Étalonnage du test des cinq mots dans une population de sujets sains

doi:10.1016/S0035-3787(07)90404-X

Revue Neurologique

Volume 163, Issue 3, March 2007, Pages 323-333

https://doi.org/10.1016/S0035-3787(07)90404-X Get rights and content

Résumé

Introduction

Le Test des 5 mots (T5M) est un test de mémoire verbale sérielle avec indiçage sémantique. Il permet d’évaluer l’apprentissage indicé de cinq mots et leur récupération volontaire (rappel libre) et facilitée (rappel indicé) lors d’un rappel immédiat puis d’un rappel différé quelques minutes plus tard. Le T5M explore rapidement la mémoire de sujets ayant une plainte mnésique, en particulier dans le cadre du diagnostic de la maladie d’Alzheimer (MA) où il se révèle sensible et spécifique.

Observations

Nous rapportons l’étalonnage du T5M chez 191 sujets normaux âgés de 50 à 90 ans (76 hommes et 115 femmes), répartis en quatre classes d’âges (50 ans, 60 ans, 70 ans et 80 ans) et trois niveaux socio-éducatifs. Le Score Total, le Score Total Pondéré, le Rappel Différé Libre, le Total Rappels Différés (score de mémoire) et le Total Rappels Libres sont des scores de choix pour apprécier la performance mnésique de ces sujets normaux. Le Score Total maximal de 10 n’est réalisé que par 74,9 p. 100 des sujets. Aucune intrusion n’a été observée lors du test aussi bien lors du rappel immédiat que retardé. En dépit d’une absence de consigne explicite, les sujets normaux eurent fréquemment tendance à produire des réponses dans l’ordre de la liste.

Conclusion

Le T5M est un test simple et intéressant pour évaluer les performances mnésiques d’un sujet de plus de 50 ans en consultation de mémoire médicale.

Summary

Introduction

The 5-word test (5WT) is a serial verbal memory test with semantic cuing. It allows to estimate cued learning, free recall, and cued recall of 5 words during immediate and delayed recalls (5 min later). The 5WT is proposed to rapidly evaluate memory of aging people. It has shown its sensitivity and its specificity in identifying patients with Alzheimer's disease (AD).

Observations

We report the constitution of a sample of 191 French speaking normal subjects, aged from 50 to 90 years, in four age classes (50 years, 60 years, 70 years, 80 years) and three education levels. Total Score, Total Weighted Score, Free Delayed Recall, Delayed Recalls Total (memory score), and Free Recalls Total appear to be the best scores to appreciate the memory performance of the normal subjects. A Total Score of 10 was obtained in 74.9 p.cent of the subjects. No immediate nor delayed intrusions were recorded. In spite of the absence of an explicit consign, the recalled words were often ordered as they were in the list.

Conclusion

The 5WT is a simple and reliable test for investigating memory in elderly people above 50 years old.

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Cited by (21)

