George Floyd in the Spring of 2020 prompted many of us to reflect on race as a social justice issue in clinical neuropsychology. As a specialty in which White Americans have historically been over-represented (Sweet et al., 2021), how much do Black lives really matter to clinical neuropsychology? Of course, the broader Civil Rights movement has been active for decades and the racial inequities in psychological science, training, and practice have existed for even longer (Guthrie, 2004). Importantly, they are inextricably linked and relevant to clinical neuropsychology. Black Americans experience marked health disparities and are over-represented in many of the clinical populations that neuropsychologists serve (e.g. vascular disease, dementia, and infectious disease). And yet, fewer than 1% (n = 75) of the nearly 11,000 articles published in our field’s six major journals since 1985 focus specifically on Black Americans. As seen in Figure 1, the limited emphasis on Black Americans in our neuropsychological research has not improved meaningfully in 35 years, as publication frequencies fall reliably below studies focused on other sociodemographic factors such as age, sex/gender, and education/literacy (ps < .0001). A majority of the neuropsychological articles on Black Americans emphasize race-based test score discrepancies, psychometrics, and norms (e.g. Heverly et al., 1986). Although such psychometric studies have value, they are nevertheless fraught with thorny interpretive issues (e.g. Manly & Echemendia, 2007; Possin et al., 2021) and represent only a small part of the brain health needs of Black Americans. Moreover, race is a social, rather than biological, construct, and the issues associated with race and brain health are tremendously complex and cannot be resolved with an exclusive psychometric focus. Inspired by the Black Lives Matter academic strike (Nature, 2020), this special issue was a call to action for clinical neuropsychologists to use their platform as clinician-scientists to promote the brain health and quality of life of Black Americans. The special issue begins with two systematic reviews examining the representation of Black Americans in neuropsychological studies. Historically, well over half of articles in clinical neuropsychology journals fail to include even basic descriptive data on","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"209-213"},"PeriodicalIF":3.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39768498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial differences in health and cognition as a function of HIV among older adults.","authors":"April D Thames,&nbsp;Rodolfo Nunez,&nbsp;George M Slavich,&nbsp;Michael R Irwin,&nbsp;Damla Senturk","doi":"10.1080/13854046.2021.1967449","DOIUrl":"https://doi.org/10.1080/13854046.2021.1967449","url":null,"abstract":"<p><p>The present study investigated the contribution of health risk factors (using the Charlson Comorbidity Index [CCI]) on cognitive outcomes in a sample of 380 HIV-positive (HIV+; <i>n</i> = 221) and HIV-seronegative (HIV-; <i>n</i> = 159) African American and European American adults aged 50+.</p><p><p>Participants were recruited from HIV clinics and community advertisements. HIV status was confirmed by serological testing. Self-report and chart history review was used to gather information about medical ssscomorbidities. The Charlson Comorbidity Index (CCI) was used to create a comorbidity score. Participants were administered a brief cognitive test battery.</p><p><p>As expected, health risks were greater among those with HIV. There was a HIV × Race interaction on CCI scores, such that in the HIV + group, European Americans had significantly higher CCI scores (<i>M</i> = 3.74; <i>SD</i> = 2.1) than African American HIV + participants (<i>M</i> = 2.70; <i>SD</i> = 1.9). However, in the HIV - group, African Americans had significantly higher CCI scores (<i>M</i> = 2.20; <i>SD</i> = 1.1) than HIV - European American participants (<i>M</i> = 1.80; <i>SD</i> = 1.2). Also, consistent with hypotheses, across the entire sample CCI score was significantly associated with global cognition (β = -.24, <i>p</i> = .02).</p><p><p>Study results underscore the importance of considering HIV serostatus in studies examining racial disparities in health, and how multiple medical risks relate to cognitive outcomes. Neuropsychologists evaluating patients living with HIV should consider how the presence of multiple medical comorbidities may contribute to the course of cognitive decline as people age.</p>","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"367-387"},"PeriodicalIF":3.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8847321/pdf/nihms-1735715.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39339717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating racial disparities in healthcare system utilization and caregiver burden among older adults with dementia.","authors":"Carolina Pereira,&nbsp;Ashley LaRoche,&nbsp;Beth Arredondo,&nbsp;Erika Pugh,&nbsp;Elizabeth Disbrow,&nbsp;Tyler H Reekes,&nbsp;Emily Brickell,&nbsp;Anneliese Boettcher,&nbsp;R John Sawyer","doi":"10.1080/13854046.2021.1951844","DOIUrl":"https://doi.org/10.1080/13854046.2021.1951844","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate racial differences in healthcare utilization and caregiver burden in a culturally diverse population of older adults with dementia.</p><p><strong>Method: </strong>One hundred and thirty-three dyads (person with dementia, PWD and caregiver, CG), with at least one emergency department (ED) visit or hospitalization 12 months prior, were enrolled. Independent sample <i>t</i>-tests and chi-squared analyses were performed to compare racial groups on healthcare utilization and CG burden. Mann-Whitney <i>U</i> test was used for item-level analyses, principal component analysis was used to examine relationships among outcomes, and regressions were used to identify the relationship between race and potential covariates.</p><p><strong>Results: </strong>PWD sample mean age was 79 years, predominantly female, and with high school education. Racial distribution was 65% White and 35% Black. CG sample mean age was 64 years, predominantly female, with more than 12 years of education. No differences were found for age or dementia severity across racial groups. Black PWD experienced more ED and ambulance utilization when compared to White counterparts. Non-emergency hospitalization rates were higher for White PWD. No significant differences were found by race for CG burden total score; however, item-level analysis suggested more anger, reduced social life, uncertainty, and inadequacy in White CGs. Regressions demonstrated a positive relationship between Black race and adult-child CGs with increased ED visits, while dyad educational attainment was associated with hospitalizations independent of race.</p><p><strong>Conclusions: </strong>Healthcare utilization disparities extend to older adults with dementia diagnoses. Our findings suggest that culturally tailored interventions may be appropriate. Future research is encouraged to explore the effect of other covariates.</p>","PeriodicalId":197334,"journal":{"name":"The Clinical neuropsychologist","volume":" ","pages":"353-366"},"PeriodicalIF":3.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13854046.2021.1951844","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39269053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}