Neuropsychological impairment in racial/ethnic minorities with HIV infection and low literacy levels: Effects of education and reading level in participant characterization

Educational attainment is an important factor in the interpretation of cognitive test scores but years of education are not necessarily synonymous with educational quality among racial/ethnic minority populations. This study investigated the comparability of educational attainment with reading level and examined whether discrepancies in education and reading level accounted for differences in neuropsychological test performance between HIV1 racial/ethnic minority and nonminority participants. Study participants were derived from the Manhattan HIV Brain Bank where 50 percent of the cohort had 8th grade reading level but only 5 percent had 8 years of education. Significantly lower reading ability and education was found among African Americans and Hispanics, and these participants were more likely to have discrepant reading and education levels compared to non-Hispanic Whites. Discrepancy in reading and education level was associated with worse neuropsychological performance while racial/ethnic minority status was not. As years of schooling overestimated racial0ethnic minority participants’ educational quality, standard norms based on education may inflate impairment rates among racial0ethnic minorities. Identifying appropriate normative standards is and will continue to be important in the detection of cognitive impairment in racial0ethnic minorities with HIV