Confrontation Naming Test Research Articles

The Relationship of Word-Finding Behaviors and Naming in Mild Cognitive Impairment and Dementia of Alzheimer’s Type

Objectives: Anomia, a fundamental language difficulty, presents in various forms of wordfinding behaviors in individuals with Mild Cognitive Impairment (MCI) and Dementia of Alzheimer’s Type (DAT). This study aims to compare the rates of word-finding behavior among these groups and determine the correlation between these rates and the results of naming tests. Methods: This study included 101 participants, consisting of forty-one healthy elderly adults, thirty individuals with MCI, and thirty individuals with DAT. Spontaneous speech data were collected using a picture description task. For the naming tests, we used the confrontation naming test (K-BNT) and the generative naming test (KCOWAT). Results: First, significant differences were observed in the rates of word-finding behavior among the three groups, especially in the global index, which indicates the overall rate of word-finding behaviors. Second, the correlation analysis results showed a significant negative correlation between the ratios of the global index, word reformulations, empty words, and performance on the confrontation naming test. Finally, there was a significant negative correlation between the ratios of the global index, word reformulations, repetitions, delays, insertions, and performance on the generative naming tests. Conclusion: These results suggest the necessity of developing a naming evaluation scale based on spontaneous speech to effectively assess anomia in individuals with MCI and DAT. The study found significant differences in the rates of word-finding behavior among healthy elderly adults, individuals with MCI, and individuals with DAT, and a correlation between the rates of word-finding behavior and naming tests.

Shave, shear, shred, or cut: PPA variant differentially impacts erroneous responses produced in a confrontation naming test of verbs

ABSTRACT Background All common variants of primary progressive aphasia (PPA) exhibit naming deficits. Variants are distinguished by relative deficits in repetition (logopenic; lvPPA), object knowledge (semantic; svPPA), and agrammatism or articulation (non-fluent/agrammatic; nfavPPA; Gorno-Tempini et al., 2011). The Hopkins Action Naming Assessment (HANA) is a 30-item verb naming task that can distinguish between variants (Stockbridge et al., 2021). Item-level accuracy is driven by target verb frequency, semantic information density, and conceptual concreteness of the target word (Stockbridge, Venezia, et al., 2022). Aims In this investigation, we examined whether word frequency, semantic density, concreteness, and age of acquisition (AoA) also shaped the incorrect responses patients provided. We hypothesised that error responses would vary in these dimensions as a function of PPA variant. Methods & Procedures The HANA was administered to 271 participants with PPA, resulting in 443 total administrations and 4,529 analysable error responses. Standardised differences between error and target responses for frequency, density, concreteness, and AoA were calculated and averaged for each patient. Analysis of variance (ANOVA) for correlated samples was used to compare variants and planned post-hoc analyses examined the effect of variant on each response quality. Outcomes & Results Participants were similar in age, sex, handedness, and education. There was a significant interaction between PPA variant and the standardised mean differences in lexical qualities (Pillai’s Trace = 0.11, F(9, 747) = 3.19, p < 0.001). Univariate ANOVAs revealed significant differences in the semantic density of error responses relative to the target (F(3) = 7.91, p < 0.001, ηP 2= 0.09), as individuals with lvPPA tended to produce error responses with greater semantic density than the target when compared to the words produced by individuals with nfavPPA (mean difference = 1.45, 95%CI = [0.60,2.29], p < 0.001; Figure 1). PPA variants also differed in the concreteness of their error responses relative to the target (F(3) = 5.99, p<0.001, ηP 2 = 0.07), as error responses produced by individuals with nfavPPA were significantly more concrete than those with lvPPA (mean difference = 0.08, 95%CI = [0.02,0.13], p = 0.003) or svPPA (mean difference=0.08, 95%CI = [0.02,0.14], p = 0.007). Variants did not differ significantly in AoA or frequency of responses relative to their targets. All variants tended to produce more frequent words with a lower AoA than the target verb. Conclusions Error responses tended to be more semantically dense, more concrete, higher frequency, and younger AoA than the target verb. However, PPA variants differed significantly in the extent to which these broader trends held true. These distinct patterns may be included as part of a larger diagnostic picture that to distinguish among PPA variants.

