How the Boston Naming Test Screens for Alzheimer's and Dementia

The Boston Naming Test is a screening tool that can help assess cognitive functioning. It often is part of several tests that are used to evaluate a person if there is concern that they have Alzheimer's or a related dementia. The author of the Boston Naming Test is Sandra Weintraub.

The original Boston Naming Test consists of 60 black line drawings, presented in order from easiest to most difficult, that the test-taker has to identify. This test assesses word-finding ability and the cognitive functions associated with that task.

Administration

The test administrator shows the person each of the pictures, one at a time in the given order. The person is given 20 seconds to say what the drawing depicts.

Some versions of the test simply move on to the next drawing after 20 seconds have passed, while other versions allow the person giving the test to offer specific verbal clues if the test-taker is not able to identify the drawing. The person may then be given another 20 seconds to identify the picture. If they still are unable to correctly identify the drawing, the test administrator will move on to the next drawing.

Scoring

Scoring differs based on which version of the test you are using, but typically each correct answer, whether given before or after verbal cues, is counted as one point.

Scoring cutoffs that indicate a concern in cognition vary per which test version is being utilized.

Versions

Several different versions of the Boston Naming Test have been used over the years. Due to the length of the test, some practitioners only use the second half (30) of the 60 drawings to assess cognition. Others use only the even or odd numbered pictures.

Another common version of the Boston Naming Test is part of a battery of tests called Consortium to Establish a Registry for Alzheimer's Disease (CERAD). CERAD uses a 15-item Boston Naming Test, in addition to several other testing instruments.

Shorter versions can be helpful due to the limited time that practitioners typically have to assess patients.

Pros and Cons

Pros

• Multiple studies have established that the different versions of the Boston Naming Test are effective in identifying people with Alzheimer's disease.
• Some research indicates that the Boston Naming Test can identify people who have not yet been diagnosed with Alzheimer's disease but may be in the very early stages of dementia.
• The Boston Naming Test is available in multiple languages.
• The shorter versions can be administered relatively quickly.

Cons

• The test is copyrighted but can be purchased online.
• This test requires adequate vision and speech.
• Some research has shown that sex, race and education level may affect performance on this test and should be taken into consideration when scoring it.

Accuracy

The Boston Naming Test is quite effective at identifying impaired cognition, in particular, the symptom of aphasia within dementia. This test should, of course, be used in conjunction with other testing by a physician when the possibility of a dementia diagnosis is being considered.