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      Verbal Comprehension Ability in Aphasia: Demographic and Lexical Knowledge Effects

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          Abstract

          Background. Assessment of sentence-level auditory comprehension can be performed with a variety of tests varying in response requirements. A brief and easy to administer measure, not requiring an overt verbal or a complex motor response, is essential in any test battery for aphasia. Objective. The present study examines the clinical utility of receptive language indices for individuals with aphasia based on the Comprehension of Instructions in Greek (CIG), a variant of the Token Test, and the Greek version of PPVT-R. Methods. Normative data from a large community sample of Greek adults aged 46–80 years was available on both measures. A word-level-independent measure of auditory comprehension was computed as the standard score difference between the two tests and used to compare patients with and without comprehension deficits as indicated by their Boston Diagnostic Aphasia Examination profile. Results and Conclusions. Indices of internal consistency and test-retest reliability were very good. Education and age effects on performance were significant, with the former being stronger. The potential clinical utility of differential ability indices (contrasting sentence- and word-level auditory comprehension tests) is discussed.

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          Most cited references51

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

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            Normative data and screening power of a shortened version of the Token Test.

            A 36-item-version of the Token Test is described and normative data obtained from its administration to 215 normal subjects are given. Years of schooling (but not age) were found to significantly affect the performance. The scores were corrected for this factor and the lower limit of the 90% tolerance interval around the mean of the adjusted scores was determined: it was found to correspond to 29 and left below it exactly 5% of the normal sample. The test was given to 200 aphasic patients. Fourteen (7%) were found to have an adjusted score of 29 or more, namely would have been classified as non-aphasic. This is a percentage remarkably smaller than that (40%) obtained with a 10 sentence comprehension test, which supports previous studies pointing to the sensitivity of the Token Test to the presence of oral language disorders. On the basis of the aphasic patients' performance, cutting scores allowing evaluation of the severity of the comprehension deficit are provided. The 36-item-version of the test appears to be an useful and convenient device to diagnose aphasic impairment of language comprehension.
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              "Preclinical" AD revisited: neuropathology of cognitively normal older adults.

              To classify neuropathologic alterations in the brains of nondemented older adults using current sets of criteria for AD. AD neuropathologic alterations are found in the brains of some nondemented elderly subjects and suggest the possibility of presymptomatic AD. Three sets of guidelines have been developed to classify AD using senile plaques, neuritic plaques, and neurofibrillary tangles (NFT). Neuropathologic changes in 59 older adults followed longitudinally with a standard battery of mental status measures were investigated using Khachaturian, Consortium to Establish a Registry for Alzheimer's Disease (CERAD), and National Institute on Aging-Reagan Institute (NIA-RI) guidelines. AD neuropathologic markers were evaluated in neocortical and allocortical regions. Cases were categorized as neuropathologically "normal" or "AD-like" and compared for possible mental status differences. Between 11 and 49% of cases met one or more of the three classifications of AD. With adjustments for multiple comparisons, only NFT in hippocampal CA1 region were associated with autopsy age, suggesting that this may represent a pathologic process associated with normal brain aging. Using the NIA-RI guidelines, subjects in the AD-like group performed less well on the immediate paragraph recall and word-list delayed recall than their counterparts who did not meet these guidelines. These data indicate that the prevalence of "preclinical" AD in our population is relatively low based on the NIA-RI classification. Although many subjects had AD-like changes based on CERAD and Khachaturian guidelines, they exhibited no differences in mental performance, suggesting that the aging brain may be able to withstand such structural changes without meaningful impact on mental functioning.
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                Author and article information

                Journal
                Behav Neurol
                Behav Neurol
                BN
                Behavioural Neurology
                Hindawi Publishing Corporation
                0953-4180
                1875-8584
                2014
                23 January 2014
                : 2014
                : 258303
                Affiliations
                1School of Medicine, University of Crete, Voutes Campus, 71003 Heraklion, Greece
                2Department of Neurology, University of Athens Medical School, Greece
                Author notes
                *Panagiotis G. Simos: akis.simos@ 123456gmail.com

                Academic Editor: Argye E. Hillis

                Article
                10.1155/2014/258303
                4006596
                24825951
                24dee70b-7fc6-4982-8a59-a63dc9968e7f
                Copyright © 2014 Panagiotis G. Simos et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 January 2013
                : 2 September 2013
                Funding
                Funded by: The European Union
                Categories
                Clinical Study

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