Composite Indices of the Color-Picture Version of Boston Naming Test Have Better Discriminatory Power: Reliability and Validity in a Chinese Sample with Diverse Neurodegenerative Diseases

Article type: Research Article

Authors: Li, Dan^{a; *} | Yu, Yue-Yi^a | Hu, Nan^b | Zhang, Min^c | Sun, Fang-Ling^d | Liu, Li^e | Fan, Li-Mei^e | Ruan, Shi-Shuang^e | Wang, Fen^a | Rosa-Neto, Pedro^{f; g; h}

Affiliations: [a] Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China | [b] Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Australia | [c] Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China | [d] Department of Laboratory Animal Center, Xuanwu Hospital, Capital Medical University, Beijing Municipal Geriatric Medical Research Center, Beijing, P.R. China | [e] Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China | [f] Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Canada | [g] Department of Neurology and Neurosurgery, McGill University, Montreal, Canada | [h] Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada

Correspondence: [*] Correspondence to: Dan Li, MD, Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Changchun Street 45, Xicheng District, Beijing, P.R. China, 100053. Tel.: +86 10 83198869; E-mail: danli@xwhosp.org.; ORCID: 0000-0001-7485-0807

Abstract: Background:The Boston Naming Test (BNT) is the most widely used measure to assess anomia. However, it has been criticized for failing to differentiate the underlying cognitive process of anomia. Objective:We validated the color-picture version of BNT (CP-BNT) in a sample with diverse neurodegenerative dementia diseases (NDDs). We also verified the differential ability of the composite indices of CP-BNT across NDDs groups. Methods:The present study included Alzheimer’s disease (n = 132), semantic variant primary progressive aphasia (svPPA, n = 53), non-svPPA (n = 33), posterior cortical atrophy (PCA, n = 35), and normal controls (n = 110). We evaluated psychometric properties of CP-BNT for the spontaneous naming (SN), the percentage of correct responses on semantic cuing and word recognition cuing (% SC, % WR). Receiver operating characteristic analysis was used to examine the discriminatory power of SN alone and the composite indices (SN, % SC, and % WR). Results:The CP-BNT had sufficient internal consistency, good convergent, divergent validity, and criterion validity. Different indices of CP-BNT demonstrated distinct cognitive underpinnings. Category fluency was the strongest predictor of SN (β= 0.46, p < 0.001). Auditory comprehension tests highly associated with % WR (Sentence comprehension: β= 0.22, p = 0.001; Word comprehension: β= 0.20, p = 0.001), whereas a lower visuospatial score predicted % SC (β= –0.2, p = 0.001). Composite indices had better predictability than the SN alone when differentiating between NDDs, especially for PCA versus non-svPPA (area under the curve increased from 63.9% to 81.2%). Conclusion:The CP-BNT is a highly linguistically relevant test with sufficient reliability and validity. Composite indices could provide more differential information beyond SN and should be used in clinical practice.

Keywords: Alzheimer’s disease, anomia, language tests, neurodegenerative disease, primary progressive aphasia

DOI: 10.3233/JAD-221227

Journal: Journal of Alzheimer's Disease, vol. 94, no. 1, pp. 393-404, 2023