Kids name the darndest things: confrontation naming in pediatric neuropsychology

ABSTRACT Few confrontation naming tests are designed for pediatric populations. The Children’s Visual Naming Test (cVNT; Hamberger et al., 2018) was developed to fill this gap. No independent studies using cVNT with clinical populations have been published to date. We aimed to characterize cVNT performance in a clinical sample and analyze the relationship between cVNT and other neuropsychological tests/constructs. Retrospective data was collected from 126 consecutively referred youth, aged 6–15 years (M = 11.28, SD = 2.80), who underwent clinical neuropsychological evaluation through an academic medical center. Naming under 2 seconds (cVNT-L2) and the summary scores (cVNT-SUM) were lower compared to the normative sample (cVNT-L2: M z =-1.30, SD = 2.17; cVNT-SUM: M z =-1.26, SD = 2.15). cVNT was related to core verbal abilities, processing speed, and response inhibition. cVNT-L2 and cVNT-SUM, but not naming under 20 seconds, were related to overall intellectual functioning, verbal fluency, and working memory, and were associated with overall attention, processing speed, executive functions, and verbal fluency. The cVNT provides assessment of confrontation naming without downward extension in pediatric neuropsychological assessment. Importantly, cVNT offers variables of higher fidelity to the neural process of naming than previous measures. cVNT may be associated with commonly assessed neuropsychological functions, providing a rapidly effective tool for screening batteries or improving efficiency.

Inter-Relationship between Conceptual Ambiguity and Naming Performance in Persons with Aphasia

Aphasia is an acquired language disorder with a wide variety of symptoms. Anomia or word finding difficulty is a common symptom of aphasia regardless of the type of Aphasia. Conventionally a wide variety of confrontation naming tests are used to assess the naming domain in Aphasia. However the confrontation naming test is deemed to be simple limiting its utility. The current study uses fusion pictures which are conceptually loaded. The developed test was administered on 8 persons with aphasia and 0 neuro-typical adults. Both between and within group analysis revealed a significant difference. Persons with aphasia exhibited more difficulty on fusion compared to non-fusion pictures unveiling the role of conceptual ambiguity in naming.

Correlations among Tip of the Tongue Phenomenon, Common Noun Naming and Memory in Healthy Elderly Adults

Objectives: The frequency of the ‘tip of the tongue (TOT) phenomenon’, a condition in which a person feels they know a target word but cannot recall its name, increases with aging. The purpose of this study was to examine the relationships among the TOT phenomenon, common noun naming, and memory.Methods: Eighty-eight healthy elderly adults participated in the study. The study used a TOT phenomenon task (celebrity naming test), common noun naming tasks (confrontational naming and generative naming), and subjective and objective memory tasks.Results: First, there were significant correlations among the total score of the confrontation naming test, the performances of generative naming test, and the TOT rate. Second, the voluntary TOT solution rate was not significantly related to performance on the common noun naming test. However, the TOT solution rate after syllable cues was significantly correlated with the performance of the confrontation naming test, the correct response rate after syllabic cues, and the phonemic category of the generative naming test. Third, the performances of subjective and objective memory were significantly correlated with the TOT rate. Fourth, the voluntary TOT solution rate was correlated with the delayed recall of objective memory, while the TOT solution rate after syllable cues was only correlated with subjective memory. Finally, regression analyses showed that confrontation naming, delayed recall, and recognition influenced the TOT rate.Conclusion: The clinical significance of this study is that it examined the relationships among the TOT phenomenon, common noun naming, and memory in healthy elderly adults.

