Boston Naming Test Performance Research Articles

Analyzing direct effects of education level and estimated IQ between cognitively intact Mexican Americans and Non-Hispanic whites on a confrontational naming task

Confrontational naming is widely used in diagnosing neurodegenerative disorders like MCI and dementia, and previous research indicates that healthy Non-Hispanic Whites outperform Hispanics in such tasks. However, understanding the factors contributing to score differences among ethnic groups remains limited. This study focuses on cognitively intact Mexican Americans and Non-Hispanic White older adults from the TARCC Hispanic Cohort project. Hierarchical regression analyses reveal that sex, age, ethnicity, education level, and estimated IQ significantly predict performance on the Boston Naming Test (BNT). Notably, education level and estimated IQ more strongly influence BNT performance in Mexican Americans than in Non-Hispanic Whites. When controlling for education level, estimated IQ has a more pronounced impact on BNT performance in aging Mexican Americans compared to Non-Hispanic Whites. Conversely, after controlling for estimated IQ, the influence of education level is weaker for Mexican Americans than Non-Hispanic Whites. These findings emphasize the need for careful evaluation of confrontational naming task scores in diverse ethnic groups, emphasizing the critical role of education and estimated IQ in understanding performance disparities.

72 Boston Naming Test Performance Improves with Increasing Age: What's Wrong with this Picture?

Objective:As word finding or "naming" impairment is a symptom of multiple neurological conditions, naming assessment is an integral component of most neuropsychological evaluations. For decades, the Boston Naming Test (BNT) has been, and remains, the most widely used measure of naming. Although it has been shown that naming is generally stable from young adulthood through middle age, we have observed, clinically, that young adults tend to have greater difficulty on the BNT than older adults. Considering that the BNT was developed more than 50 years ago, and that language and culture change over time, we hypothesized that 1) increasing age would be associated with stronger performance on the BNT, whereas 2) there would be no association between age and naming performance on more recently developed naming measures.Participants and Methods:Participants were healthy adults who served as normative subjects in the revision study of the Auditory (ANT) and Visual Naming (VNT) Tests. Due to known effects of education level on BNT performance, we excluded those with less than 16 years of education, targeting young adults through middle age, resulting in 118 adults, 20 through 50 years of age (mean age: 32.9 ± 9.2 years; mean education: 16.8 ± 1.2 years; mean FSIQ: 106.0 ± 12. 6). All participants were native English speakers or learned English by age 5 and were fully educated in English. Untimed accuracy (i.e., response within 20 seconds) is the standard performance measure for the BNT; the ANT and VNT additionally include tip-of-the-tongue (TOT) scores, which incorporate response time and reliance on phonemic cueing (TOT score = number of items named in > 2 seconds but < 20 seconds, plus items named correctly after 20 seconds, following a phonemic cue). Pearson correlations examined the relation between age and naming performance on the BNT, ANT and VNT.Results:Pearson correlations revealed a small but significant, positive correlation between age and BNT performance (r =.22, p = .017), yet no correlation between age and performance on the ANT (ANT Accuracy: r = .05, p=.60, ANT-TOT: r = -.14, p = .12) or VNT (VNT Accuracy: r = .04, p=.67, VNT-TOT; r = -.03, p = .72).Conclusions:In this sample of healthy adults, naming performance improved with increasing age on the BNT; however, while vocabulary knowledge may broaden, naming efficiency should not improve with age. By contrast, we found no relation between age and naming performance on the more recently developed ANT and VNT. Results underscore the need to revise test stimuli on verbal measures, particularly those that assess naming, and suggest caution in interpreting BNT performance in young adults, as poor BNT performance might not accurately represent their true naming ability.

27 Aging Affects Cordoba Naming Test Performance

Objective:The Cordoba Naming Test (CNT) is a 30-item confrontation naming test developed in Argentina. A common confrontation naming task used in the United States is the Boston Naming Test (BNT). Research shows that age affects BNT performance in the 60-item long form. In fact, studies show that scores on confrontation naming tasks increase in childhood and continue to improve until approximately 40 years of age. However, after this period, scores start to subsequently decline, and especially so after 70 years of age. On the other hand, some studies have reported that older adults maintain high BNT performance despite advancing age. To our knowledge, no study has investigated the aging effects of the CNT across various age groups. We expected CNT scores to increase significantly from young adulthood to mid-adulthood and then significantly decline with advancing age.Participants and Methods:The present study sample consisted of 272 neurologically and psychologically healthy participants with a mean age of 27.06 (SD = 12.21) with 14.29 years of education completed (SD = 2.46). Participants were divided into six different age groups: 18-19-year-old group, 20-29-year-old group, 30-39-year-old group, 40-49-year-old group, 50-59-year-old group, and 60-69-year-old group. All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in English. The CNT consisted of 30 black and white line drawings, ranging from easy to hard difficulty. An ANCOVA, controlling for gender, was used to evaluate CNT performance between the six age groups. We used a threshold of p < .05 for statistical significance.Results:Results revealed significant group differences between the six age groups on the CNT, p = .000, ηp2 = .14. A post-hoc test revealed that the 30-39-year-old group outperformed the 18-19-year-old, 20-29-yearold, and 60-69-year-old groups on the CNT. Finally, the 40-49-year-old group outperformed the 18-19-year-old and 60-69-year-old groups on the CNT.Conclusions:As we predicted, participants demonstrated steady improvement in the CNT until the age of 40. However, we found that until the age of 60, CNT performance started to decline significantly. Our data suggests that CNT performance declines significantly at the age of 60 compared to previous research using the BNT. Research shows other demographic variables (e.g., gender, linguistic factors) influence BNT performance. Future investigations on the CNT using a healthy sample should use a multivariate statistical analysis method to help explain influencing factors across aging. This research can have the potential to improve public health to better support and understand individuals from diverse backgrounds.

