Neuropsychological test results are affected by multiple factors, but
usually age and education are the only variables by which norms are
stratified. Some authors have questioned whether these variables alone are
sufficient (e.g., Marcopulos et al., 1997; Manly et al., 2002), since such norms have lead to
problems, such as poor specificity for African Americans on dementia
screening devices (Fillenbaum et al., 1990).
Recent research has shown that reading ability, a measure of educational
quality, attenuated racial differences in test performance (Manly et al., 2002). We specifically examined whether
reading ability would account for a greater amount of variance than
education in executive function tests in a population traditionally
subject to poor educational quality. Results determined that reading
ability accounted for a significantly greater amount of variance than
years of education for Letter-Number Sequencing, Similarities, COWA, Trail
Making Test, and Coloured Progressive Matrices. Reading ability was found
to significantly mediate the relationship between each of these tests and
education. Animal naming appears to be least affected by educational
quality or quantity. These findings hold implications for the
interpretation of neuropsychological test results, especially in those
exposed to substandard educational quality, and for the way that test
norms are constructed. (JINS, 2006, 12,
64–71.)