Normative data on the Boston Naming Test and two equivalent 30-item short forms

Because of the significance of the Boston Naming Test (BNT) in the differential diagnosis of the dementias, especially Alzheimer's disease, adequate norms from community-dwelling elderly individuals are essential. The present study describes the development of two new empirically derived equivalent short forms (30 items each) of the test. Normative data for the total BNT and the two equivalent 30-item halves based on item difficulty are presented using the performance of 314 community-dwelling individuals aged 65 and over. Age and education norms are presented using an overlapping midpoint interval strategy.     

Odd/Even Short Forms of the Boston Naming Test:Preliminary Geriatric Norms

It has been suggested that the 30-item version of the Boston Naming Test (BNT), in which either the odd or even items from the standard 60-item test are given, is the most psychometrically sound short form. However, no normative data are available for this version. We administered the Odd/Even BNT to 30 community-dwelling elderly individuals (age M = 72.93, range 61-84; education M = 13.73) in order to collect normative data. Odd and even forms were equivalent. The combined mean total correct score was 27.13 (SD = 2.06), a score consistent with that derived by retrospective extraction in the original odd/even test construction study. Each form discriminated normals from age- and education-matched patients with probable Alzheimer's disease, suggesting criterion-related validity.     

Odd/Even short forms of the Boston Naming Test: preliminary geriatric norms

It has been suggested that the 30-item version of the Boston Naming Test (BNT), in which either the odd or even items from the standard 60-item test are given, is the most psychometrically sound short form. However, no normative data are available for this version. We administered the Odd/Even BNT to 30 community-dwelling elderly individuals (age M = 72.93, range 61-84; education M = 13.73) in order to collect normative data. Odd and even forms were equivalent. The combined mean total correct score was 27.13 (SD = 2.06), a score consistent with that derived by retrospective extraction in the original odd/even test construction study. Each form discriminated normals from age- and education-matched patients with probable Alzheimer's disease, suggesting criterion-related validity.     

The 60-item boston naming test: Norms for cognitively intact adults aged 25 to 88 years

Abstract

Age-and education-stratified norms on the 60-item Boston Naming Test (BNT) are presented for 219 cognitively intact adults aged 25-88 years. The sample size, age range, and education levels of this sample represent an improvement over currently available norms. Eight short forms of the BNT are compared with the 60-item BNT. Frequency of errors for individual BNT items and the distribution of incorrect responses over seven different categories of errors are discussed. Finally, specific probes to overcome difficulties with ambiguous items are suggested.     

Normative Data Stratified for Age,Education, and Gender on the Boston Naming Test

Stratified normative data for age, education, and gender are provided for the 60-item Boston Naming Test (BNT) on 1026 older participants ages 50–95 years using overlapping age ranges. Tables are presented that convert BNT raw scores to scaled scores and percentiles. Mild dementia cases were eliminated using a comprehensive cognitive battery. In a companion paper we found significantly poorer mean BNT scores and increasing variability with successively older age groups and decreasing educational levels indicating the need for demographically stratified normative data when determining an individual's degree of impairment. These norms should be clinically useful when assessing suspected dementia cases.     

Normative data stratified for age, education, and gender on the Boston Naming Test

Stratified normative data for age, education, and gender are provided for the 60-item Boston Naming Test (BNT) on 1026 older participants ages 50-95 years using overlapping age ranges. Tables are presented that convert BNT raw scores to scaled scores and percentiles. Mild dementia cases were eliminated using a comprehensive cognitive battery. In a companion paper we found significantly poorer mean BNT scores and increasing variability with successively older age groups and decreasing educational levels indicating the need for demographically stratified normative data when determining an individual's degree of impairment. These norms should be clinically useful when assessing suspected dementia cases.     

Expanded Normative Data for the Boston Naming Test for Use with Urban,Elderly Medical Patients

Boston Naming Test (BNT) normative data from 233 neurologically intact patients ages 65-95 are provided for use in urban, medical settings. The BNT scores obtained from this sample of lower educated, ethnically diverse, medical patients were much lower than those reported in previous studies of highly educated, optimally healthy adults (e.g., Ivnik et al., 1996; Van Gorp et al., 1986). The authors argue that the selection of BNT normative data for clinical use should reflect the degree to which the demographic characteristics of the normative samples match those of their patients. Clinicians and future test developers are encouraged to pursue alternatives to census-based approaches to stratification by collecting local norms that target individuals from underrepresented demographic groups.     

Norms and the relationship of Boston Naming Test performance to vocabulary and education: A review

Background: Performance on the Boston Naming Test (BNT) reflects influences from demographic and ability variables that were not well understood at the time of the publication of the test. Means for normal samples with limited educational backgrounds, or limited vocabularies, that fall as much as two standard deviations below the original norms have been reported (Hawkins et al., 1993). Failure to recognise these influences will lead to substantial levels of misdiagnosis of dysnomia. These influences have, however, been obscured by the publication of studies reporting lesser, or no, relationship between vocabulary, or educational level, and BNT performance. Aims: The present paper aims to review studies yielding BNT norms, and to identify factors that obscure the relationship between vocabulary, education, and test performance. Main Contribution: It is established that few studies generating BNT norms have been adequately representative of the population, with the vast majority featuring a disproportionate representation of highly educated subjects. In combination with the psychometric properties of the BNT, these imbalances obscure the relationship between vocabulary, or education, and BNT demonstrated in studies utilising more representative samples. Some attempts to account for education have been distorted by a disproportionate representation of subjects of higher intellectual ability than would be typical for their stated years of schooling. Conclusions: BNT norms should be finely stratified by education. Whenever possible, the clinical interpretation of BNT scores should be further moderated by estimations of premorbid vocabulary.     