Relationships between sleep apnea and insomnia with cognition among Latinos in the National Alzheimer’s Coordinating Center (NACC)

AbstractBackgroundSleep difficulties (e.g., sleep apnea, insomnia) have been associated with worse late life cognitive health and increased risk for dementia. However, the role of sleep, a potentially modifiable factor, in cognitive aging is understudied among Hispanics/Latinos/Latinxs (henceforth Latinos)—a group that faces dementia disparities. Therefore, we examined the relationships between sleep difficulties and cognition in this population using data from the National Alzheimer’s Coordinating Center (NACC).MethodParticipants included 1,633 Latinos (64% females) ages 21 to 98 years old from the NACC (funded by NIA/NIH Grant U24 AG072122). This analysis used data collected at 35 ADRCs from 2015‐2022. Exposures included history of self‐reported and/or clinically assessed sleep apnea (n = 261) and hyposomnia/insomnia (n = 384). Outcomes were concurrent cognitive scores from tests of learning, memory, semantic fluency, processing speed, confrontation naming, and executive functioning. Covariates included age, sex, education, heritage (e.g., Cuban), cognitive status, and body mass index. General linear models separately tested the associations between sleep difficulties with cognition in crude and fully‐adjusted models. Additionally, we examined whether sex, age, or heritage modified these associations.ResultsSleep apnea was associated with faster processing speed, and insomnia was associated with worse confrontation naming in crude but not fully‐adjusted models. In fully adjusted models, sex modified the associations of both sleep apnea and insomnia with semantic fluency. Specifically, men without sleep apnea had worse semantic fluency than all other groups; no other group differences emerged. Females in either insomnia group had better semantic fluency than men in either insomnia group, and women without insomnia had marginally better semantic fluency than women with insomnia. Older age (continuous) was associated with worse executive functioning, specifically working memory, among individuals with insomnia to a greater extent than those without insomnia. Heritage did not modify associations between sleep difficulties with cognition.ConclusionConsistent with previous, we found that sleep measures were associated with cognition in this group of Latinos from a wide age‐range. Our findings were specific to semantic fluency and varied based on demographic factors (e.g., sex). Future studies should examine the relationships between sleep with longitudinal change in cognition in this underserved community.

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 &lt; .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.

30 Analyzing Spanish Speakers Cordoba Naming Test Performance

Objective:A 30-item confrontation naming test was developed in Argentina for Spanish speakers, The Cordoba Naming Test (CNT). The Boston Naming Test is an established confrontation naming task in the United States. Researchers have used the Boston Naming Test to identify individuals with different clinical pathologies (e.g., Alzheimer’s disease). The current literature on how Spanish speakers across various countries perform on confrontational naming tasks is limited. To our knowledge, one study investigated CNT performance across three Spanish-speaking countries (i.e., Argentina, Mexico, and Guatemala). Investigators found that the Guatemalan group underperformed on the CNT compared to the Argentine and Mexican groups. The purpose of this study was to extend the current literature and investigate CNT performance across five Spanish-speaking countries (i.e., Argentina, Mexico, Guatemala, Colombia, United States). We predicted that the Argentine group would outperform the other Spanish-speaking countries.Participants and Methods:The present study sample consisted of 502 neurologically and psychologically healthy participants with a mean age of 29.06 (SD = 13.41) with 14.75 years of education completed (SD = 3.01). Participants were divided into five different groups based on their country of birth and current country residency (i.e., United States, Mexico, Guatemala, Argentina, &amp; Colombia). All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in Spanish. The CNT consisted of 30 black and white line drawings, ranging from easy to hard in difficulty. An ANCOVA, controlling for gender, education, and age, was used to evaluate CNT performance between the five Spanish-speaking country groups. Meanwhile, a Bonferroni post-hoc test was utilized to evaluate the significant differences between Spanish-speaking groups. We used a threshold of p &lt; .05 for statistical significance.Results:Results revealed significant group differences between the five Spanish speaking groups on the CNT, p = .000, np2 = .48. Bonferroni post-hoc test revealed that the United States group significantly underperformed on the CNT compared to all the Spanish-speaking groups. Next, we found the Guatemalan group underperformed on the CNT compared to the Argentinian, Mexican, and Colombian groups. Additionally, we found the Argentinian group outperformed the Mexican, Guatemalan, and United States groups on the CNT. No significant differences were found between the Argentinian group and Colombian group or the Mexican group and Colombian group on the CNT.Conclusions:As predicted, the Argentinian group outperformed all the Spanish-speaking groups on the CNT except the Colombian group. Additionally, we found that the United States group underperformed on the CNT compared to all the Spanish-speaking groups. A possible explanation is that Spanish is not the official language in the United States compared to the rest of the Spanish-speaking groups. Meanwhile, a possible reason why the Argentinian and Colombian groups demonstrated better CNT performances might have been that it was less culturally sensitive than the United States, Mexican, and Guatemalan groups. Further analysis is needed with bigger sample sizes across other Spanish-speaking countries (e.g., Costa Rica, Chile) to evaluate what variables, if any, are influencing CNT performance.

