Expanded Exploration of the Auditory Naming Test in Patients with Dementia

Article type: Research Article

Authors: Hirsch, Joseph A.^{a; b; *} | Cuesta, George M.^{c; d} | Fonzetti, Pasquale^e | Comaty, Joseph^f | Jordan, Barry D.^g | Cirio, Rosanna^h | Levin, Leanneⁱ | Abrahams, Alex^j | Fry, Kathleen M.^k

Affiliations: [a] Department of Psychiatry, Lenox Hill Hospital, Northwell Health, New York, NY, USA | [b] Department of Psychology, Pace University, New York, NY, USA | [c] New York Harbor Healthcare System, Veterans Health Administration, New York, NY, USA | [d] New York University Langone Medical Center, New York, NY, USA | [e] Westmed Medical Group, Purchase, NY, USA | [f] Matrix, Inc., Baton Rouge, LA, USA | [g] Rancho Los Amigos National Rehabilitation Hospital, Downey, CA, USA | [h] Ascensia Diabetes Care, Valhalla, NY, USA | [i] New York Medical College, Department of Medicine, Valhalla, NY, USA | [j] Mount Sinai Hospital, New York, NY, USA | [k] George E. Wahlen Department of Veterans Affairs Medical Center, Department of Psychology, Salt Lake City, UT, USA

Correspondence: [*] Correspondence to: Dr. Joseph A. Hirsch, PhD, PsyD, 280 Madison Ave, Suite 1402, New York, NY 10016, USA. Tel.: +1 917 865 5066; E-mail: [email protected]. The research was done at Burke Rehabilitation Hospital, Department of Neurology, Montefiore Health System, White Plains, NY, USA, in which the IRB approval was received.

Abstract: Background:Auditory naming tests are superior to visual confrontation naming tests in revealing word-finding difficulties in many neuropathological conditions. Objective: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. Methods: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). Results: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. Conclusion:The ANT index score adds diagnostic utility to the assessment of naming difficulties in patients with suspected dementia.

Keywords: Alzheimer’s disease, anomia, auditory naming, boston naming test, dementia, mild cognitive impairment, neuropsychological assessment, word-finding

DOI: 10.3233/JAD-210322

Journal: Journal of Alzheimer's Disease, vol. 81, no. 4, pp. 1763-1779, 2021