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Objective Culturally and linguistically appropriate neuropsychological assessments for the large number of primary Spanish speakers in the United States remain imperative to serve the needs of this underserved population. As part of a larger co-norming project, we generated demographically adjusted norms for the Brief Visuospatial Memory Test-revised (BVMT-R) and the Hopkins Verbal Learning Test-revised (HVLT-R) for use with native Spanish speakers from the U.S.-Mexico border regions. Participants and Method Participants were 202 healthy native Spanish speakers recruited in San Diego, CA and Tucson, AZ, ages 19 to 60, with education ranging from 0-20 years, and 59% women. Test stimuli for the HVLT-R and instructions for both tests were adapted into Spanish by a team of native Spanish speakers from multiple countries using standard procedures (Cherner et al. 2007). Raw scores for the various learning and delayed recall outcomes were converted to T-scores using fractional polynomial equations accounting for effects of education, age, and sex. We then computed the rates of impairment that would be obtained when applying the original published norms for these two tests, and compared these results to the expected rate of impairment of -1SD (around 16%) derived from the normal distribution of T-scores in our new, demographically corrected norms. Results Results showed significant overestimation of impairment when applying the original norms for non-Hispanic English speakers to our Spanish-speaking sample, ranging from 35-38% for HVLT-R and 25-26% for BVMTR. As expected, these overestimations of impairment were greater for individuals with lower education, but our demographically corrected norms reduced the rate of impairment for all levels of education. Conclusions These findings highlight the urgent need to account for demographic effects on neuropsychological performance in order to improve the diagnostic accuracy of our measures when applied to US-dwelling Spanish speakers. References Cherner, M. Suarez, P. Lazzaretto, D. Fortuny, L. A. I. Mindt, M. R. Dawes, S.... & HNRC group. (2007). Demographically corrected norms for the Brief Visuospatial Memory Test-revised and Hopkins Verbal Learning Test-revised in monolingual Spanish speakers from the US–Mexico border region.  Archives of Clinical Neuropsychology ,  22 (3), 343-353. [ABSTRACT FROM AUTHOR]

Objective With over 37 million Spanish-speakers, the US is the second country in the world with the largest number of Spanish-speakers. Identification of neurological dysfunction via neuropsychological testing for this language group requires knowledgeable application of available tests and normative data. Accordingly, we investigated whether rates of neurocognitive impairment (NCI) varied based on the Spanish language normative method used. Method Participants included 254 healthy native Spanish-speakers (Age: M = 37.3, SD = 10.4; Education: M = 10.7, SD = 4.3; 59% Female; 78.7% of known Mexican origin/descent) living in the US-Mexico border region. Participants completed the Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test (TMT) A&B, and Animal Naming in Spanish. Raw test scores were converted to demographically-adjusted T-scores based on normative adjustments developed for this population (Neuropsychological Norms for the US-Mexico Border Region in Spanish [NP-NUMBRS]) and norms developed based on samples in Mexico (Latin American Norms from Mexico [LAN-M] and NEUROPSI). Rates of NCI (T < 40) based on the different normative methods were compared via McNemar's tests. Results Rates of NCI for NP-NUMBRS and NEUROPSI fell between the expected 15-17%. Compared to NP-NUMBRS, significantly lower rates were found when applying LAN-M for HVLT-R Total (4%) and Delayed Recall (8%), TMT-A (1%), and Animal Naming (10%; all ps <.0002). No significant differences were found for TMT-B (p >.05). Conclusions Present findings revealed that while the NP-NUMBRS and NEUROPSI norms yielded similar NCI rates, and LAN-M norms underestimated NCI on three tests. This highlights the importance of carefully considering available normative adjustments for Spanish-speakers when applying them to specific populations. [ABSTRACT FROM AUTHOR]