18 Language Predicts Verbal Learning in Parkinson's Disease

Objective:Cognitive impairment in Parkinson's disease (CIPD) is present in approximately 40% of patients. Language deficits, evidenced by poor word- retrieval, have historically characterized memory weaknesses in PD. That is, the "retrieval deficit hypothesis," suggests successful memory encoding, but poor retrieval subsequent to language and executive dysfunction, another prominent area of CIPD. However, recent studies suggest that memory impairments in PD are instead at the level of learning. At present, several suggested etiologies to explain learning impairments in PD exist that are not related to language, for example that processing speed deficits (another characteristic of CIPD) impact learning; however, other studies present evidence against this theory. Therefore, we hypothesize that deficits in language continue to be a primary component of memory impairment in PD, but at the level of learning rather than retrievalParticipants and Methods:85 adults (age M = 61.54, SD = 10.00; %female = 26.7; Dementia Rating Scale M = 137.77, SD = 5.63) diagnosed with Parkinson's disease according to the UK Brain Bank criteria for idiopathic PD, completed a neuropsychological test battery when "off" levodopa medication. The battery included the Boston Naming Test (BNT), verbal fluency tests (Controlled Oral Word Association [COWA] and category fluency), the California Verbal Learning Test, 2nd Edition (CVLT-II), and the Oral Symbol Digit Modalities Test (SDMT). Separate linear regression models were used to examine BNT, COWA, category fluency, and SDMT performance as predictors of total learning (sum of trials 1-5), short-delay free recall, long-delay free recall, and recognition discriminability on the CVLT-II. Analyses were adjusted for age, sex, education, and disease severity (MDS-Unified Parkinson's Disease Rating Scale, part 3 score). Follow up analyses adjusted for processing speed (oral SDMT).Results:Adjusted linear regression models revealed that both verbal fluencies predicted verbal learning (letter: ß = .37, p < .01; category: ß = .45, p < .01), long-delay free recall (letter: ß = .25, p = .05; category: ß = .34, p = .01), and recognition discriminability (letter: ß = .36, p = .02; category: ß =.33, p = .03) on the CVLT-II. Confrontation naming significantly predicted only long-delay free recall (ß =.31, p = .01). Processing speed predicted verbal learning (ß = .51, p < .01), short-delay free recall (ß = .35, p = .03), and long-delay free recall (ß = .44, p < .01). After adjusting for processing speed, letter fluency significantly predicted learning (ß = .23, p = .05) and discriminability (ß = .33, p = .04). Category fluency significantly predicted learning only (ß = .28, p = .04). Finally, confrontation naming significantly predicted only long-delay free recall (ß= .28, p = .01).Conclusions:While processing speed was associated with verbal learning and recall, components of language predicted variance in verbal learning in PD that was not accounted for by speed. Additionally, discriminability was related to aspects of language that are more reliant on executive functioning. It is therefore suggested that verbal memory in PD is interpreted within the context of one's language ability. Other potential mechanisms and clinical implications are discussed.

