Home › Research › Disparities
Cognitive test performance among nondemented elderly African Americans and whites
Manly JJ, Jacobs DM, Sano M, Bell K, Merchant CA, Small SA, Stern Y.. Neurology, 1998-05-01
Topic: Risk, prevention and care in population studies
We examined the neuropsychological test performance of a randomly selected community sample of English-speaking non-Hispanic African American and white elders in northern Manhattan. All participants were diagnosed as nondemented by a neurologist, whose assessment was made independent of neuropsychological test scores. African American elders obtained significantly lower scores on measures of verbal and nonverbal learning and memory, abstract reasoning, language, and visuospatial skill than whites. After using a stratified random sampling technique to match groups on years of education, many of the discrepancies became nonsignificant; however, significant ethnic group differences on measures of figure memory, verbal abstraction, category fluency, and visuospatial skill remained. Discrepancies in test performance of education-matched African Americans and whites could not be accounted for by occupational attainment or history of medical conditions such as hypertension and diabetes. These findings emphasize the importance of using culturally appropriate norms when evaluating ethnically diverse elderly for dementia.
Key findings
- African American elders obtained significantly lower scores on measures of verbal and nonverbal learning and memory, abstract reasoning, language, and visuospatial skill than whites.
- After using a stratified random sampling technique to match groups on years of education, many of the discrepancies became nonsignificant; however, significant ethnic group differences on measures of figure memory, verbal abstraction, category fluency, and visuospatial skill remained.
- These findings emphasize the importance of using culturally appropriate norms when evaluating ethnically diverse elderly for dementia.
Why it matters
This study found that nondemented African American elders scored lower than white elders on several cognitive tests, and some differences remained after matching for years of education. This is about how test performance differs between groups and the need for culturally appropriate norms, not about treating, curing, or preventing Alzheimer's disease.
New to this subject? Start with our plain-English guide: Disparities →
Study details
- Evidence strengthLow
How this study scored 63/100
Published in a leading specialty journal, and it is a randomised controlled trial. Scored zero for sample size and effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1998 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 5 / 7 | Cited 234 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 7.8 citations a year over 30 year(s) since 1998 |
| Impact for its field and year | 3 / 6 | Cited 4.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 13 other studies in this library |
| Still being cited | 2 / 4 | Cited 17 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Yaakov Stern: h-index 162 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Columbia University: institution h-index 1,824 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 9595969) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 63 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1212/wnl.50.5.1238
- PubMed: 9595969
- Original source →
- Free full text: Columbia Academic Commons (Columbia University) →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Manly, J. J., Jacobs, D. M., Sano, M., Bell, K., Merchant, C. A., Small, S. A., et al. (1998). Cognitive test performance among nondemented elderly African Americans and whites. Neurology. https://doi.org/10.1212/wnl.50.5.1238
Vancouver
Manly JJ, Jacobs DM, Sano M, Bell K, Merchant CA, Small SA, et al. Cognitive test performance among nondemented elderly African Americans and whites. Neurology. 1998. doi:10.1212/wnl.50.5.1238. PMID: 9595969.
BibTeX
@article{manly1998-9595969,
author = {Manly, J. J. and Jacobs, D. M. and Sano, M. and Bell, K. and Merchant, C. A. and Small, S. A. and Stern, Y.},
title = {{Cognitive test performance among nondemented elderly African Americans and whites}},
journal = {Neurology},
year = {1998},
doi = {10.1212/wnl.50.5.1238},
pmid = {9595969},
url = {https://doi.org/10.1212/wnl.50.5.1238}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
13 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.
Related studies in Disparities
Also tagged “cognitive-function”
1,118 studies in the library carry the topic tag “cognitive-function”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 1,118 tagged studies.