Five-Word Test, Screening of Mixed Dementia in Older Adults. Validation Study
2023, Revista Colombiana de Psiquiatria
Citation Excerpt :
Furthermore, the presence of ischemic lesions on computed tomography or magnetic resonance imaging are key in the diagnosis of individuals with MixD.13–15 The 5-word test (5WT) allows a rapid evaluation of episodic verbal memory.16 In addition, it has proven to be simple and valid for the identification of cognitive disorders, therefore, it can be culturally adapted to a different medium than the one developed and in addition to preserving its methodological qualities for screening for dementia.
The prevalence of mixed dementia (MixD), defined as the coexistence of Alzheimer's disease (AD) and vascular dementia (VaD), is likely to increase as the population ages. The five-word test (5WT) is a neuropsychological test that differentiates between major and mild neurocognitive disorder (NCD). The objective of the study is to validate 5WT for the detection of MixD.
230 participants were evaluated: cognitively healthy (CH) (n = 70), mild NCD (n = 70), and major NCD (n = 90): AD (n = 30), VaD (n = 30), and MixD (n = 30). The Spearman's coefficient, d Sommer and ROC curves were used to determine the construct validity of the 5WT. The linear regression model was performed to determine the association between age and education with 5WT performance.
The mean age was 79 ± 7.7 years (P≤.001), 58% were female (P = .252), and the mean education was 9 ± 5.3 years (P≤.001). Construct validity when comparing 5WT and MMSE was: Spearman's correlation ρ=.830 (P< .001) and d Sommer = .41 (P< .001). The area under the curve in the total weighted score (TWS) for MixD was .985, with 98% sensitivity (95%CI, 0.96-1.00) and 99% specificity (95%CI, 0.94-1.00), PPV of 88% (95%CI, 0.82-0.89), NPV of 100% (95%CI, 0.96-1.00), and cut-off point ≤16/20 (P< .001).
5WT is a rapid test with neuropsychological validation for the exploration of cognitive characteristics in major NCD type MixD, regardless of age and education.
Es probable que la prevalencia de la demencia mixta (DMix), definida como la coexistencia de enfermedad de Alzheimer (EA) y demencia vascular (DVa), aumente a medida que la población envejece. El test de 5 palabras (5WT) es una prueba neuropsicológica que diferencia entre el trastorno neurocognitivo (TNC) mayor y el menor. El objetivo del estudio es validar el 5WT para la detección de DMix.
Se evaluó a 230 participantes cognitivamente sanos (CS) (n = 70) y con TNC menor (n = 70) y TNC mayor (n = 90): EA (n = 30), DVa (n = 30) y DMix (n = 30). Se utilizó el coeficiente rho de Spearman, d Sommer y las curvas ROC para determinar la validez de constructo del 5WT. Se realizó el modelo de regresión lineal para determinar la asociación entre la edad y la educación en el rendimiento del 5WT.
La media de edad fue 79 ± 7,7 años (p ≤ 0,001), el 58% eran mujeres (p = 0,252) y la escolaridad media, 9 ± 5,3 años (p ≤ 0,001). La validez de constructo al comparar el 5WT y el MMSE fue: ρ = 0,830 (p < 0,001) y d Sommer = 0,41 (p < 0,001). El área bajo la curva en la puntuación total ponderada (PTP) para DMix fue 0,985, con sensibilidad del 98% (IC95%, 0,96-1,00) y especificidad del 99% (IC95%, 0,94-1,00), con un valor predictivo positivo del 88% (IC95%, 0,82-0,89) y un valor predictivo negativo del 100% (IC95%, 0,96-1,00), con un punto de corte ≤ 16/20 (p < 0,001).
El 5WT es una prueba rápida con validación neuropsicológica para la exploración de características cognitivas en el TNC mayor tipo DMix independientemente de la edad y la educación.
Socio-cultural adaptation and standardization of Dubois' five words testing in a population of normal subject in Mali, West Africa
2016, eNeurologicalSci
Citation Excerpt :
Beckmann [3], suggested that the influence of the level of literacy in the performance of a neuropsychological test could be related to the fact that low literacy level itself constitutes a risk factor of dementia or, on the other hand, subjects with low literacy level perceive the situation of test administration as scholarly, decreasing their involvement when they undergo the test. In this study, we did not register any intrusion as seen in Croisile's study [7]. According to Desgranges et al., intrusions give rise to numeric control and meta-memory impairment, i.e. the knowledge that a subject has of his memory and his performances [9].
Dubois' five words testing (5WT) is a verbal memory test that depends on many parameters. The aim of this study is to adapt Dubois' 5WT to the Malian socio-cultural conditions to (i) determine performances of normal subjects to the 5WT and (ii) provide reference scores of the 5WT.
A sample of 276 normal subjects aged ≥ 50 years (154 males and 122 females; 144 literates and 132 illiterates) were enrolled from February 2008 to January 2009. Subjects with a history of symptoms likely to modify cognitive functions and those who were found disabled under Lawton's four simplified item test were excluded.
The learning score in illiterates was 1.51 in Dubois' 5WT and 4.90 in the modified 5WT. The mean value of the modified 5WT total score was 9.71. Majority (90.22%) of the subjects scored the maximum (10). The modified 5WT reduced with both the age (p < 0.006) and education level (p < 0.04).
Our results show that Dubois' 5WT is influenced by culture and the socio-educative level in French. Its adaptation to the socio-cultural context could prove useful and efficient in countries with a low literacy rate and a diverse cultural background.
Memory examination in practical setting
2012, Pratique Neurologique - FMC
Explicit and implicit emotional processing modifications in pharmacoresistant left temporal lobe epilepsy and anxiodepressive disorders
2011, Epilepsy and Behavior
Citation Excerpt :
In addition, we ensured that the subjects had comparable cognitive profiles to better compare the influence of anxiodepressive mood on cognitive processing. We tested memory, language, reasoning, and executive functioning abilities using several neuropsychological tests: the MMSE [28] for a main evaluation; the five-word Dubois test [29] for episodic memory; the Stroop test for inhibition abilities [30]; Trail Making Test forms A and B for speed processing and mental flexibility [31]; the Similarities subtest of the Wechsler Adult Intelligence Scale-III [32] for reasoning; the Rey complex figure copy for planning [33], speed processing, and visuoconstructive abilities; and semantic (animal) and lexical (letter ‘p’) verbal fluency for language production [34]. Words were chosen from a study that assessed emotional characteristics of words [35] for their valence of sadness and anxiety (negative condition) and positivity (positive condition).
