Home › Research › Getting a diagnosis
Measurement differences in the Harmonized Cognitive Assessment Protocol across ethnicity and language in the United States
Emily M. Briceño, Lewis B. Morgenstern, Zachary J. Kunicki, Deborah A. Levine, Roshanak Mehdipanah, Nelda M Garcia, Wen Joen Chang, Xavier F. Gonzales et al.. Neuropsychology, 2026-02-09
Topic: Risk, prevention and care in population studies
We observed measurement differences in the HCAP across H/L and NHW older adults for the memory, language, executive functioning, and orientation, but not visuospatial, domains. Effect sizes for measurement differences in HCAP items ranged from small to large. Not accounting for measurement differences led to meaningful underestimation of cognitive function ranging from 5% (language domain) to 82% (executive functioning domain) of H/L individuals assessed in English and 11% (memory domain) to 96% (executive functioning domain) of H/L individuals assessed in Spanish. The interpretation of ethnic differences in cognitive function with the HCAP may be confounded with measurement differences. Measurement equivalence in cognitive assessment instruments across H/L and NHW populations cannot be assumed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Key findings
- We observed measurement differences in the HCAP across H/L and NHW older adults for the memory, language, executive functioning, and orientation, but not visuospatial, domains.
- Effect sizes for measurement differences in HCAP items ranged from small to large.
- Not accounting for measurement differences led to meaningful underestimation of cognitive function ranging from 5% (language domain) to 82% (executive functioning domain) of H/L individuals assessed in English and 11% (memory domain) to 96% (executive functioning domain) of H/L individuals assessed in Spanish.
- The interpretation of ethnic differences in cognitive function with the HCAP may be confounded with measurement differences.
- Measurement equivalence in cognitive assessment instruments across H/L and NHW populations cannot be assumed.
Why it matters
This study found measurement differences in a cognitive assessment protocol across Hispanic/Latino and non-Hispanic White older adults. It shows that measurement equivalence cannot be assumed, which affects how cognitive test results are interpreted, not how dementia is treated or prevented.
New to this subject? Start with our plain-English guide: Getting a diagnosis →
Study details
- Evidence strengthLow
How this study scored 39/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 37 of the 96 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Neuropsychology) |
| Journal's citation record | 2 / 4 | Neuropsychology: journal h-index 183 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| 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 | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| 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 | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 3 / 6 | Cited 4.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Richard N Jones holds only 1 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41661589) |
| Free to read | 2 / 2 | Free to read |
| Points | 37 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 37 of the 96 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Briceño, E. M., Morgenstern, L. B., Kunicki, Z. J., Levine, D. A., Mehdipanah, R., Garcia, N. M., et al. (2026). Measurement differences in the Harmonized Cognitive Assessment Protocol across ethnicity and language in the United States. Neuropsychology. https://doi.org/10.1037/neu0001059
Vancouver
Briceño EM, Morgenstern LB, Kunicki ZJ, Levine DA, Mehdipanah R, Garcia NM, et al. Measurement differences in the Harmonized Cognitive Assessment Protocol across ethnicity and language in the United States. Neuropsychology. 2026. doi:10.1037/neu0001059. PMID: 41661589.
BibTeX
@article{briceno2026-41661589,
author = {Briceño, Emily M. and Morgenstern, Lewis B. and Kunicki, Zachary J. and Levine, Deborah A. and Mehdipanah, Roshanak and Garcia, Nelda M and Chang, Wen Joen and Gonzales, Xavier F. and others},
title = {{Measurement differences in the Harmonized Cognitive Assessment Protocol across ethnicity and language in the United States}},
journal = {Neuropsychology},
year = {2026},
doi = {10.1037/neu0001059},
pmid = {41661589},
url = {https://doi.org/10.1037/neu0001059}
}
Related studies in Getting a diagnosis
Also tagged “assessment”
840 studies in the library carry the topic tag “assessment”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 840 tagged studies.