ArticleJournal of the International Neuropsychological Society : JINS2022
Assessing Bias in Cognitive Testing for Older Adults with Sensory Impairment: An Analysis of Differential Item Functioning in the Baltimore Longitudinal Study on Aging (BLSA) and the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS).
Article in Journal of the International Neuropsychological Society : JINS, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Effect of hearing aids on cognitive functions in middle-aged and older adults with hearing loss: A systematic review and meta-analysis.Frontiers in aging neuroscience · 2022Pooled it
- Hearing Loss, Cognitive Decline, and Dementia: Clinical Intersections.Audiology research · 2026Review
- Hearing Loss Among Older Adults: Epidemiology, Disparities, and Gaps in Research.Annual review of public health · 2026Review
- ReacStick: Evaluating Executive Function Independent From Level of Education.American journal of physical medicine & rehabilitation · 2026Article
- Epidemiology of visuospatial impairment in older adults: the Harmonized Cognitive Assessment Protocol.Innovation in aging · 2026Article
- Observational
- Sensory impairment and dementia risk among older adults in rural South Africa.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- The Association of Vision and Hearing Impairment on Cognitive Function and Loneliness: Evidence From the Mexican Health and Aging Study.Journal of aging and health · 2025Article
- Language, literacy, and sensory impairments and missing cognitive test scores in the Harmonized Cognitive Assessment Protocol of the China Health and Retirement Longitudinal Study.Aging clinical and experimental research · 2025Article
- Sensory and motor deficits as contributors to early cognitive impairment.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Cognitive change in prevalent and incident hearing loss: The Maastricht Aging Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Hearing loss and cognition: A protocol for ensuring speech understanding before neurocognitive assessment.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- The Influence of Vision Impairment on the Measurement of Cognition in Older Adults in India: Findings From LASI-DAD.Innovation in aging · 2024Article
- Accuracy of self- and proxy-rated hearing among older adults with and without cognitive impairment.Journal of the American Geriatrics Society · 2022Article
- Hearing Loss and Cognition: What We Know and Where We Need to Go.Frontiers in aging neuroscience · 2021Review
- Vision and hearing difficulty and effects of cognitive training in older adults.Alzheimer's & dementia (Amsterdam, Netherlands)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesVision and hearing impairments affect 55% of people aged 60+ years and are associated with lower cognitive test performance; however, tests rely on vision, hearing, or both. We hypothesized that scores on tests that depend on vision or hearing are different among those with vision or hearing impairments, respectively, controlling for underlying cognition.
methodsLeveraging cross-sectional data from the Baltimore Longitudinal Study of Aging (BLSA) and the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), we used item response theory to test for differential item functioning (DIF) by vision impairment (better eye presenting visual acuity worse than 20/40) and hearing impairment (better ear .5-4 kHz pure-tone average > 25 decibels).
resultsWe identified DIF by vision impairment for tests whose administrations do not rely on vision [e.g., Delayed Word Recall both in ARIC-NCS: .50 logit difference between impaired and unimpaired (p = .04) and in BLSA: .62 logits (p = .02)] and DIF by hearing impairment for tests whose administrations do not rely on hearing [Digit Symbol Substitution test in BLSA: 1.25 logits (p = .001) and Incidental Learning test in ARIC-NCS: .35 logits (p = .001)]. However, no individuals had differences between unadjusted and DIF-adjusted measures of greater than the standard error of measurement.
conclusionsDIF by sensory impairment in cognitive tests was independent of administration characteristics, which could indicate that elevated cognitive load among persons with sensory impairment plays a larger role in test performance than previously acknowledged. While these results were unexpected, neither of these samples are nationally representative and each has unique selection factors; thus, replication is critical.
Indexed as
Identifiers
What OpenQuestion holds
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.