Evaluating Language Comprehension in Alzheimer's disease: the use of the Token Test

Abstract

<jats:p>OBJECTIVE: To analyze the psychometric properties of the Token test (TT), a verbal comprehension test, and its applicability to the diagnosis of mild Alzheimer's disease (AD). METHODS: One hundred and sixty participants (80 AD and 80 controls) performed the TT and a short battery of neuropsychological tests designed to evaluate general cognitive status, working memory and executive functions. Internal consistency, factor structure, correlation with other measures and group comparisons were evaluated. RESULTS: The test evinced good internal consistency and a bi-factorial structure (related to comprehension and attention). Differences between AD and controls were significant, however the TT presented only moderate sensitivity and specificity for the AD diagnosis. CONCLUSION: The TT showed evidence of good psychometric properties and adequacy for characterizing comprehension deficits in AD, but it was not an appropriate test for the AD detection and diagnosis.</jats:p>

Clinical Applicability and Cutoff Values for an Unstructured Neuropsychological Assessment Protocol for Older Adults with Low Formal Education

“…The sensitivity and specificity for AD vs. MCI and MCI vs. NA was lower than those observed for AD vs. NA, but still at an acceptable range to be used in clinical practice. Our results are in accordance with other studies, with minor differences in the proposed cut-off value, and differences might be explained by sample particularities [2], [5], [10], [12]. Interestingly, our results are similar to those found in another Brazilian study which examined an elderly population with higher educational level and used a different neuropsychological protocol [2].…”

“…The short version (36 items) is adapted [24], validated [10] and has adequate normative data [13] for this population. The test was divided in two components for this study, based on the factor structure proposed on a previous report [10]: Token Test – Attention (items 1 to 15) and Token Test – Comprehension (items 16 to 36).…”

“…Two categories and one letter were chosen for the protocol, based on the normative and validity studies for the Brazilian population: Animals [5], Fruits [12] and “ S” [25] generated in one minute. The test is very sensitive for cognitive impairment in different clinical conditions [2], [10], [12].…”

Linguagem em idosos com doença de Alzheimer: uma revisão sistemática

“…Many articles showed no language problems. The study by Paula et al 11 investigated the Token Test (TT) psychometric properties, which is a verbal comprehension test, and its applicability in the diagnosis of Alzheimer's disease (AD) at an early stage. The test shows good consistency related to understanding and attention.…”

“…The aim was to prepare adequate language strategies, allowing discursive mechanisms development, in order to identify strategies to improve the interaction between caregivers with Alzheimer type dementia. With respect to Alzheimer's disease stages, three articles have addressed the initial stage, [10][11][12] two articles the moderate stage 12,13 , one article addressed all stages 14 and two reported no stage 15,16 . In the first stage (Table 1), memory impairment, episodic subsystem deficits prevalence and semantic and language memory impairment were observed.…”