Five-Word Test Is Reliable and Fast Screen for Identifying Alzheimer’s Disease: Presented at ADI
By Jenny Powers
THESSALONIKI, Greece -- March 15, 2010 -- Researchers reported that the 5-word test (5WT), which takes approximately 2 minutes to administer, is useful for rapid dementia screening and has high sensitivity and specificity, according to a study presented here on March 11 at the 25th Conference of Alzheimer’s Disease International (ADI).
Alzheimer’s disease (AD) is underdiagnosed, and it is estimated that only 50% of patients are identified. Diagnosis is complicated because the symptoms are similar to memory dysfunction often seen with ageing.
The need for a reliable and fast screen to identify Alzheimer’s disease led investigators to conduct a study to test the reliability of the 5WT, which focuses on the recall of a short list of words that are learned at different stages in development, thereby testing early and late recall abilities. The test consists of 4 items, for a total possible score of 20 points.
Moisis Gialaouzidis, MD, Day Center, Greek Association of Alzheimer’s Disease and Relative Disorders, Thessaloniki, Greece, presented this study of the 5WT conducted on 192 Greek participants who were classified into 3 groups: 73 patients with mild cognitive impairment (MCI) (mean Mini-Mental State Exam [MMSE] scores 26.85), 62 patients with dementia (MMSE 19.08), and 57 healthy elderly (MMSE 28.79).
The study aimed to examine the psychometric properties of the 5WT in dementia screening. A significant difference in the total score of the test among the 3 groups (P = .00) was demonstrated by univariate analysis of variance. The test showed a high internal consistency among the 4 items (Cronbach’s alpha = .811).
Patients’ scores on the 5WT correlated significantly with the MMSE (r = .693, P = .000), the functional cognitive assessment scale (r = .653, P = .000), and the Montreal Cognitive Assessment (r = .557, P = .000).
A cutoff of 18 points in the total score (none of the patients with AD scored 20 points) showed a high sensitivity (85%) and specificity (93%) in distinguishing between healthy elderly individuals and patients with AD. The ability of the test to discriminate between MCI patients and healthy elderly or patients with dementia showed moderate sensitivity.
The researchers concluded that the 5WT could be a useful tool for rapid dementia screening and could be appropriately used as a first assessment to discriminate between healthy people and those with dementia.
[Presentation title: Considering the 5 Words Test as Part of Dementia Screening. Abstract P022]
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