Cognitive factor structure of the NACC UDS-3 neuropsychological battery across ethno-racial, linguistic, and cognitive status groups

<b>Objective:</b> There are diagnostic disparities in dementia across ethno-racial communities. The potential contribution of measurement bias in cognitive assessments was investigated by examining the factor structure and measurement invariance of the Uniform Data Set neuropsychological battery (UDS3-NB) across ethno-racial groups as well as Spanish and English speakers along a cognitive continuum. <b>Methods:</b> Data were from the National Alzheimer's Coordinating Center (NACC) and the 1Florida Alzheimer's Disease Research Center (1FLADRC). Confirmatory factor analyses were conducted in NACC (<i>n</i> = 29,462; <i>M</i> age = 71.0, <i>SD</i> = 10.4; 58.5% female, <i>M</i> education = 15.8, <i>SD</i> = 3.0; 68.6% non-Hispanic White, 5.3% -primary Spanish speaking) to determine the UDS3-NB factor structure. Measurement invariance was tested in NACC and separately within 1FLADRC (<i>n</i> = 829; <i>M</i> age = 69.9, <i>SD</i> = 8.5; 56.5% female; <i>M</i> education = 14.6, <i>SD</i> = 3.5 years; 33.3% non-Hispanic White, 33.8% primary Spanish speaking), across ethno-racial (non-Hispanic White, Hispanic White, Black/African American), primary language (English, Spanish), and cognitive status (cognitively normal, mild cognitive impairment, dementia). Invariance was assessed at configural, metric, scalar, and strict levels. <b>Results:</b> A 4-factor model (memory, processing speed/executive functioning, language, attention) demonstrated acceptable to good fit in NACC (CFI = 0.97, TLI = 0.96, RMSEA = 0.07, SRMR = 0.03) and 1FLADRC (CFI = 0.97, TLI = 0.96, RMSEA = 0.05, SRMR = 0.04). Standardized factor loadings ranged from 0.43-0.87. Metric invariance was supported across all contrasts in both cohorts. Higher levels of invariance were cohort-dependent: CN vs. MCI achieved strict invariance in both cohorts, whereas non-Hispanic White vs. Hispanic White and English vs. Spanish only achieved strict invariance in NACC. <b>Conclusions:</b> The UDS3-NB demonstrates structural validity and metric equivalence across ethno-racial, linguistic, and cognitive status groups.

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Publication Details

Journal
The Clinical Neuropsychologist
Published
2025-10-24
DOI
https://doi.org/10.1080/13854046.2025.2576154
Citations
2
Primary Topic
Neurobiology of Language and Bilingualism
Type
article
Field-Weighted Citation Impact
2.86
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article

Cognitive factor structure of the NACC UDS-3 neuropsychological battery across ethno-racial, linguistic, and cognitive status groups

Allison A. Holgerson, Franchesca Arias, Breton M. Asken, Rosie E. Curiel et al.
2 citations
The Clinical Neuropsychologist
Neurobiology of Language and Bilingualism
2.86
article

Cognitive factor structure of the NACC UDS-3 neuropsychological battery across ethno-racial, linguistic, and cognitive status groups

Allison A. Holgerson, Franchesca Arias, Breton M. Asken, Rosie E. Curiel, Melissa J. Armstrong, Emily F. Matusz, Mónica Rosselli, Andrew M. Kiselica, Michael Marsiske, Shellie‐Anne Levy, Glenn E. Smith, Jacob Fiala, David Loewenstein, Ranjan Duara, Idaly Vélez-Uribe
article en
2 citations

Abstract

<b>Objective:</b> There are diagnostic disparities in dementia across ethno-racial communities. The potential contribution of measurement bias in cognitive assessments was investigated by examining the factor structure and measurement invariance of the Uniform Data Set neuropsychological battery (UDS3-NB) across ethno-racial groups as well as Spanish and English speakers along a cognitive continuum. <b>Methods:</b> Data were from the National Alzheimer's Coordinating Center (NACC) and the 1Florida Alzheimer's Disease Research Center (1FLADRC). Confirmatory factor analyses were conducted in NACC (<i>n</i> = 29,462; <i>M</i> age = 71.0, <i>SD</i> = 10.4; 58.5% female, <i>M</i> education = 15.8, <i>SD</i> = 3.0; 68.6% non-Hispanic White, 5.3% -primary Spanish speaking) to determine the UDS3-NB factor structure. Measurement invariance was tested in NACC and separately within 1FLADRC (<i>n</i> = 829; <i>M</i> age = 69.9, <i>SD</i> = 8.5; 56.5% female; <i>M</i> education = 14.6, <i>SD</i> = 3.5 years; 33.3% non-Hispanic White, 33.8% primary Spanish speaking), across ethno-racial (non-Hispanic White, Hispanic White, Black/African American), primary language (English, Spanish), and cognitive status (cognitively normal, mild cognitive impairment, dementia). Invariance was assessed at configural, metric, scalar, and strict levels. <b>Results:</b> A 4-factor model (memory, processing speed/executive functioning, language, attention) demonstrated acceptable to good fit in NACC (CFI = 0.97, TLI = 0.96, RMSEA = 0.07, SRMR = 0.03) and 1FLADRC (CFI = 0.97, TLI = 0.96, RMSEA = 0.05, SRMR = 0.04). Standardized factor loadings ranged from 0.43-0.87. Metric invariance was supported across all contrasts in both cohorts. Higher levels of invariance were cohort-dependent: CN vs. MCI achieved strict invariance in both cohorts, whereas non-Hispanic White vs. Hispanic White and English vs. Spanish only achieved strict invariance in NACC. <b>Conclusions:</b> The UDS3-NB demonstrates structural validity and metric equivalence across ethno-racial, linguistic, and cognitive status groups.

The Clinical Neuropsychologist
Mount Sinai Hospital (US), University of Miami (US), University of Georgia (US), University of Florida Health (US), University of Florida (US), Mount Sinai Medical Center (US), Alzheimer’s Disease Neuroimaging Initiative (US), Cognitive Research (United States) (US), Florida Atlantic University (US)
Openalex Percentile: Top 8%
Neurobiology of Language and Bilingualism
2.86
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