Use of the WHO/UCLA-AVLT-SV for culturally sensitive assessment of Alzheimer's disease with a Spanish-speaking, Hispanic population.

摘要

Clear demographic trends show the population of the United States is becoming both older and more culturally diverse, a direct consequence of which is a dramatic increase in dementia. Given the central role neuropsychological assessment plays in the differential diagnosis of Alzheimer's disease (AD), it is essential to have valid and reliable assessment tools that are applicable across diverse cultures. This cross-sectional study examined the sensitivity of a culturally neutral measure of auditory verbal learning and memory, namely the WHO/UCLA AVLT-SV, to AD-associated cognitive impairment in a Spanish-speaking, Hispanic group. This study also determined whether the characteristic pattern of impairment, reported with Anglo-American AD subjects on similar measures (critical to differential diagnosis), held true. Participants included 62 subjects (31 normal controls and 31 AD patients), drawn from archival research conducted by Rancho Los Amigos National Rehabilitation Center/USC Geriatric Neurobehavior and Alzheimer Research Center, located in Downey, Southern California. Results of this study were as follows: (a) no correlations between test performance and age or gender, and only two correlations with education (trial I/NC and trial VIII/AD) and language (learning curve/NC and trial VII/AD); (b) normal control subjects scored significantly higher across all indices of the WHO/UCLA AVLT-SV than AD subjects; and (c) the characteristic pattern of impairment was demonstrated by the AD group (impaired recent memory, little learning curve, rapid rate of forgetting, poor recognition, intrusive errors, and a greater recency than primacy effect). These findings indicate that the WHO/UCLA AVLT-SV is sensitive to AD-associated cognitive impairment, whilst the consistency in qualitative performance for the AD group suggests that this pattern may represent a genuinely universal or ethic finding. This study adds to the limited literature regarding the memory functioning of U.S. Hispanics and thus contributes to ethical clinical practice for clinicians.