Clinical neuropsychology relies on the use of appropriate test norms. Normative studies frequently stratify based on age, education, sex, and race. None to date has reported norms based on literacy, despite the substantial evidence that literacy impacts cognitive functioning. Some researchers have suggested that literacy is a more accurate reflection of academic achievement and quality of education than years of education, particularly for African Americans. The current study provides literacy-based normative data for multiple neuropsychological measures based on a sample of predominantly low socioeconomic status African Americans. These normative data should improve the diagnostic accuracy of performances by African-American clients with similar demographic backgrounds.? ? We examined the association of total comorbid score and specific chronic conditions including cardiovascular diseases, musculoskeletal conditions, diabetes mellitus, stroke, hypertension, and cancer with several cognitive domains across four different age groups: young adults (ages 18-34), young middle-aged adults (ages 35-50), middle-aged adults (ages 51-64), and older adults (ages >64). Cognitive tests measuring global ability, executive function, memory function, and perceptual speed ability were administered to 384 African Americans. Total comorbid score was computed by summing up the number of chronic conditions. Results showed an inverse association between total comorbid scores and executive and memory functions in the total sample. With the exception of the youngest group, stroke was the only prominent predictor of poor performance for all age groups, but the impact was greater in the younger age groups compared with older adults. These results suggest that the impact of medical conditions on domain specific tasks may be modified by age.
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