The Italian Version of the Five-Word Test: A Simple Diagnostic Test for Dementia due to Alzheimer’s Disease in Routine Clinical Practice

Abstract

Background The five-word test (FWT) is a neuropsychological tool (derived from the Grober and Buschke paradigm), measuring hippocampal memory trace consolidation. The study aimed to validate the test for the Italian language and to verify its ability to discriminate patients affected by mild cognitive impairment and dementia due to Alzheimer's disease from healthy matches. Methods 217 subjects (127 controls, 47 MCI due to AD, and 43 AD) underwent neuropsychological evaluation. The Spearman rank coefficient (ρ) was used to assess the correlation between immediate (IRS), delayed (DRS), and total score (TRS) of the FWT and correspondent matches of a specific short story test, while receiving operator characteristic (ROC) curves were built to investigate the diagnostic accuracy of both. Results Correlation between almost all the scores was significant in all the diagnostic subgroups; the ROC curves of the two tests were not statistically different. A TRS of the FWT with a cut-off of ≤9/10 could accurately discriminate AD patients (sensitivity: 97%, specificity: 94%) and MCI due to AD (sensitivity: 76%, specificity: 68%) from control matches. Conclusion FWT is a simple and valid test of hippocampal memory which appears recommendable in routine clinical practice.

Spanish validation and cultural adaptation of the Five-Word Test for the detection of the neurocognitive disorder in older adults

“…Nevertheless, using the 5WT (with a cut-off point of ≤ 16; 89% sensitivity and 98% specificity) together with the MMSE (with a cut-off point of ≤ 24; 83% sensitivity, and 96% specificity) could be a strategy for increasing the diagnostic accuracy of major ND with neurodegenerative etiology (Alzheimer's disease) because the nature of the 5WT allows an analysis of the amnesic mechanisms that are only superficially explored by the MMSE. On the other hand, as in the study by Rozzini et al (2017), the 5WT proved to be useful for identifying subjects with minor ND or mild cognitive impairment (MCI), albeit with lower sensitivity and specificity and area under the curve, which was .77 (95% CI [.70, .85]) with a cut-off point of ≤ 18, 66% sensitivity and 77% specificity, which can be attributed to the subtlety and heterogeneity of the cognitive alterations present in subjects with MCI. Accordingly, the use of such a screening tool could be insufficient for identifying minor ND due to the false positives it contains.…”

Translation, Adaptation and Validation of the Five-Word Test (Test Delle 5 Parole, T5P) in an Italian Sample: A Rapid Screening for the Assessment of Memory Impairment

“…Firstly, we have translated the original version of the five-word test into the Italian language [13]. Unlike previous studies [23], we adapted the test to the Italian language during the translation process from French to Italian, demonstrating that a literal translation was not satisfactory in a small sample. Then, we validated this adapted version in a large sample (n = 264) consisting of 60 patients with AD, 80 subjects with MCI, 46 participants with FMD, and 78 healthy controls, matched for education and gender.…”

Diagnostic Accuracy of the Five-Word Test for Mild Cognitive Impairment Due to Alzheimer’s Disease

“…Participants underwent the cognitive assessment with two screening instruments, the five-word test (Italian validation [ 24 ]) and the mini-mental state examination [ 27 ]. MMSE scores were corrected for age and years of schooling using the Italian validation [ 31 ].…”

“…Several neuropsychological tests using long word lists have been usually administered to differentiate the subjective memory complaints, which is a common symptom in an aging population [ 21 ], with the objective episodic memory impairment which seems to be unique of AD-MCI [ 22 ]. Indeed, the symptoms of the disease typically begin with mild memory difficulties [ 19 ], such as episodic memory loss due to the changes in the hippocampal volume [ 2 , 23 ], and to the disconnection of the hippocampus from the associative neocortical regions [ 24 , 25 ]. A previous hypothesis stated that patients with AD do not benefit from the semantic facilitation (i.e., cue) during the retrieval phase of a memory task [ 22 , 26 ].…”

“…A previous hypothesis stated that patients with AD do not benefit from the semantic facilitation (i.e., cue) during the retrieval phase of a memory task [ 22 , 26 ]. Starting from this assumption, the five-word test (FWT) seems to be a valid test to assess the verbal episodic memory and the hippocampal memory trace consolidation, and it is a simple instrument for the screening of AD [ 24 ]. However, the accuracy of the FWT has not yet been assessed in patients with a biomarker supported diagnosis of AD-MCI vs. non-AD-MCI.…”