40 Educational Quality vs Years of Education is More Strongly Associated with Neuropsychological Test Performance

Objective:Education is known to impact neuropsychological test performance, and self-reported years of education is often used in stratifying normative data. However, this variable does not always reflect education quality, particularly among underrepresented populations, and may overestimate cognitive impairment in individuals with low education quality. This cross-sectional study evaluated relative contributions of years of education and reading level to several verbally mediated assessments to improve interpretation of neuropsychological performance.Participants and Methods:Data was obtained from the Vanderbilt Memory and Aging Project. Cognitively-unimpaired participants (n=175, 72±7 years, 59% male, 87% Non-Hispanic White, 16±2 years of education) completed a comprehensive neuropsychological protocol. Stepwise linear regressions were calculated using education and Wide Range Achievement Test (WRAT)-3 Reading subtest scores as predictors and letter fluency (FAS, CFL), category fluency (Vegetable and Animal Naming), the Boston Naming Test (BNT), and California Verbal Learning Test (CVLT)-II as outcomes to assess increase in variance explained by educational quality. Models covaried for age and sex. The False Discovery Rate (FDR) based on the Benjamini-Hochberg procedure (Benjamini & Hochberg, 1995) was used to correct for multiple comparisons.Results:The mean WRAT-3 score was 51±4 (range:37-57), indicating post-high school reading level. Education and WRAT-3 scores were moderately correlated (r=0.36, p<0.01). Both WRAT-3 and years of education independently predicted letter fluency (WRAT-3 p<0.001; education p<0.02), category fluency (WRAT-3 p<0.001; education p<0.05), and CVLT-II performance (WRAT-3 p-values<0.005; education p-values<0.02) in single predictor models. On BNT, WRAT-3 (p<0.001), but not education (p=0.06), predicted performance in single predictor models. In combined models with both WRAT-3 and education, WRAT-3 scores remained a significant predictor of FAS (WRAT-3 b=1.21, p<0.001; education b=0.006, p=0.99) and CFL performance (WRAT-3 b=1.02, p<0.001; education b=0.51, p=0.14). Both WRAT-3 (b=0.21, p=0.01) and years of education (b=0.35, p=0.03) predicted Animal Naming, while WRAT-3 (b=0.16,p=0.008), but not years of education (p=0.37), predicted Vegetable Naming. WRAT-3 was a significant predictor of BNT performance (b=0.21, p<0.001) but not years of education (p=0.65). WRAT-3 predicted CVLT-II learning (b=0.32, p=0.04), immediate recall (b=0.16, p=0.005), and delayed recall performances (b=0.15, p=0.005), while education did not (p-values>0.14). All significant results persisted after FDR correction. WRAT-3 scores explained an additional level of variance beyond the covariates and education alone for FAS (AR=18%), CFL (AR=13%), Animal Naming and Vegetable Naming (AR= 3%), BNT (AR=18%), and CVLT-II learning (AR=2%), immediate recall (AR=4%), and delayed recall (AR=3%).Conclusions:Reading level more strongly associated with performance on several verbally mediated neuropsychological measures than years of education. For all measures, the addition of reading level significantly increased the amount of variance explained by the model compared to covariates and education alone, which aligns with existing research. However, most of this past work looks at individuals with lower levels of educational quality. Because our cohort was highly educated and at the upper end of the reading spectrum, our results suggest that reading level is important to consider even for more highly educated individuals. Therefore, reading level is a critical variable to consider when interpreting verbally mediated neuropsychological measures for individuals across the educational spectrum.

24 Individual Differences in CAMCOG-DS Performance in Children and Adults with Down's Syndrome and Relationship to Language and Reasoning

Objective:The Cambridge Cognitive Examination for Down's Syndrome (CAMCOG-DS) was developed to assess cognitive functioning and dementia-related cognitive decline in people with Down's Syndrome (DS). It has been translated into different languages and is often used in international studies. Although adapted for people with intellectual disabilities (ID), many tasks involve verbal responses and instructions are presented orally. Therefore, the administration for people with severe language deficits can be challenging. The aim of this retrospective data analysis is to examine the influence of language ability and reasoning on CAMCOG-DS performance. Study 1 examined the relationship between CAMCOG-DS, picture naming, single word comprehension and reasoning in adults with DS. Study 2 replicates and broadens the findings in a sample of children and adults with DS.Participants and Methods:Study 1 included 40 adults with DS between 18 and 51 years (M = 28.6, SD = 8.4). 25 had a mild and 15 a moderate ID. CAMCOG-DS, the short form of the Boston Naming test (BNT), a test for single word comprehension from the Werdenfelser Testbatterie (WTB) and the Colored Progressive Matrices (CPM) were administered. Study 2 included 38 participants between 8 and 59 years (23 children, M = 11.4; 15 adults; M = 31.3). 3 had a borderline, 23 a mild, and 12 a moderate ID. The same tasks as in Study 1 were applied, but the CPM was replaced by its successor, the Raven's 2.Results:In Study 1, participants with mild ID performed better in all tasks than those with moderate ID (p < .05). Moderate relationships were found between CAMCOG-DS total score and the language tasks (r = .56 and r = .46), which remained significant when level of ID was controlled for. There was also a moderate relationship between CAMCOG-DS and reasoning (r = .46). Regression analysis showed that BNT performance predicted CAMCOG-DS performance (R2 = .31). In Study 2, those with mild ID, compared to those with moderate ID, performed better in all tasks (p < .05), however, regarding the CAMCOG-DS and language tasks, this effect was larger in adults than in children. Adults performed better than children in the CAMCOG-DS and BNT (p < .05), but not in single word comprehension or reasoning. As in Study 1, moderate to large correlations were revealed between CAMCOG-DS and language tasks and between CAMCOG-DS and reasoning (r > .52), remaining significant when age and ID level were controlled for. Regression analysis showed that both naming and reasoning but not single word comprehension or age predicted CAMCOG-DS performance (R2 = .69), however, performance was best predicted by naming (R2 = .65).Conclusions:Our results suggest that language ability and reasoning relate to CAMCOG-DS performance, which is best predicted by BNT picture naming. This should be considered in CAMCOG-DS interpretation, as the capabilities of patients with lesser language ability might be underestimated. Future developments of dementia assessments for people with ID should include more nonverbal tasks.

Item-Level Scores on the Boston Naming Test as an Independent Predictor of Perirhinal Volume in Individuals with Mild Cognitive Impairment.

