Faculty Bibliography

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/CONCLUSIONS:The ANT index score adds diagnostic utility to the assessment of naming difficulties in patients with suspected dementia.

Impaired memory is a common consequence of ischemic stroke. Cognitive rehabilitation of memory is an essential component of any comprehensive rehabilitation program for these patients. Generalizable methods and methods to teach domain-specific knowledge are two principal means whereby impaired memory can be improved. Compensatory strategies can be taught to patients whose memory is not likely to improve. Cognitive remediation using these methods has been shown to be an effective intervention to treat memory deficits. More well-controlled, randomized studies are needed to further investigate the efficacy of the various interventions available.