How do age, education and sex affect word-list memory in China?
In healthy Chinese adults, older age and fewer years of education were linked to poorer learning and recall of word lists, while sex made little difference, and the translated test picked up memory problems in people with multiple sclerosis.
Source
Effects of age, sex, and education on California Verbal Learning Test-II performance in a Chinese-speaking population
Study at a glance
- Design
- Cross-sectional — Single testing session with a translated CVLT-II; ANCOVAs and regressions of scores on age group, education group and sex, plus comparison of 29 MS patients with 58 matched controls and ROC analysis
- N
- N=246 · 246 cognitively healthy adults (114 men, 132 women) for the age/sex/education analyses; separate comparison of 29 people with relapsing-remitting MS versus 58 matched healthy participants
- Population
- Cognitively healthy Chinese adults aged 21-80 recruited from the community in Tianjin, and people with relapsing-remitting multiple sclerosis from Tianjin Medical University General Hospital
- Outcome
- CVLT-II indices: total learning over five trials, short- and long-delay free and cued recall, semantic and serial clustering, serial position effects, recognition hits, false positives and discriminability
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What they did
The researchers translated the California Verbal Learning Test-II, in which people hear a 16-word list from four categories five times and then recall it immediately, after a distractor list, and after 20 minutes, with and without category cues, followed by a recognition test. They gave it to 246 cognitively healthy adults aged 21 to 80 and compared performance across six age bands, three education bands and the two sexes, controlling for the other variables. They also compared 29 people with multiple sclerosis with 58 healthy people matched on age, sex and education.
What they found
Performance on learning, delayed recall, recognition and semantic clustering (recalling words grouped by category) was worse with older age and better with more education. Differences were small within the young groups (20s vs 30s) and within the older groups (50s to 70s), suggesting the sharpest drop happens around middle age. Sex had few effects: women had more recognition hits and men showed more repetitions and a stronger recency effect. People with MS learned and recalled fewer words and used semantic clustering less, but the test separated them from controls only modestly, with a best area under the curve of about 0.69.
The limits
What it doesn't show
Because different people of different ages were tested once, the study shows age differences rather than how memory changes within individuals over time, and generational differences in schooling could contribute. With 246 people split into six age bands and three education bands, some cells were small, and there were no women in their 20s with low education. Healthy participants were not given brain scans or biomarker tests, so some older adults may have had undetected disease. The MS comparison was small and the test's ability to distinguish patients was only modest.
Key terms
- Episodic memory
- Memory for specific personal events or items encountered at a particular time and place, such as a list of words heard in a test.
- Semantic clustering
- An encoding strategy of recalling words grouped by their shared category, such as naming all the animals together.
- Serial position effect
- The tendency to recall items from the beginning (primacy) and end (recency) of a list better than those in the middle.
- Recognition discriminability
- How well someone tells studied words from new ones, calculated as hit rate minus false-positive rate.
- Normative data
- Scores from a healthy reference sample, adjusted for factors like age and education, used to judge whether an individual's performance is impaired.
- ROC curve and AUC
- A way of measuring how well a test separates two groups; an area under the curve of 0.5 is chance and 1.0 is perfect.
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Quiz yourself
Which factor had the weakest influence on CVLT-II performance in healthy adults?
Common questions
Why does education matter for a memory test?
The authors suggest education may build cognitive reserve through mental stimulation, go along with healthier lifestyles, and teach efficient encoding strategies like grouping words by meaning, all of which could improve recall.
Why include people with multiple sclerosis?
To check that the translated test detects real memory impairment. MS commonly affects verbal learning, and the MS group did score worse than matched controls.
Does this show memory declines sharply in middle age?
It hints at it, since differences were small within the young and within the older groups, but a cross-sectional design cannot confirm when individuals actually decline.
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