The performance of cognitive tests is highly dependent on the proficiency of the language in which the tests are administered. Not all Indonesians speak Indonesian daily and many are bilingual. We investigate whether language(s) spoken affects the performance on three language tests in 840 participants ranging in age (16–80) and education (6–22 years). Analysis of covariance followed by Helmert contrasts showed a disadvantage on the Boston Naming Test (BNT) and on the most difficult items of the Token Test for those who do not speak Bahasa daily. Bilinguals did worse on the BNT. Education had a large positive effect on the language tests, age a smaller negative effect. This suggests that besides age and education, the factor of language spoken, either in public or at home, needs to be taken into account when a participant's test scores on the BNT and TT are interpreted and compared with normative data.

Specific language impairment (SLI) is a very common childhood disorder that is characterized by impairments in expressive and/or receptive language regarding different modalities. Part V of the German version of the Token Test was evaluated as a potential screening tool for the early detection of SLI. Forty-five male and 16 female monolingual native German-speaking preschoolers with SLI (4–6 years) and 61 age- and gender-matched typically developing controls were examined with a German version of the Token Test and an established intelligence measure. Token Test performance was significantly worse in preschoolers with SLI including greater group differences at age 4 than at ages 5 and 6. Analyses showed a detection rate of 77% for Part V of the Token Test in the whole sample as well as 85.1% at age 4, 80.6% at age 5, and a nonsignificant detection at age 6. Correctly detected preschoolers with SLI showed significantly worse performance than typically developing controls regarding nonverbal and verbal intelligence, numeracy, problem solving, working memory, visual attention, and memory. Children with SLI show worse Token Test performance, whereas at ages 4 and 5, Part V of the Token Test could potentially serve as a screening tool for the detection of SLI.

Background: Neuropsychological tests, including tests of language ability, are frequently used to differentiate normal from pathological cognitive aging. However, language can be particularly difficult to assess in a standardized manner in cross-cultural studies and in patients from different educational and cultural backgrounds. This study examined the effects of age, gender, education and race on performance of two language tests: the animal fluency task (AFT) and the Indiana University Token Test (IUTT). We report population-based normative data on these tests from two combined ethnically divergent, cognitively normal, representative population samples of older adults.

Methods: Participants aged ≥65 years from the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) and from the Indianapolis Study of Health and Aging (ISHA) were selected based on (1) a Clinical Dementia Rating (CDR) score of 0; (2) non-missing baseline language test data; and (3) race self-reported as African-American or white. The combined sample (n = 1885) was 28.1% African-American. Multivariate ordinal logistic regression was used to model the effects of demographic characteristics on test scores.

Results: On both language tests, better performance was significantly associated with higher education, younger age, and white race. On the IUTT, better performance was also associated with female gender. We found no significant interactions between age and sex, and between race and education.

Conclusions: Age and education are more potent variables than are race and gender influencing performance on these language tests. Demographically stratified normative tables for these measures can be used to guide test interpretation and aid clinical diagnosis of impaired cognition.