Specific tests frequently used
Trail making test: (Army Individual Test Battery) tests basic attention (part A) and working memory (moreso part B) (Daffner et al, 2016)
- In part A, the patient simply draws lines connecting consecutive numbered circles
- In part B, the patient must draw lines connecting circles containing both numbers and letters in alternating sequence (i.e. 1-A-2-B-3-C).
- The test is measured by time. Time to complete part B minus time to complete part A can be calculated, the larger this difference suggests problems with working memory
- TMT-B correlates with reduced driving performance (poorer scores on TMT-B and serious road errors predicted motor vehicle accidents (Perera et al, 2017)
- Advantages: sensitive measure for sustained attention, attention control, and set-shifting; additionally, careful attention to how patients approach the test provides valuable clinical data (Daffner et al, 2016)
- Limitations: test is affected by age and educational status (Daffner et al, 2016)
Boston naming test 15-item short form: tests visual processing, lexical-semantic memory and processing, output phonology, and speech (Daffner et al, 2016)
- The patient is shown black and white line drawings of common objects as a visual confrontation naming task (patients have 20 seconds to come up with the name of each item)
- Items are scored as correct, correct with semantic cue, or correct with phonemic cue – a score of 13/15 was demonstrated as normal in a large cohort of elderly controls (age 65-93) w/ 12 or more years of education
- Advantages: brief, simple screen
- Limitations: does not fully assess a patient’s language ability and deficits; affected by demographic factors (language, education, culture)
Semantic / category fluency test: tests lexical-semantic processing, organization and strategy of thought, output phonology, aspects of speech (Daffner et al, 2016)
- Patients are given 1 minute to provide as many words possible within a certain category (i.e. animals, vegetables, fruits, etc.).
- Often given along with a phonemic / letter fluency to compare the two. Generally, semantic fluency lists should be longer than letter fluency
CERAD-word list memory test: tests verbal episodic memory, auditory working/episodic memory function (Daffner et al, 2016)
- Patient has 3 learning trials to memorize 10 words, they are asked to sequentially read one word aloud every 2 seconds. They are then asked for delayed recall and forced-choice recognition (they are given a word and asked whether it was on the list of words they had to remember)
- Good discrimination between elderly controls (94% accuracy) and mild AD (86% accuracy).
References
Adjutant General’s Office. Army Individual Test Battery. In: War Department, ed. Manual of Directions and Scoring. (1944).
Daffner, K. R. et al. Improving clinical cognitive testing: Report of the AAN Behavioral Neurology Section Workgroup. Neurology 85, 910–918 (2015). https://pubmed.ncbi.nlm.nih.gov/26163433/
Perera, T. et al. The Clinical TMS Society Consensus Review and Treatment Recommendations for TMS Therapy for Major Depressive Disorder. 24 (2017). https://pubmed.ncbi.nlm.nih.gov/27090022/