Boston Naming Test in Alzheimer's disease

The 60-item Boston Naming Test (BNT) was administered to 55 subjects: 15 mildly-to-moderately demented patients meeting NINCDS-ADRDA criteria for "probable" Alzheimer's disease (AD), 15 age-equivalent normal control (NC) subjects, and--for purposes of validation--25 additional subjects with other forms of dementia (OD). A cutting score of 51 correctly classified 80% of AD patients and 86% of NC subjects. To facilitate rapid screening of confrontation-naming performance in these populations, three 30-item shortened versions of the BNT were constructed. Even and Odd Versions were equivalent for AD, NC, and OD subjects; high correlations between these two and the 60-item BNT permit easy extrapolation to a total BNT score. A new Empirical Version, derived from performance of our AD and NC reference groups, maintained most of the intergroup discrimination of the full BNT.     

Noun and verb retrieval in healthy aging.

This study tests the hypothesis that retrieval of object and action names declines at different rates with age. Uncued and cued performance on the Boston Naming Test (BNT) and the Action Naming Test (ANT) were examined for 171 individuals from 50 to 88 years old. To control for differences in item difficulty, a subset of items from each of the two tests was selected for which uncued performance was equivalent in individuals in their 50s. With this matched set of items, differences in action and object naming were tested in the 60s and 70+ age groups. Although age-related decline in name retrieval was observed for both the BNT and the ANT subsets, no differences between object and action retrieval were found. Our results, thus, do not confirm previous studies reporting that object names and action names are differentially retrieved with aging. We discuss these new findings in relation to evidence of dissociations in object and action naming in brain-damaged individuals.     

A Danish adaptation of the Boston Naming Test: preliminary norms for older adults and validity in mild Alzheimer’s disease

Abstract

Objective: The purpose of the present study was to develop a Danish adaptation of the Boston Naming Test (BNT) including a shortened 30-item version of the BNT for routine clinical use and two parallel 15-item versions for screening purposes. Method: The Danish adaptation of the BNT was based on ranking of items according to difficulty in a sample of older non-patients (n = 99). By selecting those items with the largest discrepancy in difficulty for non-patients compared to a mild Alzheimer’s disease (AD) sample (n = 53), the shortened versions of the BNT were developed. Using an overlapping cells approach preliminary education and age norms for older Danes were constructed. Results: The Danish adaptation of the BNT had adequate reliability and the short versions were all highly correlated with the full 60-item BNT (BNT-60). The sensitivity and specificity of the BNT-60 was .83 and .86, respectively. The shortened versions displayed some reduction in sensitivity (.70–.77) but similar or better specificity (.86–.91). Post-test probabilities of mild AD associated with performances along selected score ranges of the BNT were estimated. Likelihood ratios were presented that can be combined with information regarding the base rate of AD in any setting in order to assist in interpreting the clinical significance of a given performance. Conclusion: The short Danish versions of the BNT were highly correlated with the full BNT indicating that they measure the same construct. The Danish versions had acceptable diagnostic accuracy discriminating between mild AD and older non-patients.     

Neuropsychological tests' norms above age 55: COWAT,BNT, MAE token,WRAT-R reading,AMNART, STROOP,TMT, and JLO

Abstract

Age- (> 55 years) and education-based norms are presented for eight neuropsychological tests: COWAT, BNT, MAE Token, WRAT-R Reading, AMNART, STROOP, TMT, and JLO. These data were obtained via several research projects that are known collectively as Mayo's Older Americans Normative Studies (MOANS). While this normative information should prove useful for each test, the fact that these norms were simultaneously obtained from the same reference group should promote accuracy in the comparison of any person's performance on one test against his or her functioning on any other tests with MOANS norms. Finally, the unique features of this MOANS sample are reviewed. These features must be kept in mind when these norms are applied in any specific clinical or research setting.     

