The Diagnostic Value of Language Screening in Primary Progressive Aphasia: Validation and Application of the Sydney Language Battery.

PURPOSE: The three variants of primary progressive aphasia (PPA) differ in clinical presentation, underlying brain pathology, and clinical course, which stresses the need for early differentiation. However, brief cognitive tests that validly distinguish between all PPA variants are lacking. The Sydney Language Battery (SYDBAT) is a promising screening instrument that can be used as a first step in a comprehensive neuropsychological assessment to distinguish PPA subtypes, but evidence on its validity and reliability is to date limited. In the current study, the validation and diagnostic value of the SYDBAT are described for discriminating PPA subtypes as well as distinguishing PPA from mild cognitive impairment (MCI) or Alzheimer's dementia (AD). METHOD: Forty-five patients with PPA (13 with semantic PPA, 20 with logopenic PPA, and 12 with nonfluent/agrammatic PPA), 25 MCI patients, 13 AD patients, and 50 cognitively unimpaired controls were included in this study. Both patients and controls completed the SYDBAT-NL (Dutch version). Performance on and predictive ability of the four subtests (i.e., Naming, Word Comprehension, Repetition, and Semantic Association) were assessed. In addition, construct validity and internal consistency were examined. RESULTS: Different SYDBAT performance patterns were found across PPA and non-PPA patient groups. While a discriminant function analysis based on SYDBAT subtest scores could predict PPA subtype with 78% accuracy, it was more difficult to disentangle PPA from non-PPA patients based on SYDBAT scores alone. For assisting in clinical interpretation, simple rules were set up and translated into a diagnostic decision tree for subtyping PPA, which was capable of diagnosing a large proportion of the cases. Satisfying validity and reliability measures were found. CONCLUSIONS: The SYDBAT is an easy-to-use and promising screen for assessing single-word language processes, which may contribute to the differential diagnostic process of PPA and the assessment of language impairment in MCI and AD. It can be easily implemented for initial screening of patients in a memory clinic.

Goal Management Training in Adults With ADHD: An Intervention Study.

OBJECTIVE: This article describes a controlled, neuropsychological intervention study in adult ADHD. We examined whether adults with ADHD would benefit from a structured course based on Goal Management Training (GMT). The comprehensive course also included psycho-education on the important aspects of executive functioning as well as counseling with respect to coping behaviors. METHOD: The intervention group was compared with a control group of patients who received psycho-education only ( n = 12 and n = 15, respectively). The effects of the intervention were evaluated using subjective and objective test measures. In addition, a structured preassessment, an evaluation, and a group comparison were carried out by an experienced clinician, who was blinded to the intervention itself. RESULTS: The results of the structured clinical interview obtained in the active intervention group were significantly better in the intervention group than those of the control group. CONCLUSION: The findings suggest that the combination of GMT with psycho-education and counseling may have validity for adults with ADHD.

The identification of attention complaints in the general population and their effect on quality of life.

OBJECTIVE: To provide more insight into subjective attention complaints in a healthy adult and elderly population and how these affect Quality of Life (QoL). METHOD: A group of 1,550 healthy Dutch participants complete a postal questionnaire including items from the Maastricht Attention and Memory Checklist (MAC). The impact of attention complaints on QoL is investigated in a subsample of 499 participants. RESULTS: Factor analysis (N = 1,550) reveals two factors: Attention and Memory. Attention complaints are related to depressed mood, anxiety, vitality, and sleep problems that can have serious consequences for daily life functioning and QoL (n = 499). Memory complaints are related to other aspects of health, such as pain and changes in health. CONCLUSION: Attention complaints in the healthy population are common and related to depression, anxiety, and sleep and several aspects of QoL, such as problems with social functioning, emotional problems, and vitality.