Development of a Screening Algorithm for Alzheimer's Disease Using Categorical Fluency and Confrontational Naming Abilities

OBJECTIVE: Declines in naming ability and semantic memory are well-known features of early Alzheimer's disease (AD). We developed a new screening algorithm for AD using two brief language tests : the Categorical Fluency Test (CFT) and 15-item Boston Naming Test (BNT15). METHODS: We administered the CFT, BNT15, and Mini-Mental State Examination (MMSE) to 150 AD patients with a Clinical Dementia Rating of 0.5 or 1 and to their age- and gender-matched cognitively normal controls. We developed a composite score for screening AD (LANGuage Composite score, LANG-C) that comprised demographic characteristics, BNT15 subindices, and CFT subindices. We compared the diagnostic accuracies of the LANG-C and MMSE using receiver operating curve analysis. RESULTS: The LANG-C was calculated using the logit of test scores weighted by their coefficients from forward stepwise logistic regression models : logit (case)=12.608−0.107×age+1.111×gender+0.089×education−0.314×HS(1st)−0.362×HS(2nd)+0.455×perseveration+1.329×HFCR(2nd)−0.489×MFCR(1st)−0.565×LFCR(3rd). The area under the curve of the LANG-C for diagnosing AD was good (0.894, 95% confidence interval=0.853–0.926 ; sensitivity=0.787, specificity=0.840), although it was smaller than that of the MMSE. CONCLUSION: The LANG-C, which is easy to automate using PC or smart devices and to deliver widely via internet, can be a good alternative for screening AD to MMSE.

Development of an adapted version of the Boston Naming Test for Portuguese speakers / Desenvolvimento de uma versão adaptada do Boston Naming Test para a língua portuguesa

OBJECTIVE: To present the development of an adapted version of the Boston Naming Test for Portuguese speakers, and to investigate the effects of age, education and gender on both the original and the adapted Boston Naming Test in respect of Brazilian Portuguese speakers. METHOD: Eighty items, including the 60 original ones and 20 adapted items were administered to 739 healthy Brazilian subjects aged between 6 and 77 years who received 0 to 17 years of education. RESULTS: The coefficients of the General Linear Model estimation suggested that both age and education were statistically significant to predict total scores. In addition, score variances, justified by such predictors, were 41.20 percent in the original Boston Naming Test against 25.84 percent in the adapted Boston Naming Test. These results suggest that the scores from the original BNT are more dependent on age and education than those from the adapted Boston Naming Test. CONCLUSION: These findings demonstrated the suitability of the adapted Boston Naming Test version for the Brazilian population and described provisional norms for the original and adapted Boston Naming Test for Portuguese speakers.

OBJETIVO: Apresentar o desenvolvimento de uma versão adaptada do Boston Naming Test para a língua portuguesa e investigar os efeitos da idade, escolaridade e gênero nas versões original e adaptada do Boston Naming Test. MÉTODO: 80 itens foram administrados incluindo os 60 originais e 20 itens adaptados em 739 brasileiros saudáveis com idades entre 6 e 77 anos e escolaridade entre 0 e 17 anos. RESULTADOS: Os coeficientes de estimação do Modelo Linear Geral sugeriram que a idade e escolaridade eram preditores significativos do resultado total. Além disto, as variâncias dos resultados explicadas por estes preditores no Boston Naming Test original era de 41,20 por cento, enquanto que no adaptado era de 25,84 por cento. Estes achados sugerem que os resultados do Boston Naming Test original são mais dependentes de idade e escolaridade do que os do adaptado. CONCLUSÃO: Estes achados demonstram a adequação do Boston Naming Test adaptado para a população brasileira e descrevem normas provisionais da versão original e adaptada do Boston Naming Test para a língua portuguesa.

Parallel Short Forms for the Korean-Boston Naming Test (K-BNT)

BACKGROUND: The Korean-Boston Naming Test (K-BNT) is a popular measure of the confrontational naming ability. It is particularly sensitive to the early cognitive changes in Alzheimer's disease (AD) and Vascular dementia (VaD). The current study was conducted to develop parallel short forms for the K-BNT used in repeated assessments as well as in situations where the administration of the complete K-BNT is not practical. METHODS: Four 15-item short forms were newly constructed based on the item difficulties of the K-BNT measured from 565 normal elderly aged over 55. The K-BNT was administered to 130 dementia patients (75 AD, 55 VaD) and 130 healthy community-dwelling elderly whose age, sex, and education level were matched with the dementia patients. Scores for the short forms were derived by dividing up the items of the K-BNT. RESULTS: On each short form, normal elderly performed better than dementia patients, and scores on each could be extrapolated to a complete 60-item K-BNT score. Significant correlations were found between short forms and the K-BNT. To compare the probabilities of correctly identifying dementia, the areas under Receiver Operating Characteristic (ROC) curves of each form and the K-BNT were compared. It was found that all the short forms were as efficient as the 60-item K-BNT in identifying dementia. CONCLUSIONS: These results confirm that the four 15-item short forms developed in the current study are parallel and valid as the short forms of the K-BNT.

Boston Naming Test in Chinese Elderly, Patient with Mild Cognitive Impairment and Alzheimer's Dementia / 中国心理卫生杂志

Objective: To investigate applicability for Boston naming test (30 items) (BNT) in Chinese elderly and identify effect for mild cognitive impairment (MCI) and Alzheimer's dementia(AD) using BNT. Methods:100 normal elderly, 38 amnesic MCI, 34 mild AD and 38 moderate AD were evaluated by neuropsychological tests (include BNT, mini mental state examination and auditory verbal memory test, etc). MMSE total score of 4 groups were 28.4?1.5, 26.1?2.6, 20.7?1.7, and 15.6?3.3, respectively. Results: Age, sex, level of education were found to be significant factors affecting overall scores of spontaneous naming in normal elderly group. Spontaneous naming score for participants of elementary, high school and college groups were 22.2?3.3, 25.5?2.5 and 26.3?1.8, respectively. Scoring of male participants higher than that of females. Spontaneous naming score of 4 groups were 24.9?3.0, 20.9?3.6, 18.7?4.0 and 15.7?4.2, respectively. As cut-off ≤22 score of spontaneous naming of BNT, the sensitivities for MCI, mild AD and moderate AD were 61%, 79% and 95% respectively; the specificities were all around 81%. Selective impairment of unfamiliar items occurred MCI and mild AD and hold of familiar item across diagnostic groups. Semantic cue naming and recognition ability by BNT showed there was progressive damage in AD patients, but less than that of spontaneous naming of BNT. Conclusion: The ability of naming is influenced by age, gender and educational level. Patients with MCI or mild AD have impairment in naming.