We explored the methodological value of an item-level scoring procedure applied to the Boston Naming Test (BNT), and the extent to which this scoring approach predicts grey matter (GM) variability in regions that sustain semantic memory. Twenty-seven BNT items administered as part of the Alzheimer's Disease Neuroimaging Initiative were scored according to their "sensorimotor interaction" (SMI) value. Quantitative scores (i.e., the count of correctly named items) and qualitative scores (i.e., the average of SMI scores for correctly named items) were used as independent predictors of neuroanatomical GM maps in two sub-cohorts of 197 healthy adults and 350 mild cognitive impairment (MCI) participants. Quantitative scores predicted clusters of temporal and mediotemporal GM in both sub-cohorts. After accounting for quantitative scores, the qualitative scores predicted mediotemporal GM clusters in the MCI sub-cohort; clusters extended to the anterior parahippocampal gyrus and encompassed the perirhinal cortex. This was confirmed by a significant yet modest association between qualitative scores and region-of-interest-informed perirhinal volumes extracted post hoc. Item-level scoring of BNT performance provides complementary information to standard quantitative scores. The concurrent use of quantitative and qualitative scores may help profile lexical-semantic access more precisely, and might help detect changes in semantic memory that are typical of early-stage Alzheimer's disease.

A-184 Increased Cerebrospinal Fluid Levels of Amyloid Following Traumatic Brain Injury are Associated with Confrontation Naming Performance

Abstract Objective: To explore whether beta-amyloid (AB) overproduction is implicated in the relationship between traumatic brain injury (TBI) and Alzheimer’s disease (AD), we compared cerebrospinal fluid (CSF) levels of AB in individuals with a TBI history versus controls (CTRLs) and related CSF AB levels to confrontation naming performance, a pseudo-marker for preclinical AD. Method: We selected 113 non-impaired Veterans (TBI=57, CTRL=56) from the Alzheimer’s Disease Neuroimaging Initiative-Department of Defense database with available Boston Naming Test (BNT) data and CSF measures for three AB peptides (AB-42, AB-40, AB-38). Analysis of covariance (ANCOVA) compared CSF AB levels between groups adjusting for age. Spearman’s correlations related CSF AB levels to BNT performance. Three separate mediation models explored the relationship between TBI and BNT performance with each AB peptide as a mediator. Results: The TBI group had higher CSF AB-40 (F=5.20, p=0.02) and AB-38 (F=3.78, p=0.05) levels than the CTRL group, but groups did not significantly differ in CSF AB-42 levels (p>0.1). BNT was negatively correlated with all three AB peptides (AB-42: rho=-0.28, p=0.003; AB-40: rho=-0.20, p=0.03; AB-38: rho=-0.19, p=0.05). Mediation models showed a significant indirect effect of TBI on BNT performance through AB-40 (B=-0.16, 95% CI [-0.391, -0.007], PM = 0.54). TBI positively affected AB-40 levels (B=0.45, p=0.02), and AB-40 levels, in turn, negatively affected BNT performance (B=-0.14, p=0.04). Indirect effects of TBI on BNT performance with AB-42 or AB-38 as mediators were not significant. Conclusions: TBI may increase risk of AD-related cognitive decline through AB overabundance in the brain, as evidenced by elevated CSF AB levels, particularly AB-40.

Culture Effects on the Chinese Version Boston Naming Test Performance and the Normative Data in the Native Chinese-Speaking Elders in Mainland China.

BackgroundThe Chinese version of Boston Naming Test (BNT-C) is administered in China widely. However, the neuropsychological parameter of BNT-C in native Chinese-speaking elders in mainland China has not been explored systematically. The aim of this study was to explore cultural influences on BNT-C performance and establish norms among native Chinese-speaking elders in Beijing.MethodsA total of 161 native, Chinese-speaking, cognitively normal elders aged ≥55 years were enrolled from various communities in Beijing. The BNT-C was conducted on all the participants. The internal consistency, participants' familiarity, and naming accuracy were analyzed and compared with data from Chinese areas outside the mainland and from American published previously. The influencing factors and stratified norms for BNT-C were established.ResultsThe BNT-C showed good internal consistency (α = 0.738). Strong correlation between naming accuracy and object familiarity was found (r = 0.962, P < 0.001). Participants' familiarity and correct naming rate for many items were notably different between the Chinese-speaking elders and English-speaking elders in America. The difference in some items' correct naming rate also existed between Beijing, Taiwan, and Hongkong. Higher education was associated with higher scores, whereas age and gender had no effect on BNT-C performance. The recommended norms of total naming scores for elders with education ≤ 9 and >9 years were 16 and 23, respectively.ConclusionThe participants' familiarity with BNT items differed between different cultures, which further affected the naming accuracy and total scores. The education stratified norms established here are helpful for the better application of BNT-C in mainland China.

