Evaluating Language Comprehension in Alzheimer's disease: the use of the Token Test / Avaliação da compreensão da linguagem na doença de Alzheimer: o uso do Token Test

OBJECTIVE: To analyze the psychometric properties of the Token test (TT), a verbal comprehension test, and its applicability to the diagnosis of mild Alzheimer's disease (AD). METHODS: One hundred and sixty participants (80 AD and 80 controls) performed the TT and a short battery of neuropsychological tests designed to evaluate general cognitive status, working memory and executive functions. Internal consistency, factor structure, correlation with other measures and group comparisons were evaluated. RESULTS: The test evinced good internal consistency and a bi-factorial structure (related to comprehension and attention). Differences between AD and controls were significant, however the TT presented only moderate sensitivity and specificity for the AD diagnosis. CONCLUSION: The TT showed evidence of good psychometric properties and adequacy for characterizing comprehension deficits in AD, but it was not an appropriate test for the AD detection and diagnosis.

OBJETIVO: Investigar as propriedades psicométricas do Token test (TT), um teste de compreensão verbal, e sua aplicabilidade no diagnóstico da doença de Alzheimer em fase inicial (DA). MÉTODOS: Cento e sessenta participantes (80 DA e 80 controles) foram avaliados por meio do TT e de testes neuropsicológicos que avaliam a cognição geral, memória operacional e funções executivas. Avaliou-se a consistência interna, correlações com outros testes neuropsicológicos, estrutura fatorial e poder diagnóstico do TT. RESULTADOS: O teste apresenta boa consistência interna e estrutura bi-fatorial (relacionada à compreensão e atenção). Foram encontradas diferenças significativas entre o desempenho de DA e dos controles. Contudo, a sensibilidade e especificidade do TT para o diagnóstico de DA foi apenas moderada. CONCLUSÃO: O TT apresenta boas propriedades psicométricas e mostra-se adequado para a caracterização de comprometimentos de linguagem na DA. Entretanto, nossos resultados sugerem que o teste por si só é insuficiente para a detecção e diagnóstico dessa demência.

Estudo Normativo do Token Test versão reduzida: dados preliminares para uma população de idosos brasileiros / Normative study of the Token Test (short version): preliminary data for a sample of Brazilian seniors

INTRODUÇÃO: A preservação das habilidades de compreensão da fala nos idosos está correlacionada com a preservação das funções cognitivas. Essa habilidade é característica fundamental para a comunicação e sua avaliação possibilita a identificação de déficits cognitivos mais específicos, além de facilitar o desenvolvimento de estratégias de intervenção mais precoces e eficientes. OBJETIVO: Disponibilizar normas contemporâneas para a utilização de um instrumento de avaliação da compreensão verbal, o Token Test, para idosos brasileiros saudáveis. MÉTODO: Uma amostra com 120 idosos (76 mulheres), com médias de 71,1 anos para idade e de 6,9 anos de educação formal para escolaridade, foi avaliada utilizando o Miniexame do Estado Mental, para identificação da existência de comprometimento cognitivo, e o Token Test, para avaliação da compreensão da fala. RESULTADOS: Foram encontradas correlações significativas (p < 0,01) entre o escore do Token Test e a educação formal e a idade, os quais corresponderam respectivamente a 5 por cento e 21 por cento da variância compartilhada. Tais variáveis foram consideradas nas tabelas normativas. CONCLUSÃO:Nossos dados indicam que as normas disponibilizadas aqui são suficientemente representativas. Este trabalho abre caminho para estudos futuros de comparação entre o desempenho no Token Test de idosos saudáveis e daqueles em processos de declínio cognitivo.

INTRODUCTION: The preservation of oral comprehension in the elderly is correlated with the preservation of their cognitive functions. Oral comprehension is a key feature for communication and its evaluation allows for the identification of more specific cognitive deficits, in addition to facilitating the development of more effective, early intervention strategies. OBJECTIVE: Provide contemporary standards for the use of an instrument to assess oral comprehension, the Token Test, in a sample of healthy seniors. METHOD: A sample of 120 patients (76 women) with mean age of 71.1 years and 6.9 years of formal education, was assessed using the Mini Mental State Examination to identify the existence of cognitive impairment, and the Token Test to assess oral comprehension. RESULTS: There were significant correlations (p < 0.01) between the token test scores for education and age, which accounted for 5 percent and 21 percent of shared variance, respectively. These two variables were considered on the normative data tables. DISCUSSION: The data obtained indicate that the standards provided here are sufficiently representative. This study identifies the need for future studies comparing the Token Test performance in elderly people either healthy or in the process of cognitive decline.

Impact of cerebral vascular diseases on elderly intellectual status: A neuropsychological study / 中国康复理论与实践

@#ObjectiveTo study the impact of stroke on elderly's mental status.Methods71 elderly inpatients aged between 60 to 90 who suffered stroke(31 cases) or not(40 cases) were assessed the mental status as a whole, the evaluation of comprehension of linguistic information,and non-verbal reasoning abilities using Mini Mental State Examination(MMSE), Token Test and Raven Test.The relationships between these cognitive aspects and stroke was also analysed.ResultsThere were 68% of elderly suffering dementia symptoms in stroke group which was much higher than Non-stroke group (15%).The correlation between MMSE and Token is more close than the correlation between MMSE and Raven in stroke group. The correlations among MMSE, Token and Raven were significant different between stroke and Non-stroke groups. There is a positive correlation coefficient between age and Token scores in dementing patients; whereas a closer relationship between age, education level and Raven in Non-stroke group was found. This implied the impacts of stroke on the time-course of mental degeneration.Conclusions stroke can interrupt normal mental structure and speed up the process of degeneration of cognitive functions. Semantic dysfunction might manifestation earlier than non-linguistic functions. Token is more sensitive than Raven in detecting dementia symptoms of stroke type.

Relationship between Token Test and higher neuropsychological function disorder due to left and right hemispheric damages / 中国康复理论与实践

@#ObjectiveTo evaluate the value of Token Test in testing Chinese aphasia and study the mechanism of bilateral hemispheric asymmetry.Methods33 patients with left hemispheric cerebral vascular diseases and 30 patients with right hemispheric cerebral vascular diseases were studied by Token Test and Aphasia Battery of Chinese(ABC). ResultsThe statistical analysis shows that the score of Token Test was significantly correlated with all tests of ABC in both left and right hemispheric damages groups(P<0.01), and that the score of Token Test was significantly negative correlated with infarction areas in left hemispheric damages groups (P<0.01),but incorrelated with infarction areas in right hemispheric damages groups(P>0.05). There is a significant correlation between the score of Token Test and the severity of the aphasia(P<0.01). Conclusions Token Test was closely related with ABC. It can be effective to detect some higher neuropsychological function disorder.

Relationship between the Token Test and Chinese aphasia with different types due to left hemispheric damages / 中国康复理论与实践

@#In order to evaluate the effect of Token Test for comprehension ability of Chinese aphasia,33 aphasics with different types due to left hemispheric damages were conducted in this study of Token Test and Aphasia Battery in Chinese(ABC).The statistic analysis showed that the score of Token Test was significant correlated with the comprehension ability,word recognition and dictation of Chinese language,construction and visual-spatial function,praxia,calculation,attention and memory ability(P<0.01)and significant correlated with the severity of their aphasia(P<0.05).This study revealed that the score of Token Test was influenced by the type and the severity of Chinese aphasia especially the comprehension ability of speech and also influenced by attention,memory,praxia,visual-spatial function,cognition,etc.Token Test was a very sensitive test of measuring the comprehension ability for Chinese speech.