Background: More than ten years ago it was validated and successfully used
an adaptation of the Boston naming test for South America (Allegri and cols,
1997). The same had been validated with information of the relatives or caregivers of patients. It presented limitations of low educational degree and lack of
aging patients (> 75 years) in the sample. Our objectives were to study the normative data of the Argentina Version for the Boston Naming test in a dwelling
extended population of normal subjects. To analyze the discriminative validity
for detect disorders of the language in patients with Alzheimer disease.
Methods: 210 normal adult subjects were selected between 20-93 years
old of the data base Argencog (Program of Baremizacion de Test Diagnoses
in the Area of Neurociencias Mental). Were selected 356 patients with probably Alzheimer disease (AD) and with vascular disease. Then was administered a test of language based on pictures that score in a range from 0 to
60. The sample was divided considering the age in 4 groups: < 55 (G1),
56-65 (G2), 66-75 (G3) y > 75 (G4). The groups were matched by age, education, and Beck Inventory. In addition, an analysis was performed according
to educational degree (primary school, high school and university). Positive
Predictive value (VPP) and negative (VPN) and positive likelihood ratio
(LR+) were calculated. Also Areas under the curve (AUC) with the ROC
method were obtained (Receiver Operator Characteristics). Results: In normal controls, were observed better performance in the Boston Naming Test
with higher educational level (r 0.43; p < 0.001) and less results in aging
subjects (r 0.50; p < 0.001). Differences between groups were confirmed
with the ANOVA test. Better Cut off point were calculated for all the groups
with AD; CDR mean 1.17 (0.62). Patients G2: AUC 0.97, cut off point 45
(sensitivity 96.2%; specificity 90.9%, LR+10.58). Patients G3:0.97, cut
off point 47 (sensitivity 96.6%; specificity 90.9; LR+10.62). Patients G4:
AUC 0.93, cut off point 40 (sensitivity 84.2%; specificity 87.5%;
LR+6.73). Conclusions: Normative data for a South American version of
the Boston Naming Test show an excellent discriminative validity. It present
as a useful diagnostic test for detection disorders of the language in AD. Losing sensitivity and specificity in elderly patients.
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while the FH-, e4- group performed best (intercept of -.268; annual change
of .014 z-scores). No effect of FH_APOE was observed for Speed & Flexibility (p .42) or Verbal Learning & Memory (p .11). Conclusions: These
preliminary results suggest that cognitive differences may be emerging long
before clinical symptoms appear and that individuals with both a family history of AD and an APOE e4 allele may be at highest risk of early declines.
Follow-up is needed to determine whether current differences increase with
age and whether those with non-clinical deficits will develop MCI or AD.
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