School of Medicine Publications and Presentations
Document Type
Article
Publication Date
10-16-2025
Abstract
Introduction: Neuropsychological assessment of bilingual (English/Spanish) individuals presents challenges that can impact test validity. Language proficiency influences cognitive performance, yet clear guidelines for determining the appropriate test language are lacking. We describe our experiences at the South Texas Alzheimer's Disease Research Center (STAC) in addressing these challenges within the context of National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS) assessments and broader Alzheimer's Disease Research Center (ADRC) protocols. We outline steps toward a structured language assessment approach.
Methods: We implemented a process to assess language proficiency, integrating self-reported and objective measures, including the language dominance index (LDI). Case examples illustrate the impact of language on cognitive testing.
Results: Challenges included discrepancies between self-reported and objective language proficiency, language switching during assessments, and resistance to testing in the dominant language.
Discussion: Language assessment improves test validity and research consistency. Future efforts should refine bilingual assessment methods and establish standardized protocols.
Highlights: Systematic test language selection may improve accuracy in bilingual assessments. Discrepancies in reported versus objective language proficiency challenge bilingual assessments. Language evaluation guidelines are needed to improve test validity and data consistency.
Recommended Citation
Santiago-Mejias, S., Hromas, G., LaRoche, A., Gonzalez, D. A., Hilsabeck, R. C., Rascovsky, K., Arango, S. M., Werry-McFarlin, A., Satizabal, C. L., Trevino, H., Goss, M., Bosque, J. D., Seidl, A., Garcia, R., Valdez, M. S., Velarde, A., Zapata, J., Gates, S., Hernandez, P., Toranzo, J., … Sullivan, A. C. (2025). Addressing language challenges in bilingual neuropsychological assessments at the South Texas Alzheimer's Disease Research Center (ADRC). Alzheimer's & dementia : the journal of the Alzheimer's Association, 21(10), e70800. https://doi.org/10.1002/alz.70800
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.
Publication Title
Alzheimer's & Dementia
DOI
10.1002/alz.70800
Academic Level
faculty
Mentor/PI Department
Neuroscience

Comments
© 2025 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.