The Relationship Between Memory, Type, and Severity of Aphasia With Confrontation Naming in Post-stroke Patients With Chronic Aphasia

Objectives: The brain’s widespread neural functions lead to aphasia in which the patients experience difficulties in cognitive and language functions. Memory, type, and severity of aphasia are associated with language and the naming process. In the current study, we investigated the relationship between memory, type, and severity of aphasia using the confrontation naming test in post-stroke patients with chronic aphasia. Methods: This research was a descriptive-analytic cross-sectional study. We selected 45 chronic aphasia patients aged 35-70 years. The participants with a mild to moderate score in Mini-Mental State Examination (MMSE) were assessed with the Persian naming test, Wechsler Memory Scale, and Persian Western Aphasia Battery. Results: There was a significant difference between memory with correct answers without a cue, correct answers with a semantic cue, and the total correct answers from confrontation naming (P&lt;0.001, r=0.62; P=0.01, r=0.37; and P&lt;0.001, r=0.71; respectively). Furthermore, the results indicated a significant difference between the type of aphasia with subtests of confrontation naming involving correct answers with semantic cues and total correct answers (P=0.02). Also, the results showed a significant difference between the severity of aphasia with correct answers without a cue, correct answers with a semantic cue, and the total correct answers from confrontation naming (P&lt;0.001, r=0.77; P=0.03, r=0.31; and P&lt;0.001, r=0.67; respectively). In comparing semantic and phonetic cues, memory, type, and severity of aphasia indicated significant association only with semantic cues. Discussion: There is an association between memory, type, and severity of aphasia with confrontation naming in patients with aphasia. The data have highlighted the importance of factors that need to be considered to formulate a comprehensive treatment plan to achieve further improvement in naming skills.

Anomia across the atypical AD phenotypic spectrum

AbstractBackgroundVisual naming is impaired in AD, most prominently in the typical late‐onset amnestic and logopenic variant Primary Progressive Aphasia (lvPPA) syndromes. However, little is known about how patients with these or other AD syndromes (Posterior Cortical Atrophy; PCA, and early‐onset amnestic dysexecutive) perform on auditory confrontation naming tests that do not rely on visual perception of stimuli. Performance on such tests may be of particular relevance to measuring anomia in PCA, who present with visual cognitive deficits. The present study analyzes Auditory Naming Test (ANT) performance across the atypical AD phenotypic spectrum.MethodFifty‐three patients (19 PCA, 13 lvPPA, 21 amnestic dysexecutive) were administered the ANT. Total uncued correct responses and total correct responses with phonemic cues were analyzed. Performance differences between groups were evaluated using one‐way ANOVA. Independent samples t‐tests were performed to verify between‐group differences.ResultUncued auditory naming was impaired across all atypical AD groups, with group differences observed (F(2,50)=10.31, p&lt;0.001) such that the lvPPA group (60% correct) performed most poorly followed by the amnestic dysexecutive group (77% correct; t=2.09, p=0.04). PCA patients performed best (91% correct; lvPPA &lt; PCA, t=5.5, p&lt;0.001; amnestic dysexecutive &lt; PCA, t=2.5, p=0.02). Auditory naming after phonemic cuing also differed across groups (F(2,50)=6.15, p=0.004): lvPPA (76% correct), amnestic dysexecutive (81% correct), and PCA (97% correct). Performance was still impaired in lvPPA and amnestic dysexecutive groups after cuing, but were comparable to each other (p &gt; 0.6), while PCA patients performed better than lvPPA (t=4.5, p=0.001) and amnestic dysexecutive (t=2.7, p=0.03) groups, falling within normal limits.ConclusionAuditory naming was most impaired in lvPPA but improved with phonemic cues. In contrast, cues did not greatly improve performance in the amnestic dysexecutive group, suggesting either a goal‐directed retrieval deficit or semantic knowledge loss. PCA patients demonstrated mild word retrieval deficits in the absence of visual stimuli, potentially reflecting auditory‐verbal working memory deficits previously identified in the literature. However, the PCA group improved with phonemic cuing, suggesting intact semantic knowledge. We plan to build on these results by next examining the cognitive contributors to and regional atrophy correlates of ANT performance in each group.