The 30-item and 15-item Boston naming test Czech version: Item response analysis and normative values for healthy older adults

ABSTRACT Objective The Boston Naming Test (BNT) is the most widely used test to assess visual confrontation naming in both research and clinical settings. Recently, an abbreviated Czech version of the BNT was described. The purpose of this study is to assess the validity of this new test at the item level with advanced psychometric methods to assess its equivalence with the original test. The rationale was to help busy clinicians in the differential diagnosis of language disorders. Method We administered the BNT-30 (odd item form of BNT-60) (N = 535; 75.61 ± 9.11; 60–96 years) and shortened the BNT-15 (N = 754; 71.94 ± 7.88; 60–96 years) to a large sample of healthy older adults. Results Significant but low associations between BNT performance and age, education, and sex were found. We found strong evidence for the unidimensionality of both BNT-15/BNT-30 versions in healthy adults (p’s < .001). Conclusion In-depth psychometric analysis of the BNT-15 and BNT-30 Czech versions show that test stimuli function in a similar fashion as the original BNT. Normative values adjusting for the influence of age, education, and sex are provided for use in clinical settings and future cross-cultural comparisons.

A-100 Examining Spanish-English Bilingual Boston Naming Test Norms in Traumatic Brain Injury Survivors

Abstract Objective We examined two established Spanish-English bilingual norms to assess if traumatic brain injury (TBI) deficits were still found if language was no longer a variable influencing Boston Naming Test (BNT) performance. Method The sample consisted of 47 healthy comparison (HC; 24 English-Monolinguals; 23 Spanish-English Bilinguals), 33 acute TBI (ATBI; 20 English-Monolinguals; 13 Spanish-English Bilinguals), and 25 Chronic TBI (CTBI: 13 English-Monolinguals; 12 Spanish-English Bilinguals) participants. Raw scores and adjusted demographic T-scores (Roberts et al., 2002; Rosselli et al., 1997) were used to evaluate BNT performance. Results An ANCOVA controlling for age, revealed the HC group outperformed the TBI group on the BNT (raw score), p = 0.003, ηp2 = 0.11. We also found monolinguals outperformed bilinguals on the BNT, p = 0.000, ηp2 = 0.24. Using the Roberts et al., (2002) norms, we found the HC group outperformed the TBI group, p = 0.003, ηp2 = 0.11, but no language differences were found. Next, using Rosselli et al., (1997) norms, we found the HC group outperformed the TBI group on the BNT, p = 0.003, ηp2 = 0.11, and monolingual speakers outperformed bilingual speakers, p = 0.014, ηp2 = 0.06. No interactions were found. Conclusions As expected, the TBI group demonstrated worse BNT performance compared to HC group on both language norms. However, when using Roberts et al., (2002) Spanish-English bilingual norms, no language group differences were found. Our data indicates that when examining BNT performance in a Spanish-English bilingual and English-monolingual TBI sample, Roberts et al., (2002) normative data may be better suited to evaluate BNT deficits in a TBI while taking language into account.

Boston Naming Test: Lose the Noose.

Administering the noose item of the Boston Naming Test (BNT) has been questioned given the cultural, historical, and emotional salience of the noose in American culture. In response, some have modified the BNT by skipping/removing this item and giving the point as if the examinee responded correctly. It is unknown, however, whether modifying standardized administration and scoring in this manner affects clinical interpretation. In the present study, we examined the prevalence of noose item failure, whether demographic and clinical characteristics differed between those who responded correctly versus failed the item, and whether giving a point to those who failed affected clinical interpretation. Participants included a mixed clinical sample of 762 adults, ages 18-88years, seen for neuropsychological evaluation at one of five sites within the USA. Those who failed the item (13.78%) were more likely to be female, non-White, and have primary diagnoses of major neurocognitive disorder, epilepsy, or neurodevelopmental disorder. Noose item failure was associated with lower BNT total score, fewer years of education and lower intellectual functioning, expressive vocabulary, and single word reading. Giving a point to those who failed the item resulted in descriptor category change for 17.1%, primarily for patients with poor overall BNT performance. Only a small percentage of patients fail the noose item, but adding a point for these has an impact on score interpretation. Factors associated with poorer overall performance on the BNT, rather than specific difficulty with the noose item, likely account for the findings.

A-035 What Make Them Tick? The Clock Drawing Test and Correlations Between Cognitive and Functional Abilities

Abstract Objective The Clock Drawing Test (CDT) is among the most researched cognitive measures and is frequently used to screen for neurocognitive disorders (NCDs). No study to date has investigated the relationship between qualitative errors on the CDT and independence in instrumental activities of daily living (IADLs) or discrete cognitive abilities. Therefore, this study sought to evaluate the correlations between qualitative errors on the CDT and IADL status as well as performance in individual cognitive domains. Method Data were retrospectively collected from patients seen at an outpatient clinic in eastern Massachusetts, including 16 healthy controls, 22 patients with mild NCD, and 35 patients with major NCD. Analyses were performed between qualitative errors on the CDT and patients’ scores on the Lawton IADL Scale, Mattis Dementia Rating Scale-2 (DRS-2), Digit Span Forward and Backward, Trail Making Test (TMT), and the Boston Naming Test (BNT). Results IADL scores were moderately correlated with CDT error types. DRS-2 scores were strongly correlated commission of qualitative errors. Strong to very strong correlations were observed between TMT parts A &amp; B scores and all qualitative error types. BNT performance was strongly correlated with conceptual deficits and spatial/planning errors. Digit Span Forward and Backward scores showed low correlations with all CDT errors. Conclusions Functional status appears only moderately correlated with commission of various CDT errors; however, several cognitive measures showed high correlation with various CDT error types. These findings suggest that certain qualitative errors may be indicative of cognitive impairments warranting further workup. Clinical implications and future directions are discussed.

