Analysis of brief language tests in the detection of cognitive decline and dementia

• Autor(a) principal: Radanovic,Marcia
• Data de Publicação: 2007
• Outros Autores: Carthery-Goulart,Maria Teresa, Charchat-Fichman,Helenice, Herrera Jr.,Emílio, Lima,Edson Erasmo Pereira, Smid,Jerusa, Porto,Cláudia Sellitto, Nitrini,Ricardo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Dementia & Neuropsychologia
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642007000100037
• topic: language tests; cognitive disorders; dementia; Alzheimer disease; education.

Abstract Lexical access difficulties are frequent in normal aging and initial stages of dementia. Verbal fluency tests are valuable to detect cognitive decline, evidencing lexico-semantic and executive dysfunction. Objectives: To establish which language tests can contribute in detecting dementia and to verify schooling influence on subject performance. Method: 74 subjects: 33 controls, 17 Clinical Dementia Rating (CDR) 0.5 and 24 (Brief Cognitive Battery - BCB e Boston Naming Test - BNT) 1 were compared in tests of semantic verbal fluency (animal and fruit), picture naming (BCB and BNT) and the language items of Mini Mental State Examination (MMSE). Results: There were significant differences between the control group and both CDR 0.5 and CDR 1 in all tests. Cut-off scores were: 11 and 10 for animal fluency, 8 for fruit fluency (in both), 8 and 9 for BCB naming. The CDR 0.5 group performed better than the CDR 1 group only in animal fluency. Stepwise multiple regression revealed fruit fluency, animal fluency and BCB naming as the best discriminators between patients and controls (specificity: 93.8%; sensitivity: 91.3%). In controls, comparison between illiterates and literates evidenced schooling influence in all tests, except for fruit fluency and BCB naming. In patients with dementia, only fruit fluency was uninfluenced by schooling. Conclusion: The combination of verbal fluency tests in two semantic categories along with a simple picture naming test is highly sensitive in detecting cognitive decline. Comparison between literate and illiterate subjects shows a lesser degree of influence of schooling on the selected tests, thus improving discrimination between low performance and incipient cognitive decline.