ArticleJournal of the International Neuropsychological Society : JINS2017
Racial Differences in Neurocognitive Outcomes Post-Stroke: The Impact of Healthcare Variables.
Article in Journal of the International Neuropsychological Society : JINS, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
- Ethnic disparities in the longer-term clinical care and outcomes of stroke patients in England.PloS one · 2026Observational
- Trends in Ethnic Disparities in Stroke Care and Long-Term Outcomes.JAMA network open · 2025Article
- Racial and Ethnic Disparities in Stroke Incidence and Outcomes.Current cardiovascular risk reports · 2025Article
- Health Literacy Mediates Racial Differences in Cognitive Functioning among African American/Black and White People with and without HIV in the Deep South.Nursing (Auckland, N.Z.) · 2025Article
- History of obstructive sleep apnea associated with incident cognitive impairment in white but not black individuals in a US national cohort study.Sleep medicine · 2023Article
- New Onset Poststroke Dementia at one Year in Africans.Journal of geriatric psychiatry and neurology · 2022Observational
- Vascular-brain Injury Progression after Stroke (VIPS) study: concept for understanding racial and geographic determinants of cognitive decline after stroke.Journal of the neurological sciences · 2020Review
- Neural and Genetic Bases for Human Ability Traits.Frontiers in human neuroscience · 2020Article
- Lived experiences of chronic cognitive and mood symptoms among community-dwelling adults following stroke: a mixed-methods analysis.Aging & mental health · 2019Article
- Association of sickle cell trait with measures of cognitive function and dementia in African Americans.eNeurologicalSci · 2019Article
- Racial and ethnic disparities in stroke outcomes: a scoping review of post-stroke disability assessment tools.Disability and rehabilitation · 2019Article
- Post-stroke cognitive decline among women in midlife.Women's health (London, England)Observational
- Disability in Community-Dwelling Older Adults: Exploring the Role of Stroke and Dementia.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
objectivesThe present study examined differences in neurocognitive outcomes among non-Hispanic Black and White stroke survivors using the NIH Toolbox-Cognition Battery (NIHTB-CB), and investigated the roles of healthcare variables in explaining racial differences in neurocognitive outcomes post-stroke.
methodsOne-hundred seventy adults (91 Black; 79 White), who participated in a multisite study were included (age: M=56.4; SD=12.6; education: M=13.7; SD=2.5; 50% male; years post-stroke: 1-18; stroke type: 72% ischemic, 28% hemorrhagic). Neurocognitive function was assessed with the NIHTB-CB, using demographically corrected norms. Participants completed measures of socio-demographic characteristics, health literacy, and healthcare use and access. Stroke severity was assessed with the Modified Rankin Scale.
resultsAn independent samples t test indicated Blacks showed more neurocognitive impairment (NIHTB-CB Fluid Composite T-score: M=37.63; SD=11.67) than Whites (Fluid T-score: M=42.59, SD=11.54; p=.006). This difference remained significant after adjusting for reading level (NIHTB-CB Oral Reading), and when stratified by stroke severity. Blacks also scored lower on health literacy, reported differences in insurance type, and reported decreased confidence in the doctors treating them. Multivariable models adjusting for reading level and injury severity showed that health literacy and insurance type were statistically significant predictors of the Fluid cognitive composite (p<.001 and p=.02, respectively) and significantly mediated racial differences on neurocognitive impairment.
conclusionsWe replicated prior work showing that Blacks are at increased risk for poorer neurocognitive outcomes post-stroke than Whites. Health literacy and insurance type might be important modifiable factors influencing these differences. (JINS, 2017, 23, 640-652).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.