1. Developing a Scientific Agenda for Cultural Neuropsychology Jennifer Manly HNS Conference November 2015

2. Overview Examples of gaps in knowledge with impact on practice Bilingualism as protective factor Neuropathology among African Americans with AD Interdisciplinary approaches Lifecourse Model Deconstructing culture to understand mechanisms Summary

3. Bilingualism and cognitive aging Bialystok suggests that the continuous task of managing competing representations of two languages imparts cognitive reserve However, the results of these studies are mixed (Zahodne, Schofield, Farrell, Stern, & Manly, 2013)

4. Prior studies on bilingualism and cognitive aging/dementia ProtectiveNo effect Cross-sectional Retrospective Alladi et al., 2013 Bialystok et al., 2007 Bialystok et al., 2012 Craik et al., 2010 Gollan et al., 2011 Schweizer et al., 2013 Kavé et al., 2008 Longitudinal Trajectory Incidence Zahodne et al., 2014 Crane et al., 2009 Sanders et al., 2012 Yeung et al., 2014 Lawton et al., 2015

5. Zahodne et al., (2014) Survival curves by (a) age, (b) education, (c) gender, and (d) degree of bilingualism

6. Barnes et al. Neurology 2015 Racial differences in mixed pathology in black and white decedents with Alzheimer disease (AD) dementia

7. Source: Carl Hill, PhD

8. Lifecourse Model of Disparities in Cognitive Aging Glymour & Manly, 2008

9. Deconstructing Race/Ethnicity and Education Socioeconomic status Years of school School quality Exposure to mainstream culture Geographic region Motivation Racial socialization Stereotype threat Early life SES Genetics Early life nutrition Access to health care Cerebrovascular function Chronic medical illness Accelerated aging Racial discrimination

10. Conclusions Critical knowledge gaps in cultural neuropsychology must be addressed To understand mechanisms and reduce disparities in cognitive test performance and neurocognitive disorders To improve diagnostic accuracy of neuropsychological tests To understand brain behavior relationships Social justice and health equity Training in interdisciplinary science is fundamental Lifecourse model of cultural neuropsychology Race/ethnicity are meaningful variables in neuropsychology