A-46 The Influence of Acculturation on Mexicans and Guatemalans Cordoba Naming Test Performance

Abstract Objective The United States carries a diverse Latinx population. This population largely consists of Mexicans however, there has been a population decrease since 2010. Though, the Guatemalan population has increased since 2010 and has become the third most growing population in the United States. Previous research shows that level of acculturation influences neuropsychological test performance. The Córdoba Naming Test (CNT) is a confrontation naming test created for Spanish-speakers. We examined the relationship between acculturation and CNT performance in a Latinx sample that immigrated to the United States. Method The sample consisted of 44 Mexicans and 14 Guatemalans that were neurologically and psychologically healthy residents. All the participants completed the CNT and the Abbreviated Multidimensional Acculturation Scale (AMAS) in Spanish. ANOVAs were used to examine CNT performance and acculturation on the AMAS subscales. Results Results revealed the Guatemalan immigrant group outperformed the Mexican immigrant group on the CNT, p = 0.035, ηp2 = 0.08. Additionally, we found that on the English language subscale of the AMAS, the Mexican immigrant group reported higher English language levels than the Guatemalan immigrant group, p = 0.002, ηp2 = 0.16. Conclusion Our findings showed that Guatemalans demonstrated better CNT performance compared to Mexicans. To our knowledge, this is the first study to examine confrontation naming performance in a Latinx immigrant sample. Furthermore, we found that Mexicans reported higher English language compared to Guatemalans. Future research on the CNT with larger samples should investigate possible interactions between acculturation and other cultural variables (e.g., bilingualism) in the interpretation of test performance in a Latinx immigrant population.

Computer Adaptive Testing for the Assessment of Anomia Severity.

Anomia assessment is a fundamental component of clinical practice and research inquiries involving individuals with aphasia, and confrontation naming tasks are among the most commonly used tools for quantifying anomia severity. While currently available confrontation naming tests possess many ideal properties, they are ultimately limited by the overarching psychometric framework they were developed within. Here, we discuss the challenges inherent to confrontation naming tests and present a modern alternative to test development called item response theory (IRT). Key concepts of IRT approaches are reviewed in relation to their relevance to aphasiology, highlighting the ability of IRT to create flexible and efficient tests that yield precise measurements of anomia severity. Empirical evidence from our research group on the application of IRT methods to a commonly used confrontation naming test is discussed, along with future avenues for test development.

Expanded Exploration of the Auditory Naming Test in Patients with Dementia.

Auditory naming tests are superior to visual confrontation naming tests in revealing word-finding difficulties in many neuropathological conditions. To delineate characteristics of auditory naming most likely to reveal anomia in patients with dementia, and possibly improve diagnostic utility, we evaluated a large sample of patients referred with memory impairment complaints. Patients with dementia (N = 733) or other cognitive impairments and normal individuals (N = 69) were evaluated for frequency of impairment on variables of the Auditory Naming Test (ANT) of Hamberger & Seidel versus the Boston Naming Test (BNT). Naming impairment occurred more frequently using the ANT total score (φ= 0.41) or ANT tip-of-the tongue score (TOT; φ= 0.19) but not ANT mean response time compared to the BNT in patients with dementia (p < 0.001). Significantly more patients were impaired on ANT variables than on the BNT in Alzheimer's disease (AD), vascular dementia (VaD), mixed AD/VaD, and multiple domain mild cognitive impairment (mMCI) but not in other dementias or amnestic MCI (aMCI). This differential performance of patients on auditory versus visual naming tasks was most pronounced in older, well-educated, male patients with the least cognitive impairment. Impaired verbal comprehension was not contributory. Inclusion of an ANT index score increased sensitivity in the dementia sample (92%). Poor specificity (41%) may be secondary to the inherent limitation of using the BNT as a control variable. The ANT index score adds diagnostic utility to the assessment of naming difficulties in patients with suspected dementia.

