title: Performance of Hispanics and Non-Hispanic Whites on the NIH Toolbox Cognition Battery: the roles of ethnicity and language backgrounds.
abstract: OBJECTIVE
  This study examined the influence of Hispanic ethnicity and language/cultural background on performance on the NIH Toolbox Cognition Battery (NIHTB-CB).
  
  
  METHODS
  Participants included healthy, primarily English-speaking Hispanic (n = 93; Hispanic-English), primarily Spanish-speaking Hispanic (n = 93; Hispanic-Spanish), and English speaking Non-Hispanic white (n = 93; NH white) adults matched on age, sex, and education levels. All participants were in the NIH Toolbox national norming project and completed the Fluid and Crystallized components of the NIHTB-CB. T-scores (demographically-unadjusted) were developed based on the current sample and were used in analyses.
  
  
  RESULTS
  Spanish-speaking Hispanics performed worse than English-speaking Hispanics and NH whites on demographically unadjusted NIHTB-CB Fluid Composite scores (ps < .01). Results on individual measures comprising the Fluid Composite showed significant group differences on tests of executive inhibitory control (p = .001), processing speed (p = .003), and working memory (p < .001), but not on tests of cognitive flexibility or episodic memory. Test performances were associated with language/cultural backgrounds in the Hispanic-Spanish group: better vocabularies and reading were predicted by being born outside the U.S., having Spanish as a first language, attending school outside the U.S., and speaking more Spanish at home. However, many of these same background factors were associated with worse Fluid Composites within the Hispanic-Spanish group.
  
  
  CONCLUSIONS
  On tests of Fluid cognition, the Hispanic-Spanish group performed the poorest of all groups. Socio-demographic and linguistic factors were associated with those differences. These findings highlight the importance of considering language/cultural backgrounds when interpreting neuropsychological test performances. Importantly, after applying previously published NIHTB-CB norms with demographic corrections, these language/ethnic group differences are eliminated.
authors.affiliation: a Department of Psychology , San Diego State University , San Diego , CA , USA.
authors.forename: Ilse
authors.initials: I
authors.lastname: Flores
authors.affiliation: b SDSU/UCSD Joint Doctoral Program in Clinical Psychology , San Diego , CA , USA.
authors.forename: Kaitlin B
authors.initials: KB
authors.lastname: Casaletto
authors.affiliation: c Department of Psychiatry , UCSD School of Medicine , San Diego , CA , USA.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Marquine
authors.affiliation: c Department of Psychiatry , UCSD School of Medicine , San Diego , CA , USA.
authors.forename: Anya
authors.initials: A
authors.lastname: Umlauf
authors.affiliation: c Department of Psychiatry , UCSD School of Medicine , San Diego , CA , USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Moore
authors.affiliation: d Department of Neurology , University of California , Davis , CA , USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Mungas
authors.affiliation: e Department of Medical Social Sciences, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Gershon
authors.affiliation: e Department of Medical Social Sciences, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.affiliation: c Department of Psychiatry , UCSD School of Medicine , San Diego , CA , USA.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition; D003469:Culture; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D014481:United States; D044465:White People / Q000523:psychology*
keywords: Acculturation; cognition; cultural aspects; language; toolbox