Impaired or invalid? Limitations of assessing performance validity using the Boston Naming Test

The Boston Naming Test (BNT) has been proposed as an embedded performance validity test (PVT), though replication is needed to provide further empirical support of its simultaneous use as a cognitive ability measure and embedded PVT. This cross-sectional study examined BNT performance in a mixed neuropsychiatric sample of 137 patients with/without cognitive impairment. Four independent criterion PVTs classified 109 (80%) as valid and 28 (20%) as invalid. BNT raw and demographically-corrected T-scores were significantly higher among the valid group with small effect sizes (ηp 2 = 0.04–0.05). Raw/T-scores differentiated valid/invalid groups, but with low classification accuracy (areas under the curve [AUCs] = 0.68/0.63), and unacceptably weak sensitivities (i.e. 7%/18%). When separated by impairment status, raw score accuracy appreciably increased (AUC = 0.87; 61% sensitivity/89% specificity) among unimpaired patients, whereas T-score accuracy, while significant, remained low (AUC = 0.68; 21% sensitivity/89% specificity). Conversely, among impaired patients, neither the raw (AUC = 0.59) nor T-score (AUC = 0.60) accurately identified invalid performance. In sum, BNT scores were not able to differentiate valid from invalid performance when cognitive impairment was present, and therefore showed limited overall utility as embedded PVTs. These findings further caution against inferring performance validity from measures in which a single score is used to assess both cognitive ability and validity.

The Boston Naming Test-South African Short Form, Part I: Psychometric properties in a group of healthy English-speaking university students

The Boston Naming Test (BNT) is a popular cognitive test designed to detect word-finding difficulties in neurologic disease. However, numerous studies have demonstrated the BNT’s inherent cultural bias and cautioned against uncritical administration outside of North America. There is little research on the BNT performance of South African samples and on ways to make the test culturally fair for use in this country. In this article, we describe the development and psychometric properties of the BNT-South African Short Form (BNT-SASF). This instrument includes 15 items drawn from the original test pool and judged by a panel of practising neuropsychologists and community members to be culturally appropriate for use in South Africa. We administered the standard 60-item BNT and the BNT-SASF to a homogeneous (English-fluent, high socioeconomic status and highly educated) sample of young South African adults. This design allowed us to avoid potentially confounding sociodemographic influences in our evaluation of the instrument’s basic utility. We found that the BNT-SASF demonstrates fundamental psychometric properties that are the equivalent of short forms developed elsewhere. Moreover, it appears to measure the same construct as the 60-item BNT while being less culturally biased. We conclude that the BNT-SASF has potential utility in South African assessment settings. It is quick and easy to administer, thus aiding in the rapid screening of patients. Moreover, it is cost-effective because its items are drawn from the pool comprising the original test. Future research will describe psychometric properties of Afrikaans and isiXhosa versions of the BNT-SASF and investigate diagnostic validity in dementia patients.

B-66 The Effect of Bilingualism on Boston Naming Test Performance in Traumatic Brain Injury Survivors and Healthy Adults

Abstract Objective The Boston Naming Test (BNT) is a lexical-retrieval task. It has been documented that those with a history of traumatic brain injury (TBI) have reduced performance on the BNT. Bilingualism is also known to impact BNT performances. We examined the relationship of TBI and bilingualism/monolingualism on BNT performances. Method The sample (N = 95) consisted of 36 healthy controls (19 bilingual; 17 monolingual), 32 acute TBI participants (12 bilingual; 20 monolingual), and 27 chronic TBI participants (16 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury and chronic TBI participants were tested 12 months or more post-injury. All participants passed performance validity testing. A 3X2 ANOVA was conducted to determine the effect of TBI and bilingualism/monolingualism on BNT performance. Results A main effect was found for group (i.e., control, 6 month TBI, and 12 month TBI), p &lt; .001, ηp² = .21. Pairwise comparisons revealed that acute TBI participants performed worse than the control and chronic TBI groups. A main effect for bilingualism/ monolingualism was found, p &lt; .001, ηp² = .14; monolinguals performed better on the BNT. No interactions were found between TBI and bilingualism/monolingualism. Conclusions BNT performance improves overtime in TBI and the pattern of improvement post-TBI is not statistically different between bilingual/monolingual groups. Relative to monolinguals, bilingual participants demonstrated worse BNT performance.