Psycholinguistic variables influencing word retrieval in Persian speaking people with aphasia

ABSTRACT Background Word retrieval deficits are one of the hallmark symptoms of people with aphasia (PWA). Psycholinguistic variables can predict word retrieval accuracy and latency in aphasia, but results to date have been mixed. Aims In this study, we investigate the effects of age of acquisition (AOA), familiarity, word frequency, and word length on the naming accuracy and reaction time of Persian-speaking PWA. Methods & Procedures This study consists of 25 participants with mild to moderate aphasia who completed a confrontation naming test. Naming accuracy was determined per participant per picture and reaction times were calculated using DMDX and CHECKVOCAL. Outcomes & Results The results showed that the four psycholinguistic variables were significantly correlated with naming accuracy and reaction time across the group of PWA. Multiple linear regressions demonstrated that among the four psycholinguistic variables, word familiarity had the strongest effect on reaction time; frequency and familiarity were most predictive of naming accuracy. Conclusions The purpose of the present study was to evaluate the influence of four psycholinguistic variables on word retrieval in Persian-speaking PWA using picture naming. The result of this study showed that word familiarity led to more accurate and faster retrieval, while word frequency led to more accurate word retrieval. The effect of psycholinguistic variables in picture naming is relevant to various fields of study, such as the underlying processes of language production, brain lesions, and functional imaging of naming.

Exploring Parkinson’s Disease Predictors based on Basic Intelligence Quotient and Executive Intelligence Quotient

It is important to identify the risk factors of dementia and prevent them for the health of patients and caregivers. This study (1) explored sampling methods that could minimize overfitting due to data imbalance using a data-level approach, (2) developed nine ensemble learning models for predicting Parkinson's Disease–Mild Cognitive Impairment (PD-MCI) ((undersampling, oversampling, and SMOTE) × (boosting, bagging, and random forest)=9), and (3) compared the accuracies, sensitivities, and specificities of these models to understand the prediction performance of the developed models. We examined 368 subjects: 320 healthy elderly people (≥60 and ≤74 years old) without Parkinson's disease (168 men and 152 women) and 48 subjects with PD-MCI (20 men and 28 women). This study used the Cognition Scale for Olde Adults (CSOA), which could measure cognitive functions comprehensively while considering age and education level, to determine the specific cognitive level of the subject. Our study developed nine prediction models ((undersampling, oversampling, and SMOTE) × (boosting, bagging, and random forest)=9) for developing a model to predict PD-MCI based on basic intelligence quotient and executive intelligence quotient. The analysis results showed that a random forest classifier with SMOTE had the best prediction performance with a sensitivity of 69.2%, a specificity of 75.7%, and a mean overall accuracy of 74.0%. In this final model, digit span test-backward, stroop test-interference trial, verbal memory test-delayed recall, verbal fluency test, and confrontation naming test were identified as the key variables with high weight in predicting PD-MCI. The results of this study implied that a random forest classifier with SMOTE could produce models with higher accuracy than a bagging classifier with SMOTE or a boosting classifier with SMOTE when analyzing imbalanced data.