Boston Naming Test automatic credits inflate scores of nonaphasic mild dementia patients

Introduction: The Boston Naming Test (BNT), a 60-item test of confrontation naming, may be administered either from Item 1 or Item 30, depending on assumptions of performance. If the BNT is administered from Item 30, 29 automatic credits are given for preceding items, allowing identical norms for either administration. We aimed to compare effects of automatic credits. Method: We compared effects of automatic credits in the Gothenburg Mild Cognitive Impairment Study, first between normal controls (n = 23) and patients (n = 259), and then between the same patients grouped by stage of impairment: subjective cognitive impairment (SCI, n = 75), mild cognitive impairment (MCI, n = 117), or mild dementia (n = 67). Results: Automatic credits added to all groups. Both administrations from Item 1 and those from Item 30 discriminated between controls (n = 23) and all patients (n = 259), as well as between the above stages of impairment. However, neither administration discriminated between normal controls and SCI patients. When earned scores were compared, with scores counted from Item 30 plus 29 automatic credits, mild dementia patients on average received a 3.4-credit boost. This equals 82% of the standard deviation of Tallberg’s Swedish norms [Brain and Language, 94(1), 19–31 (2005)] or 117% of our normal controls’ standard deviation. Conclusions: In our homogenous material, administration of BNT from Item 30 distinguished between stages of deterioration as well as administration from Item 1. In line with recent literature, we also find BNT results skewed. Thus, for clinical accuracy, we recommend use of cumulative percentages, careful consideration of education and demographic factors, and, most importantly, never to mix forms of administrations with and without automatic credits. While BNT automatic credits diminish accuracy on all levels, they inflate scores significantly for nonaphasic mild dementia patients.     

Mayo's Older African Americans Normative Studies: norms for Boston Naming Test, Controlled Oral Word Association, Category Fluency, Animal Naming, Token Test, WRAT-3 Reading, Trail Making Test, Stroop Test, and Judgment of Line Orientation

Normative data for older African Americans are presented for several clinical neuropsychological measures, including Boston Naming Test, Controlled Oral Word Association, Category Fluency, Token Test, WRAT-3 Reading, Trail Making Test, Stroop Color and Word Test, and Judgment of Line Orientation. Age-adjusted norms were derived from a sample of 309 cognitively normal, community-dwelling individuals, aged 56 through 94, participating in Mayo's Older African Americans Normative Studies (MOAANS). Years of education were modelled on age-scaled scores to derive regression Equations that may be applied for further demographic correction. These data should enhance interpretation of individual test performances and facilitate analysis of neuropsychological profile patterns in older African American patients who present for dementia evaluations.     

A Maltese adaptation of the Boston Naming Test: A shortened version

The Boston Naming Test (BNT) is the most widely used naming test worldwide in research and clinical settings. This study aimed to develop a method for adapting the BNT to suit different linguistic and cultural characteristics using the example of Maltese in a bilingual context. In addition, it investigated the effects in Malta of age and level of education on naming performance. The words of the BNT were first translated into Maltese. The test was then piloted to establish target and alternative responses. Naming performance data were later collected from individuals of different ages and levels of education. Only 38 BNT items had at least 70% name agreement. Main effects of age and education were found. A Maltese adaptation was proposed using 38 items and lenient scoring. Similar procedures may be used in other bilingual populations. The study suggests that normative data should be stratified according to age and education.     

Mayo's Older African Americans Normative Studies: Norms for Boston Naming Test,Controlled Oral Word Association,Category Fluency,Animal Naming,Token Test,Wrat-3 Reading,Trail Making Test,Stroop Test,and Judgment of Line Orientation

ABSTRACT

Normative data for older African Americans are presented for several clinical neuropsychological measures, including Boston Naming Test, Controlled Oral Word Association, Category Fluency, Token Test, WRAT-3 Reading, Trail Making Test, Stroop Color and Word Test, and Judgment of Line Orientation. Age-adjusted norms were derived from a sample of 309 cognitively normal, community-dwelling individuals, aged 56 through 94, participating in Mayo's Older African Americans Normative Studies (MOAANS). Years of education were modelled on age-scaled scores to derive regression Equations that may be applied for further demographic correction. These data should enhance interpretation of individual test performances and facilitate analysis of neuropsychological profile patterns in older African American patients who present for dementia evaluations.     

Olfactory identification in non-demented elderly population and in mild cognitive impairment: a comparison of performance in clinical odor identification versus Boston Naming Test

Performance in olfactory identification was studied in mild cognitive impairment (MCI), using slightly expanded standard clinical approach to study the olfactory nerve. Four hundred and eighty-six cognitively normal individuals and 72 individuals with MCI underwent spontaneous and cued odor identification and delayed odor recall. Performance in these was compared with the performance in the CERAD version of the Boston Naming Test (BNT). The individuals with MCI scores significantly worse in all tests compared with controls, but the performance in tests assessing odor were less impaired than performance in the BNT. Standard assessment of olfactory nerve function is not sufficient to study cognitive impairment in MCI.     

Mayo's Older African Americans Normative Studies: normative data for commonly used clinical neuropsychological measures

This report describes the methodology and sample characteristics of Mayo's Older African Americans Normative Studies (MOAANS). These studies reflect a multidisciplinary, collaborative effort by investigators at Mayo Clinic to provide age-appropriate normative data for African American elders on commonly used neuropsychological tests. A sample of 309 community-dwelling individuals over age 55 contributed to the MOAANS sample. Norms were calculated for midpoint age groups, based on percentile scores derived from cumulative frequencies of raw test scores. Demographic, medical, and sociocultural data were also collected, and are summarized to assist clinicians in making determinations regarding the appropriateness of these norms for individual patients. In most cases, the use of MOAANS norms should improve diagnostic accuracy in dementia evaluations of African American elders.