title: Do neuropsychological test norms from African Americans in the United States generalize to a Zambian population?
abstract: Healthy Zambian adults (N = 324) were evaluated to determine to what degree a Western neuropsychological (NP) test battery, with African American norms adjusted for age, gender, and education could be used in healthy Zambians, including 157 men (48.46%) and 167 women (51.54%) with an average age of 38.48 (SD = 12.80) years and an average education level of 11.02 (SD = 2.58) years. The NP battery included tests of attention/working memory, executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. The Zambian Achievement Test (ZAT) and the U.S. Wide Range Achievement Test-4 (WRAT-4) reading subtest also were administered to assess literacy and quality of education. Similar to findings in Western countries, the Zambian results show substantial age and education effects on most tests and smaller, less consistent effects of gender. Beyond the basic demographic effects, urban/rural background had small effects on some cognitive variables, and the ZAT (but not WRAT-4) reading level was a robust predictor of performance on many NP tests, even when other background characteristics were controlled. Women in the United States tend to outperform men on tests of processing speed and episodic memory. However, Zambian women showed modest but statistically significant disadvantages versus their male counterparts. The results show that tests developed in the United States may be used in Zambia. Nevertheless, development and use of local cultural norms remains very important and is a must. New demographically corrected norms were developed for the cohort that was examined.
authors.affiliation: Department of Psychology, The Norwegian University of Science and Technology.
authors.forename: Knut A
authors.initials: KA
authors.lastname: Hestad
authors.affiliation: Department of Psychology, University of Zambia.
authors.forename: J Anitha
authors.initials: JA
authors.lastname: Menon
authors.affiliation: Department of Psychology, University of Zambia.
authors.forename: Robert
authors.initials: R
authors.lastname: Serpell
authors.affiliation: Department of Psychology, University of Zambia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kalungwana
authors.affiliation: Department of Psychology, University of Zambia.
authors.forename: Sidney O C
authors.initials: SO
authors.lastname: Mwaba
authors.affiliation: Department of Psychology, University of Zambia.
authors.forename: Norma
authors.initials: N
authors.lastname: Kabuba
authors.affiliation: Department of Psychiatry, University of California at San Diego.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Franklin
authors.affiliation: Department of Psychiatry, University of California at San Diego.
authors.forename: Anya
authors.initials: A
authors.lastname: Umlauf
authors.affiliation: Department of Psychiatry, University of California at San Diego.
authors.forename: Scott
authors.initials: S
authors.lastname: Letendre
authors.affiliation: Department of Psychiatry, University of California at San Diego.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D003431:Cross-Cultural Comparison; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012016:Reference Values; D014481:United States; D015024:Zambia