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AIMS: To test the discriminant and concurrent validity of the Spanish version of the Bayer Activities of Daily Living scale (B-ADL) in mild cognitive impairment (MCI) and mild Alzheimer disease (AD). METHODS: The B-ADL scale, the Blessed Dementia Rating Scale (BDRS), and the Interview for Deterioration in Daily Living in Dementia (IDDD) were administered to 277 elderly Spanish patients (78 MCI and 199 AD). Correlations between scales were performed, and ROC curves were plotted. RESULTS: In MCI and mild AD discrimination, an area under the ROC curve of 0.84 was found; a cut-off point of 3.3 was proposed with values of 0.81 for sensitivity and 0.72 for specificity. The B-ADL correlated positively to both the BDRS (r = 0.7) and the IDDD (r = 0.8). CONCLUSION: The B-ADL is a valid and sensitive scale that can be used to discriminate mild AD from MCI.

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OBJECTIVE: Present data on discriminative and normative validity for the Memory Impairment Screen (MIS) in a cross-sectional validation study within a dementia-clinic setting using a Spanish adaptation of the MIS. Assess its usefulness as a screening instrument for memory problems related to primary dementing disorders, foremost Alzheimer's Disease (AD). MATERIAL AND METHODS: 403 subjects, including 188 demented subjects according to DSM-IV criteria (119 of which presented AD according to NINCDS-ADRDA criteria) and 215 controls, over 50 years. The MIS, a four word memory test using a specific encoding technique and scoring on a 0-8 range, formed part of the neuropsychological workup, but it was not used for diagnosis. Sensitivity, specificity and predictive values positive (PPV) and negative (NPV) were calculated for the MIS against the gold-standard of clinical diagnosis by two blinded clinicians. ROC curves for the discrimination between demented subjects and controls, and AD subjects and controls were plotted. RESULTS: Control subjects were significantly younger and better educated than the demented samples (p<0.001). No sex differences could be established. ROC curves demonstrated excellent discriminative validity of the MIS 402 for dementia on a whole (0.944) and even better for AD (0.978). The MIS presents satisfying results regarding sensitivity and specificity as well as PPV for different base rates, but the most effective cut-off score lies at < or = 4 points. For all demented subjects this cut-off represents a sensitivity of 0.74 and specificity of 0.96; for AD results are 0.86 and 0.96. More importantly, PPV values are above 0.65 for assumed base rates of 10% and more. Negative predictive values are almost 1 for all assumed base rates. CONCLUSION: The Spanish version of the MIS reliably differentiates between normal and demented subjects. Nevertheless one has to consider the setting of the study when interpreting the results. The use of the S-MIS seems to be justified as first level dementia screening tool.

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Objetivo. Presentar datos normativos y de validez discriminativa de la versión española del Memory Impairment Screen (MIS) en un estudio transversal en el ámbito de una consulta especializada, y valorar su utilidad como instrumento de cribado para trastornos de memoria relacionados con la demencia, sobre todo la enfermedad de Alzheimer (EA).Material y métodos. Cuatrocientos tres sujetos, incluyendo 188 pacientes con demencia según criterios DSM-IV (119 con EA según criterios NINCDS-ADRDA) y 215 controles, mayores de 50 años. Se administró el MIS, un test de memoria de cuatro palabras que utiliza técnicas específicas de codificación y se puntúa en un rango de O a 8 como parte de la exploración neuropsicológica, pero no se usó para el diagnóstico. Se calcularon valores de sensibilidad, especificidad y valores predictivos positivo (VPP) y negativo (VPN) para el MIS en comparación con el diagnóstico clínico de dos clínicos ciegos a la prueba. También se obtuvieron las curvas ROC para evaluar la capacidad de discriminación entre dementes y controles y con EA y controles.Resultados. Los pacientes con demencia fueron significativamente mayores de edad y con inferior escolaridad que los controles (p < 0,001). No había diferencias significativas por sexo. Las curvas ROC demostraron datos discriminativos excelentes para la demencia (0,944) y aún mejores para la EA (0,978). El MIS presenta resultados satisfactorios en cuanto a la sensibilidad, especificidad y los VPP para diferentes prevalencias basa les, pero el punto de corte más efectivo se sitúa en :S; 4 puntos. En este punto de corte y para los pacientes con demencia en general la sensibilidad es de 0,74 y la especificidad es de 0,96; para la EA los resultados son de 0,86 y 0,96, respectivamente. Más importante aún, los VPP son mayores del 65% para todas las prevalencias a partir del 10%, mientras que los VPN rozan el 100% en casi todas las prevalencias asumidas.Conclusión. La versión española del MIS diferencia de forma válida entre controles y pacientes con demencia, con mejores resultados para la EA. No obstante, hay que tener en cuenta los posibles sesgos de la población del estudio al interpretar los datos normativos. Se recomienda el uso del MIS como herramienta de cribado de primer nivel para la demencia

Objective. Present data on discriminative and normative validity for the Memory Impairment Screen (MIS) in a cross-sectional validation study within a dementia-clinic setting using a Spanish adaptation of the MIS. Assess its usefulness as a screening instrument for memory problems related to primary dementing disorders, foremost Alzheimer's Disease (AD).Material and methods. 403 subjects, including 188 demented subjects according to DSM-N criteria (119 of which presented AD according to NINCDS-ADRDA criteria) and 215 controls, over 50 years. The MIS, a four word memory test using a specific encoding technique and scoring on a 0-8 range, formed part of the neuropsychological workup, but it was not used for diagnosis. Sensitivity, specificity and predictive values positive (PPV) and negative (NPV) were calculated for the MIS against the gold-standard of clinical diagnosis by two blinded clinicians. ROC curves for the discrimination between demented subjects and controls, and AD subjects and controls were plotted.Results. Control subjects were significantly younger and better educated than the demented samples (p<0.00l). No sex differences could be established. ROC curves demonstrated excellent discriminative validity of the MIS for dementia on a whole (0.944) and even better for AD (0.978). The MIS presents satisfying results regarding sensitivity and specificity as well as PPV for different base rates, but the most effective cut-off score lies at <=4 points. For all demented subjects this cut-off represents a sensitivity of 0.74 and specificity of 0.96; for AD results are 0.86 and 0.96. More importantly, PPV values are above 0.65 for assumed base rates of 10% and more. Negative predictive values are almost 1 for all assumed base rates. Conclusion. The Spanish version of the MIS reliably differentiates between normal and demented subjects. Nevertheless one has to consider the setting of the study when interpreting the results. The use of the S-MIS seems to be justified as first level dementia screening tool

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INTRODUCTION: The Boston Naming Test (BNT) is one of the most widely used tests in neuropsychological evaluation of language disorders, specifically when testing for anomia. The aim of this study is to establish preliminary normative data for the second edition of the BNT for young spanish adults (age range between 20 and 49 years). METHODS: A total of 160 subjects (60 % female and 40 % male) were administered the BNT. Mean age was 33.89 years (SD: 9.45) and average number of years of education was 13.98 (SD: 3.97). The version used in the present study is the second edition of the BNT (Kaplan et al., 2001) which includes two new components: multiple choice and error typology. STATISTICAL ANALYSIS: Descriptive statistics of the test's variables. Lineal regression to establish the possible degree of influence of the variables age and education on test performance. RESULTS: The sample's mean score was 51.84. Education significantly influences the final score (B: 0.476; p= 0.001). Multiple choice was effective in 89 % of cases. DISCUSSION: The present results will allow proper clinical interpretation of results in the BNT 2001 version in young Spanish adults.

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