Boston Naming Test performance in French-speaking Acadians

ABSTRACTBackground: Standardized tools for the assessment of language and cognition for French Canadians are limited, especially for those living outside of Quebec, making it difficult for clinicians to diagnose and treat language and cognitive impairments. Acadians are an understudied, linguistically diverse group with varying levels of bilingualism in French and English that affords the opportunity to study naming performance in individuals with varying degrees of bilingualism.Aims: The goals of this investigation were threefold: a) to describe the naming performance of Acadians in French, including name agreement on individual Boston Naming Test (BNT) items and naming performance as a function of age and education; b) to investigate the effect of using different published datasets (Kaplan’s norms for English speakers and the Quebec naming dataset for French speakers) when calculating the naming ability level (i.e., high average, average, low average, borderline, and extremely low) on the BNT in French; and c) to examine the effects of bilingualism on BNT performance in French and English.Methods & Procedures: French-speaking Acadians (N = 119) aged 20–81 years (M = 44.3, SD = 14.49) completed a questionnaire self-reporting their language proficiency and use, followed by the administration of the BNT (Kaplan et al., 2001) in French.Outcomes & Results: Name agreement analyses revealed a high percentage of correct responses for many items, while other items were frequently described using regionalisms. Naming performance improved as a function of education, but there was no effect of age. The study also highlighted the effects of using different naming datasets to calculate each participant’s naming ability. Overall, the Acadian sample’s naming ability was lower than expected when calculating naming ability using either the Kaplan English norms (Kaplan et al, 2001) or the Quebec naming dataset for French speakers (Roberts & Doucet, 2011). Moreover, agreement in the naming ability level (from extremely low to high average) was poor. Consistent with previous studies, total BNT scores in French were significantly lower for French-speaking bilinguals (FS-BIs) compared to French-speaking unilinguals (FS-UNIs) after controlling for educational levels. It was also noted that French-English bilinguals performed better on the English compared to the French administration of the BNT.Conclusion: The results of this study support the need for a separate naming dataset for bilingual and French-speaking Acadians. Implications for the assessment of naming ability and deficits in clinical practice with French and French/English bilingual speakers are discussed.

Performance discrepancies on the Boston Naming Test in African-American and non-Hispanic White American young adults

ABSTRACTThe Boston Naming Test (BNT) is one of the most commonly used naming measures in neuropsychology. Although research in the older adult population has shown that African-American (AA) adults perform more poorly on the BNT than non-Hispanic White American (WA) adults, these findings have yet to be replicated in younger adults. The BNT and measures of word reading (WJ-Letter Word ID) and vocabulary (Wechsler Abbreviated Scale of Intelligence Vocabulary) were administered to 50 WA and 33 AA young adults. Performance was age-normed based on published norms and transformed into z-scores. Despite being matched on age, gender, SES, and level of education, the AA group performed more poorly on the BNT (z = − 1.01(1.09)) than the WA group (z = − .28(.92)), t(104) = 3.44, p < .01, d = 0.73. AAs (18%) were more likely to perform in the impaired range than WAs (4%) when impairment cutoff was z-score≤ − 2. Healthy AA young adults are more likely to perform poorly on the BNT despite vocabulary and word reading being well within normal limits. Average BNT performance in both groups were at least one z-score lower than average vocabulary z-scores. Clinicians should interpret poor scores on the BNT with caution, and within the context of individual vocabulary or word reading performance.

White Matter Changes and Confrontation Naming in Retired Aging National Football League Athletes.

Using diffusion tensor imaging (DTI), we assessed the relationship of white matter integrity and performance on the Boston Naming Test (BNT) in a group of retired professional football players and a control group. We examined correlations between fractional anisotropy (FA) and mean diffusivity (MD) with BNT T-scores in an unbiased voxelwise analysis processed with tract-based spatial statistics (TBSS). We also analyzed the DTI data by grouping voxels together as white matter tracts and testing each tract's association with BNT T-scores. Significant voxelwise correlations between FA and BNT performance were only seen in the retired football players (p < 0.02). Two tracts had mean FA values that significantly correlated with BNT performance: forceps minor and forceps major. White matter integrity is important for distributed cognitive processes, and disruption correlates with diminished performance in athletes exposed to concussive and subconcussive brain injuries, but not in controls without such exposure.

