Exploration of executive function measures in native English-speaking adults with varying education and reading levels

Neuropsychological performance is influenced by demographic/premorbid factors in addition to acquired cognitive impairment. This study examined relationships between educational attainment, reading ability, and executive functions in a clinical sample. We conducted a retrospective analysis of 71 adult native English-speaking neuropsychology outpatients who completed Color Trails Test (CTT), Trail Making Test (TMT), Wechsler Test of Adult Reading (WTAR), and Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference, Verbal Fluency, and Design Fluency subtests. Linear regressions and t-tests examined associations among education, WTAR scores, and executive performance. Both TMTB and CTT2 significantly predicted cognitive impairment ratings (CTT2 (B = .008, p < .001) and Trails B (B = .008, p < .001)), and their predictive strength did not differ significantly (z = –.86, p > .05). WTAR scores demonstrated stronger and more consistent associations with executive performance and impairment ratings than years of education. In patients with lower WTAR scores (WTAR≤ 85, N = 19), performance on CTT2 was significantly faster than TMTB (t[18] = –2.726, p = .014), while no significant difference was observed in the higher WTAR group. These preliminary findings from an exploratory retrospective study support further investigation of the influence of reading ability on executive functioning test performance. Future research should examine potential mechanisms, including educational quality, literacy-related factors, and premorbid cognitive ability.