Dementia & Neuropsychologia ()

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

  • Marcia Radanovic,
  • Maria Teresa Carthery-Goulart,
  • Helenice Charchat-Fichman,
  • Emílio Herrera Jr.,
  • Edson Erasmo Pereira Lima,
  • Jerusa Smid,
  • Cláudia Sellitto Porto,
  • Ricardo Nitrini

DOI
https://doi.org/10.1590/S1980-57642008DN10100007
Journal volume & issue
Vol. 1, no. 1
pp. 37 – 45

Abstract

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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.

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