Mild Cognitive Impairment in Retired Professional Football Players With a History of Mild Traumatic Brain Injury: A Pilot Investigation

Traumatic brain injury (TBI) is a known risk factor for neurodegenerative dementias such as Alzheimer disease (AD); however, the potential risk of mild cases of TBI, such as concussions, remains unclear. To explore whether a small sample of retired professional athletes with a diagnosis of mild cognitive impairment (MCI)-the prodromal stage of AD-and a history of multiple mild TBIs exhibit greater neuropsychological impairment than age-matched nonathletes with MCI and no history of TBI. Ten retired National Football League players diagnosed with MCI and reporting multiple mild TBIs, and 10 nonathletes, also diagnosed with MCI but with no history of TBI, completed a standard neurologic examination and neuropsychological testing. Independent samples t tests were conducted to examine differences in neuropsychological performance between the two groups. The retired athletes with a history of mild TBI obtained generally similar scores to the nonathlete controls on measures of verbal learning and memory, verbal fluency, and processing speed. However, the retired athletes scored lower than the controls on tests of confrontation naming and speeded visual attention. Retired athletes with MCI and a history of mild TBI demonstrated similar neuropsychological profiles as nonathlete controls despite lower scores on measures of confrontation naming and speeded visual attention. These findings suggest that a history of multiple mild TBIs does not significantly alter the overall neuropsychological profile of individuals with MCI; confirmation of this will require longitudinal research with larger sample sizes.

Word retrieval across the biomarker-confirmed Alzheimer's disease syndromic spectrum

Alzheimer's disease (AD) is now conceptualized as a biological entity defined by amyloid and tau deposition and neurodegeneration, with heterogeneous clinical presentations. With the aid of in vivo biomarkers, clinicians are better poised to examine clinical syndromic variability arising from a common pathology. Word retrieval deficits, measured using verbal fluency and confrontation naming tests, are hallmark features of the early clinical stages of the amnestic presentations of AD, specifically in category fluency and naming with relatively spared letter fluency. As yet, there is no consensus regarding performance on these tests in atypical clinical phenotypes of AD, including posterior cortical atrophy (PCA) and logopenic primary progressive aphasia (lvPPA), in individuals who are amyloid-positive (Aβ+) but present with different clinical profiles and patterns of neurodegeneration compared to amnestic AD. The goal of the current study is to determine how Aβ+ individuals across the syndromic spectrum of AD perform on three different word retrieval tasks. A secondary goal is to determine the neuroanatomical substrates underlying word retrieval performance in these Aβ+ individuals. Thirty-two Aβ+ participants with the amnestic presentation, 16 with Aβ+ PCA, 22 with Aβ+ lvPPA, and 99 amyloid-negative (Aβ-) control participants were evaluated with verbal fluency and visual confrontation naming tests as well as high-resolution MRI. The Aβ+ patient groups were rated at very mild or mild levels of severity (CDR 0.5 or 1) and had comparable levels of global cognitive impairment (average MMSE = 23.7 ± 3.9). Behaviorally, we found that the word retrieval profile of PCA patients is comparable to that of amnestic patients, characterized by intact letter fluency but impaired category fluency and visual confrontation naming, while lvPPA patients demonstrated impairment across all tests of word retrieval. Across all AD variants, we observed that letter fluency was associated with cortical thickness in prefrontal, central precuneus, lateral parietal and temporal cortex, while category fluency and naming were associated with cortical thickness in left middle frontal gyrus, posterior middle temporal gyrus, and lateral parietal cortex. Visual confrontation naming was uniquely associated with atrophy in inferior temporal and visual association cortex. We conclude that a better understanding of the word retrieval profiles and underlying neurodegeneration across the AD syndromic spectrum will help improve interpretation of neuropsychological profiles with regard to the localization of neurodegeneration, particularly in the atypical AD variants.

Comparing the Boston Naming Test With the Neuropsychological Assessment Battery–Naming Subtest in a Neurodegenerative Disease Clinic Population

The Boston Naming Test-Second edition (BNT-2) and the Neuropsychological Assessment Battery-Naming (NAB-N) subtest are two commonly used confrontation naming tests used to evaluate word-finding ability in individuals suspected of neurodegenerative disease. The BNT-2 and NAB-N are designed to measure the same construct; however, observations in practice suggest these two tests provide divergent estimates of naming ability. This study sought to systematically investigate the level of agreement between performance on the BNT-2 and NAB-N. Records from 105 consecutive referrals seen for neuropsychological evaluation as part of routine care in an outpatient memory disorders clinic were reviewed. Discrepancy scores, concordance correlation coefficients, and root mean squared differences were calculated between demographically adjusted T-scores on the BNT-2 and NAB-N. Results indicated that estimates of word finding ability generated by the BNT-2 and NAB-N have a strong linear relationship but systematically generate scores that are inconsistent. Despite similar task demands, the BNT-2 and NAB-N provide different information about naming ability and further research is needed to understand these differences and inform clinicians on interpreting the naming estimates provided by each test.

