Department of Speech and Language Studies, Dr. S. R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, India.
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India.
Int J Lang Commun Disord. 2022 Jul;57(4):881-894. doi: 10.1111/1460-6984.12728. Epub 2022 May 6.
Picture-naming tests (PNTs) evaluate linguistic impairment in dementia due to semantic memory impairment, impaired lexical retrieval or perceptual deficits. They also assess the decline in naming impairment at various stages of dementia and mild cognitive impairment (MCI) that occurs due to progressive cognitive impairment. With the increasing numbers of people with dementia globally, it is necessary to have validated naming tests and norms that are culturally and linguistically appropriate.
In this cross-sectional study we harmonized a set of 30 images applicable to the Indian context across five languages and investigated the picture-naming performance in patients with MCI and dementia.
METHODS & PROCEDURES: A multidisciplinary expert group formed by the Indian Council of Medical Research (ICMR) collaborated towards developing and adapting a picture naming test (PNT) known as the ICMR-PNT in five Indian languages: Hindi, Bengali, Telugu, Kannada and Malayalam. Based on cross-cultural adaptation guidelines and item-wise factor analysis and correlations established separately across five languages, the final version of the ICMR-PNT test was developed. A total of 368 controls, 123 dementia and 128 MCI patients were recruited for the study. Psychometric properties of the adapted version of the ICMR-PNT were examined, and sensitivity and specificity were examined.
OUTCOMES & RESULTS: The ICMR-PNT scores in all languages combined were higher in controls compared with patients with dementia and MCI (F = 139.85; p < 0.001). Furthermore, PNT scores for MCI was higher in comparison with patients with dementia in all languages combined (p < 0.001). The area under the curve across the five languages ranged from 0.81 to 1.00 for detecting dementia. There was a negative correlation between Clinical Dementia Rating (CDR) and ICMR-PNT scores and a positive correlation between Addenbrooke's Cognitive Examination-III (ACE-III) and ICMR-PNT scores in control and patient groups.
CONCLUSIONS & IMPLICATIONS: The ICMR-PNT was developed by following cross-cultural adaptation guidelines and establishing correlations using item-wise factor analysis across five languages. This adapted PNT was found to be a reliable tool when assessing naming abilities effectively in mild to moderate dementia in a linguistically diverse context.
What is already known on this subject Picture-naming evaluates language impairment linked to naming difficulties due to semantic memory, lexical retrieval or perceptual disturbances. As a result, picture naming tests (PNTs) play an important role in the diagnosis of dementia. In a heterogeneous population such as India, there is a need for a common PNT that can be used across the wide range of languages. What this study adds to existing knowledge PNTs such as the Boston Naming Test (BNT) were developed for the educated, mostly English-speaking, Western populations and are not appropriate for use in an Indian context. To overcome this challenge, a PNT was harmonized in five Indian languages (Hindi, Bengali, Telugu, Kannada and Malayalam) and we report the patterns of naming difficulty in patients with MCI and dementia. The ICMR-PNT demonstrated good diagnostic accuracy when distinguishing patients with mild to moderate dementia from cognitively normal individuals. What are the potential or actual clinical implications of this work? With the growing number of persons suffering from Alzheimer's disease and other forms of dementia around the world, its critical to have culturally and linguistically relevant naming tests and diagnosis. This validated ICMR-PNT can be used widely as a clinical tool to diagnose dementia and harmonize research efforts across diverse populations.
图片命名测试（PNT）通过语义记忆损伤、词汇检索受损或知觉缺陷来评估痴呆症患者的语言障碍。它们还评估了由于认知逐渐受损，在痴呆症和轻度认知障碍（MCI）的各个阶段命名障碍的下降情况。随着全球痴呆症患者人数的增加，有必要拥有经过文化和语言验证的命名测试和标准。
在这项横断面研究中，我们协调了一组适用于印度背景的 30 张图片，适用于五种语言，并研究了 MCI 和痴呆症患者的图片命名表现。
印度医学研究理事会（ICMR）的一个多学科专家组合作开发并改编了一种图片命名测试（PNT），称为 ICMR-PNT，适用于五种印度语言：印地语、孟加拉语、泰卢固语、卡纳达语和马拉雅拉姆语。根据跨文化适应指南和单项因素分析以及在五种语言中分别建立的相关性，开发了 ICMR-PNT 测试的最终版本。共有 368 名对照者、123 名痴呆症患者和 128 名 MCI 患者被招募参加研究。检验了改编版 ICMR-PNT 的心理测量特性，并检验了敏感性和特异性。
所有语言合并的 ICMR-PNT 分数在对照组中均高于痴呆症和 MCI 患者（F = 139.85；p <0.001）。此外，在所有语言中，MCI 的 PNT 分数均高于痴呆症患者（p <0.001）。五种语言的曲线下面积（AUC）均在 0.81 到 1.00 之间，用于检测痴呆症。临床痴呆评定量表（CDR）与 ICMR-PNT 评分之间存在负相关，而 Addenbrooke 认知测验-III（ACE-III）与对照组和患者组的 ICMR-PNT 评分之间存在正相关。
ICMR-PNT 是按照跨文化适应指南开发的，并通过在五种语言中使用单项因素分析建立相关性。当在语言多样化的背景下有效评估轻度至中度痴呆患者的命名能力时，这种改编的 PNT 被证明是一种可靠的工具。
关于这个主题已经知道了什么：图片命名评估与命名困难有关的语言障碍，这些命名困难归因于语义记忆、词汇检索或知觉障碍。因此，图片命名测试（PNT）在痴呆症的诊断中起着重要作用。在印度这样一个多样化的人群中，需要一种可以在广泛的语言范围内使用的通用 PNT。这篇文章增加了哪些新知识：波士顿命名测试（BNT）等 PNT 是为受过教育的、主要是讲英语的西方人群开发的，不适用于印度的情况。为了克服这一挑战，我们协调了五种印度语言（印地语、孟加拉语、泰卢固语、卡纳达语和马拉雅拉姆语）的 PNT，并报告了 MCI 和痴呆症患者的命名困难模式。ICMR-PNT 在区分轻度至中度痴呆患者与认知正常个体时表现出良好的诊断准确性。这可能或实际的临床意义是什么：随着全球阿尔茨海默病和其他形式的痴呆症患者人数的增加，拥有文化和语言相关的命名测试和诊断标准至关重要。这种经过验证的 ICMR-PNT 可以广泛用作临床工具，用于诊断痴呆症，并协调不同人群的研究工作。
