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Investigating the Psychometric Properties of a South African Adaptation of the Boston Naming Test: Evidence for Diagnostic Validity from a Memory Clinic Population

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Investigating the Psychometric Properties of a South African Adaptation of the Boston Naming Test: Evidence for Diagnostic Validity from a Memory Clinic Population 1 Investigating the Psychometric Properties of a South African Adaptation of the Boston Naming Test: Evidence for diagnostic validity from a Memory Clinic population Lauren Baerecke BRCLAU004 A minor dissertation submitted in partial fulfillment of the requirements for the award of the degree of Master of Arts (Psychological Research) Department of Psychology Faculty of the Humanities University of Cape Town 2013 University of Cape Town COMPULSORY DECLARATION This work has not been previously submitted in whole, or in part, for the award of any degree. It is my own work. Each significant contribution to, and quotation in, this dissertation from the work, or works, of other people has been attributed, and has been cited and referenced. Signature: Date: 13 September 2013 The copyright of this thesis vests in the author. No quotation from it or information derived from it is to be published without full acknowledgement of the source. The thesis is to be used for private study or non- commercial research purposes only. Published by the University of Cape Town (UCT) in terms of the non-exclusive license granted to UCT by the author. University of Cape Town 2 Acknowledgements I would like to take this opportunity to express my appreciation to my supervisor, Kevin Thomas, for his support and guidance on this project. I would also like to thank Dr. Sebastiana Kalula and Sonya Hendricks for their help in accessing patient files at the Memory Clinic and accommodating my presence at the Institute for Aging in Africa. I wish to express my appreciation to the management and staff of the housing complex from which a number of participants for this study were drawn, for their interest in the project and their hospitality during the times I spent there. In addition, my sincerest thanks go to the men and women who gave of their time to participate in this research, and without whom this project would not have been possible. Lastly, I wish to thank my family and friends for their encouragement, support, and patience. Scholarships: Thanks to the University of Cape Town University Research Scholarship for supporting this project. University of Cape Town 3 Table of Contents Acknowledgements .......................................................................................................... 2 Table of Contents ............................................................................................................. 3 List of Figures .................................................................................................................. 7 List of Tables ................................................................................................................... 8 Abstract ............................................................................................................................ 9 Introduction .................................................................................................................... 10 A Brief Introduction to the BNT .............................................................................. 10 Development of BNT Short Forms .......................................................................... 11 Clinical Findings ...................................................................................................... 13 Confrontation naming in dementia .................................................................... 13 The BNT in Alzheimer’s disease (AD) ....................................................... 14 The BNT in early AD ............................................................................ 15 Using the BNT to distinguish AD from other types of dementia ...................... 16 Differences in BNT performance between AD and vascular dementia ...... 16 Differences in BNT performance between AD and mixed Alzheimer’s and . vascular dementia ......................................................................................... 17 Differences in BNT performance between AD and frontotemporal dementia ...................................................................................................................... 17 Differences in BNT performance between AD and other types of dementia .. ...................................................................................................................... 17 Cognitive Processes Underlying Confrontation Naming ......................................... 18 The nature ofUniversity the naming deficit in AD of ............................................................. Cape Town 19 Perceptual impairment ................................................................................. 19 Lexical-semantic impairment ....................................................................... 19 Semantic degradation hypothesis ........................................................... 20 Lexical access hypothesis ...................................................................... 20 Multiple underlying deficits ................................................................... 21 Moderators of BNT Performance ............................................................................ 22 Age and BNT performance ................................................................................ 22 Education and BNT performance ...................................................................... 23 Vocabulary and BNT performance .................................................................... 24 Sex and BNT performance................................................................................. 25 4 Culture, language, and BNT performance ......................................................... 26 Bilingualism ................................................................................................. 29 Adaptations of the BNT for Use with Diverse Cultures and Languages ................. 30 Current Issues in Cross-Cultural Neuropsychology in South Africa ....................... 31 Research on the BNT in South Africa ............................................................... 33 Summary and Rational for the Current Study .......................................................... 34 Specific Aims and Hypotheses ................................................................................ 36 Methods.......................................................................................................................... 38 Design and Setting ................................................................................................... 38 Participants ............................................................................................................... 38 Patient groups..................................................................................................... 38 Control group ..................................................................................................... 40 Inclusion and exclusion criteria ................................................................... 42 Materials .................................................................................................................. 42 Demographic form ............................................................................................. 42 Screening measures ............................................................................................ 43 Mini-Mental State Examination ................................................................... 43 Geriatric Depression Scale ........................................................................... 44 Bristol Activities of Daily Living Scale ....................................................... 44 BNT-SA-SF ....................................................................................................... 45 Procedure ................................................................................................................. 46 Patients ............................................................................................................... 46 Controls .............................................................................................................. 46 BNT-SA-SF Universityadministration ............................................................................... of Cape Town 47 Ethical Considerations ............................................................................................. 48 Patients ............................................................................................................... 48 Controls .............................................................................................................. 49 Follow-up procedures .................................................................................. 49 Cognitive impairment ............................................................................ 49 Depression .............................................................................................. 49 Data Management and Statistical Analyses ............................................................. 50 Step 1: Sample characteristics ........................................................................... 50 Step 2: Internal consistency ............................................................................... 50 Step 3: Between-groups differences in BNT-SA-SF performance .................... 50 5 Step 4: General linear model: Relationship between BNT-SA-SF performance and sociodemographic variables .......................................................................
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