Disparate trajectories of cognitive aging among American Indian and Alaskan Native people with and without HIV.

OBJECTIVE: This study describes trajectories of cognitive aging among American Indian/Alaskan Native (AI/AN) adults with and without HIV and the role of immunosenescence longitudinally. METHOD: We characterized trajectories of cognitive aging in a sample of 333 AI/AN and 309 non-Hispanic White (NHW) adults who were followed longitudinally for up to 20 years by the HIV Neurobehavioral Research Program (HNRP) across six U.S. research sites. We used growth curve modeling with autoregressive Lag-1 structures and heterogeneous residual variances to assess the role of ethnoracial identity and HIV grouping upon decline in trajectories of cognitive aging. RESULTS: HIV- AI/AN adults demonstrated earlier and steeper decline in normative trajectories of cognitive aging on tasks of processing speed, timed tasks of attention/working memory, executive function, and psychomotor speed in comparison to HIV- NHW adults. Accentuated trajectories of cognitive aging were evident in both HIV+ and HIV+ immunosuppressed groups in comparison to HIV- peers and were primarily driven by the role of immunosenescence. CONCLUSIONS: AI/AN disparities in trajectories of cognitive aging are evident and are likely explained by the interplay of biopsychosociocultural factors, including immunosenescence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Illiteracy: the neuropsychology of cognition without reading.

Illiterates represent a significant proportion of the world's population. Written language not only plays a role in mediating cognition, but also extends our knowledge of the world. Two major reasons for illiteracy can be distinguished, social (e.g., absence of schools), and personal (e.g., learning difficulties). Without written language, our knowledge of the external world is partially limited by immediate sensory information and concrete environmental conditions. Literacy is significantly associated with virtually all neuropsychological measures, even though the correlation between education and neuropsychological test scores depends on the specific test. The impact of literacy is reflected in different spheres of cognitive functioning. Learning to read reinforces and modifies certain fundamental abilities, such as verbal and visual memory, phonological awareness, and visuospatial and visuomotor skills. Functional imaging studies are now demonstrating that literacy and education influence the pathways used by the brain for problem-solving. The existence of partially specific neuronal networks as a probable consequence of the literacy level supports the hypothesis that education impacts not only the individual's day-to-day strategies, but also the brain networks. A review of the issues related to dementia in illiterates is presented, emphasizing that the association between the education level and age-related cognitive changes and education remains controversial. The analysis of the impact of illiteracy on neuropsychological test performance represents a crucial approach to understanding human cognition and its brain organization under normal and abnormal conditions.

Professional considerations for improving the neuropsychological evaluation of Hispanics: a National Academy of Neuropsychology education paper.

In a national survey, 82% of U.S. neuropsychologists who offered services to Hispanics self-reported inadequate preparation to work with this population (Echemendia, Harris, Congett, Diaz, & Puente, 1997). The purpose of this paper is to improve the quality and accessibility of neuropsychological services for Hispanic people living in the United States by giving guidance for service delivery, training, and organizational policy. General guidance towards this end comes from professional ethics for psychologists and interpreters/translators, federal civil rights law, the International Test Commission, and the Office of Minority Health of the U.S. Department of Health and Human Services, among others. This guidance is specifically applied here to cover professional cultural and linguistic competence of neuropsychologists, psychometrists, interpreters, translators, and consultants; languages of evaluation; use of interpreters; evaluation of acculturation; test translation, adaptation, and interpretation; application of test norms; intervention issues; reimbursement; and organizational issues.

Community-based neuropsychological rehabilitation in the cosmopolitan setting.

In the developed, urban world, professional neuropsychological rehabilitation services have increasingly tried to move into the community to facilitate community integration, acceptance of rehabilitation, acceptance of the person with disabilities in the community, and the generalisation of cognitive, emotional, and social skills. This promising trend has only partially realised its goals. In the developing, rural world, rehabilitation has worked directly with community resources towards similar goals through the World Health Organization's community-based rehabilitation model, but with limited focus on neuropsychological disabilities (Judd & DeBoard, 2007). We have previously proposed a neuropsychological extension of this model. We now propose a blending of these trends to address developed, urban community needs with respect to people with neuropsychological disabilities. The approach involves expanding objectives, funding, training, and research measures to address community change. Techniques include: (1) involvement of community members (including people with disabilities) in planning, decision-making, and evaluation of programmes; (2) discovering and using available community resources; (3) teaching community members about disabilities, rights, and attitudes and training them in rehabilitation and advocacy skills; and (4) coordination between rehabilitation, education, social, vocational, and other community resources.

Rehabilitation of the emotional problems of brain disorders in developing countries.

Emotional and behavioural problems of people with brain disorders are major undertreated problems in developing countries. These can be addressed by training lay volunteers in community-based rehabilitation. Training and pro gramme implementation must be highly sensitive to local conditions. Basic concepts that can be trained in such conditions include case finding, triage, evaluation skills, emotional rehabilitation, restoration and compensation strategies, the continuum of responsibility, the zone of recovery, scaffolding, adjusting the person-environment fit, awareness of deficits, setting goals, communicating with others about the disability, disability rights, support groups, and circles of support.