A-01 Age of Immigration and Test Performance for Immigrant Spanish-speakers on Córdoba Naming Test

Abstract Objective This study examines the correlation between age of immigration for Spanish speakers in the USA and their performance on the Córdoba Naming Test (CNT), a confrontation naming test designed to be multicultural. We predicted that those who immigrated at a later age, whom we expect to have more years of education in their native language, will perform better on the CNT. Method The study used the CNT with a sample of 44 Spanish-speakers from the United States. We worked with participants with no prior history of medical complications, such as damage to the central nervous system, drug use, or excessive alcohol use. 21 male and 23 female participants were recruited. The age of participants ranged from 20 to 89 years old and education ranged from 0 to 22 years of schooling (either in the United States or in their native country). The variables of focus are the age of immigration into the United States (when participants migrated into the US) and their test performance on the CNT (total score of correct responses). Results Our results indicate a statistically significant positive correlation between age of immigration and performance on the CNT, (r(44)) = .357, p = .019). Conclusions: The overall trend of the data suggested that older age at immigration was indeed associated with better performance on the CNT, thus highlighting the importance of language and acculturation issues when being assessed with neuropsychological or cognitive testing. Conclusions The overall trend of the data suggested that older age at immigration was indeed associated with better performance on the CNT, thus highlighting the importance of language and acculturation issues when being assessed with neuropsychological or cognitive testing.

How Does Circadian Rhythmicity Relate to Neuropsychological and Neuroimaging Markers in Older People at Risk for Dementia?

BACKGROUND: Changes in the circadian regulation of the sleep-wake cycle occur with ageing and may be linked to neurodegeneration. It is unclear the extent to which such changes are evident in mild cognitive impairment (MCI), and how they may relate to neuropsychological functioning, the integrity of key temporal lobe structures and longitudinal decline. METHOD: 334 older individuals (mean age=66.1, sd=8.9) with subjective cognitive impairment (SCI) and MCI (mean MMSE=28.1, sd=1.4) received detailed neuropsychological assessment including Logical Memory, Rey Auditory Verbal Learning Test, Rey Figure and Boston Naming Test. They also received clinical and wrist-worn actigraphic assessment, and a subset of 60 individuals underwent neuroimaging. Circadian rhythm analysis was performed using non-parametric methods to obtain intradaily variability, interdaily stability, and activity during the least and most active 5-hours and 10-hours of the day, respectively. Cosinor methods were also used to derive amplitude, mean, and variability of the rest-activity rhythm. For the neuroimaging subset, cortical thickness of the entorhinal cortex and hippocampal volume were derived using Freesurfer. A subset of 90 individuals had 2-year longitudinal follow-up data from which memory decline scores were computed. RESULTS: Compared to SCI, after controlling for age, participants with MCI showed significantly greater intradaily variability as well as lower amplitude of activity across the circadian period, and lower activity during the most active 10-hour period. Across both groups, circadian disruption was associated with poorer performance on tests of verbal memory (p<0.05), visuospatial memory (p<0.001) and confrontation naming (p<0.001). Lower activity amplitude was associated with reduced cortical thickness in the entorhinal cortex. For those with follow-up data, greater activity during the least active 5-hours of the day was associated with memory decline longitudinally (p<0.05). CONCLUSION: Disruptions to the rest-activity cycle relate to both memory and language decline cross-sectionally and memory decline longitudinally as well as to degeneration of key temporal brain regions. Alterations in this cycle may represent a preclinical or prognostic marker for dementia and may warrant intervention.