Neuropsychological tests generally require adjustments for years of
education when determining the presence of neurocognitive impairment.
However, evidence indicates that educational quality, as assessed with
reading tests, may be a better reflection of educational attainment among
African Americans. Thus, African Americans with poor educational quality
may be incorrectly classified with neurocognitive impairment based on
neuropsychological tests. We compared the accuracy of neuropsychological
test scores standardized using reading grade-equivalent versus
years of education in predicting neurocognitive impairment among a sample
of Whites and African-American adults who were HIV+. Participants were
examined by a neurologist and classified with or without HIV-associated
neurocognitive disorders according to accepted criteria. Participants were
also classified as impaired versus not impaired based on their
neuropsychological test scores standardized by 1) self-reported education
or 2) WRAT-3 reading grade-level. Cross tabulation tables were used to
determine agreement of the two methods in detecting impairment. Among
African-Americans, standardized scores derived from reading scores had
greater specificity than those derived from years of education (84.1%
vs. 77.3). Among the Whites, correction based on years of
education had both greater specificity and sensitivity. The results
suggest that reading tests may be a useful alternative for determining NCI
among African Americans. (JINS, 2007, 13,
462–470.)