Pulmonary Function Affects Language Performance in Aging

Event Abstract Back to Event Pulmonary Function Affects Language Performance in Aging Dalia Cahana-Amitay1, 2*, Lewina O. Lee1, 2, 3, Abigail C. Oveis1, 2, Emmanuel A. Ojo1, 2, Avron Spiro1, 2, 3, Loraine K. Obler1, 2, 4 and Martin L. Albert1, 2 1 Boston University School of Medicine, United States 2 VA Boston Healthcare System, United States 3 Boston University School of Public Health, United States 4 The Graduate Center, City University of New York, United States Background Good pulmonary function (PF) is associated with preservation of cognitive performance, primarily of executive functions, in aging (Albert et al., 1995; Chyou et al., 1996; Emery, Finkel, & Pedersen, 2012; Yohannes & Gindo, 2013). The contribution of PF to older adults’ language abilities, however, has never been explored, to our knowledge. We addressed this gap by examining the effects of PF on older adults’ language functions, as measured by naming and sentence processing accuracy. We predicted similar effects as found for executive functions, given the positive associations between executive functions and sentence processing in aging (e.g., Goral et al., 2011). Methods Data were collected from 190 healthy adults aged 55 to 84 years (M = 71.1, SD = 8.1), with no history of neurological or psychiatric disorders. Procedure PF was measured prior to language testing. Measures included forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). Language functions were assessed through performance on computer-administered lexical retrieval and sentence processing tasks. Sentence processing was measured using two auditory comprehension tasks: one, of embedded sentences (ES), the other, of sentences with multiple negatives (MN). Lexical retrieval was measured using the Boston Naming Test (BNT) and Action Naming Test (ANT). Performance was scored for percent accuracy. Additionally, lexical retrieval was evaluated with a phonemic fluency task (FAS), which also taps executive function abilities. Statistical Analyses Multiple regression was used to examine the association between pulmonary and language functions, adjusting for age, education, gender, history of respiratory illness, current level of physical activities, and current and past smoking. Results Better PF was associated with better sentence processing and lexical retrieval on naming tasks, but not with phonemic fluency, after adjusting for covariates. Higher FVC was associated with better ES performance (B = 6.64, SE = 2.43, p = .01). Higher FVC and FEV1 were related to better MN performance, but this did not reach statistical significance (FVC: B = 3.68, SE = 2.16, p = .09; FEV1: B = 4.92, SE = 2.64, p = .06). Higher FVC (B = 3.98, SE = 1.44, p = .01) and FEV1 (B = 4.79, SE = 1.75, p = .01) were associated with better ANT performance. The positive association between PF and BNT performance was marginally significant (FVC: B = 4.19, SE = 2.18, p = .06; FEV1: B = 3.51, SE = 2.66, p = .10). Discussion and Conclusion Better PF was associated with higher accuracy on sentence processing and naming-based lexical retrieval tasks, consistent with the conclusion that pulmonary function affects older adults’ language performance. Our findings support the emerging thesis that language changes in aging are influenced by health-related physiological and neural mechanisms (e.g., Albert et al., 2009; Cahana-Amitay et al., 2013). From a clinical perspective, these findings highlight the promise of targeting PF as an intervention for improving language abilities among the elderly. References Albert, M. L., Spiro, A., Sayers, K. J., Cohen, J. A., Brady, C. B., Goral, M., & Obler, L. K. (2009). Effects of health status on words finding in aging. Journal of the American Geriatrics Society, 57(12), 2300-2305. Albert, M. S., Jones, K., Savage, C. R., Berkman, L., Seeman, T., Blazer, D., et al. (1995). Predictors of cognitive change in older persons: MacArthur studies of successful aging. Psychology and Aging, 10(4), 578-589. Cahana-Amitay, D., Albert, M. L., Ojo, E. A., Sayers, J., Goral, M., Obler, L. K., & Spiro, A. (2013). Effects of hypertension and diabetes on sentence comprehension in aging. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 68(4), 513-521. Chyou, P. H., White, L. R., Yano, K., Sharp, D. S., Burchfiel, C. M., Chen, R., et al. (1996). Pulmonary function measures as predictors and correlates of cognitive functioning in later life. American Journal of Epidemiology, 143(8), 750–756. Emery, C. F., Finkel, D., & Pedersen, N. L. (2012). Pulmonary function as a cause of cognitive aging. Psychological Science, 23(9), 1024–1032. Goral, M., Clark-Cotton, M., Spiro, A., Obler, L. K., Verkuilen, J., &. Albert, M. L. (2011). The contribution of set switching and working memory to sentence processing in older adults. Experimental Aging Research, 37(5), 516-538. Yohannes, A., & Gindo, T. (2013). Association of pulmonary function and cognitive decline in older adults from the English Longitudinal Study of Aging. Chest, 144 (4 Meeting Abstracts), 788A. Keywords: Language, Aging, Pulmonary Function, sentence processing, lexical retrieval, executive functions Conference: Academy of Aphasia -- 52nd Annual Meeting, Miami, FL, United States, 5 Oct - 7 Oct, 2014. Presentation Type: Poster presentation ONLY Topic: Not student Citation: Cahana-Amitay D, Lee LO, Oveis AC, Ojo EA, Spiro A, Obler LK and Albert ML (2014). Pulmonary Function Affects Language Performance in Aging. Front. Psychol. Conference Abstract: Academy of Aphasia -- 52nd Annual Meeting. doi: 10.3389/conf.fpsyg.2014.64.00048 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 25 Apr 2014; Published Online: 04 Aug 2014. * Correspondence: Dr. Dalia Cahana-Amitay, Boston University School of Medicine, Boston, MA, United States, dcamitay@bu.edu Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Dalia Cahana-Amitay Lewina O Lee Abigail C Oveis Emmanuel A Ojo Avron Spiro Loraine K Obler Martin L Albert Google Dalia Cahana-Amitay Lewina O Lee Abigail C Oveis Emmanuel A Ojo Avron Spiro Loraine K Obler Martin L Albert Google Scholar Dalia Cahana-Amitay Lewina O Lee Abigail C Oveis Emmanuel A Ojo Avron Spiro Loraine K Obler Martin L Albert PubMed Dalia Cahana-Amitay Lewina O Lee Abigail C Oveis Emmanuel A Ojo Avron Spiro Loraine K Obler Martin L Albert Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. 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