We examined whether anxiodepressive patients with left temporal lobe epilepsy could be differentiated from those with depression but without epilepsy on tasks that investigate attentional bias toward and explicit judgment of emotional stimuli. Eight depressive patients, eight anxiodepressive patients with epilepsy, and eight controls participated in the present study. Anxiodepressive with epilepsy and depressive patients had comparable depression scores and the same cognitive profile. Two distinct emotional tasks were used: the decision lexical task and the number comparison task. Three emotional connotations were presented: neutral, positive, and negative. The pattern of results showed an attentional bias toward negative words and pictures in depressive patients and only toward negative words in anxiodepressive patients with epilepsy. Moreover, depressive patients explicitly judged negative stimuli with lower intensity and anxiodepressive patients judged neutral stimuli with higher intensity. The present study specifies the emotional functioning in depression with or without left temporal lobe epilepsy.
The 5-word test in 37 depressed patients compared with 36 normal controls and 35 patients with mild Alzheimer's disease
2011, Encephale
Les troubles dépressifs majeurs (TDM) sont fréquents dans la population âgée ainsi qu’au stade léger de la maladie d’Alzheimer (MA). Il est de ce fait important de déterminer si les plaintes de mémoire d’un dépressif âgé sont à rapporter à une MA débutante ou aux dysfonctionnements cognitifs de sa dépression. Le Test des 5 mots (T5 M) est couramment utilisé pour évaluer la mémoire de sujets âgés se plaignant de leur mémoire. Notre travail a évalué, au moyen du T5 M, les performances de 37 patients âgés ayant un TDM, comparés à 36 témoins et 35 patients ayant une forme légère de MA. Le score total des dépressifs ne différait pas significativement de celui des témoins mais était significativement supérieur à celui des patients avec MA. Les taux d’oubli des dépressifs (13,6 %) et des témoins (2,8 %) ne différaient pas entre eux mais étaient significativement inférieurs à celui des patients avec MA (72,4 %). Avec un seuil de 9 au score total, il était très facile de différencier témoins et MA (sensibilité = 94,3 %, spécificité = 100 %) ; au seuil de 8, il était assez facile de différencier TDM et MA (sensibilité = 88,5 %, spécificité = 89,2 %) ; il était en revanche difficile de distinguer les TDM des témoins car le meilleur seuil de 10 était spécifique (88,9 %) mais peu sensible (37,8 %). La dépression d’un patient ne pourrait ainsi être tenue pour responsable d’un déficit mnésique significatif lors du T5 M. Un tel déficit inciterait à poursuivre les investigations neuropsychologiques.
Patients with major depression (MD) express frequent memory complaints leading to consultations in memory clinics. The 5-word test (5WT) is a verbal memory test with semantic cueing, which has shown its sensitivity and its specificity in identifying patients with Alzheimer's disease (AD). Our objective was to evaluate memory performances of aged patients with MD compared with controls and AD patients.
Characteristics of the 5WT were investigated in a sample of 37 patients with MD (66.8 ± 7.5 years) compared with 36 normal controls (67.3 ± 6.8 years) and 35 mild AD patients (67.5 ± 6.1 years).
Duration of depression was 15.3 ± 11.5 years. Memory complaints of MD patients were ancient (4.6 ± 5.5 years) and severe (McNair memory questionnaire = 47.6 ± 20.7). The Total score of MD patients did not differ from controls but was greater than those of AD patients. Learning and Memory scores of MD patients were significantly lower than those of controls and significantly greater than those of AD patients. Forgetting rate between Learning and Memory scores was more important in AD (72.4%) than in controls (2.8%) and MD (13.6%). No intrusions were recorded in controls, three MD patients each made one intrusion, whereas 80% of AD patients made between one to six intrusions (mainly during cued delayed recall). Receiver operating characteristic curves determined the most significant cut-off scores of the Total score. It appeared easy to discriminate AD patients from controls (cut-off = 9, sensitivity = 94.3%, specificity = 100%) or MD patients (cut-off = 8, sensitivity = 88.5%, specificity = 89.2%) whereas it was more difficult to discriminate MD patients from controls (cut-off = 10, specificity = 88.9%, sensitivity = 37.8%).
MD patients had significant difficulties with the 5WT as compared to controls, without being of the magnitude of those observed in AD patients.
The 5WT allows a reliable evaluation of memory in MD patients. The presence of true memory deficits with the 5WT could not be ascribed to depression but to other pathological conditions. Consequently, further memory testing should be conducted.
The five-word test in three aged-groups of mild Alzheimer's disease (60, 70 and 80 year-old patients): Utility of the Total Score, Total Weighted Score, Learning Score and Memory Score
2010, Revue Neurologique
Le Test des cinq mots (T5 M) est une épreuve de mémoire verbale sérielle utilisée en pratique médicale courante pour le repérage de la maladie d’Alzheimer (MA) chez des sujets se plaignant de leur mémoire. Après un apprentissage renforcé par un encodage sémantique, il mesure la qualité du rappel libre et l’efficacité des indices sémantiques de récupération, lors d’un rappel immédiat puis différé.
Le T5 M a été comparé chez 202 sujets normaux et 302 patients ayant une forme légère de MA (MMS supérieur ou égal à 20) répartis en trois classes d’âge : les 60 ans (60 à 69 ans), les 70 ans (70 à 79 ans) et les 80 ans (80 à 92 ans). Neuf scores ont été évalués (Score Total, Score Total Pondéré, Rappel Immédiat Libre, Score d’apprentissage, Rappel Différé Libre, Score de mémoire, taux d’oubli, efficacités de l’indiçage immédiat et différé) ainsi que la présence d’intrusions. Des courbes receiver operating characteristic ont déterminé les valeurs seuils les plus discriminantes dans chaque classe d’âge.
Les scores des patients sont toujours significativement différents de ceux des témoins. La prise en compte de l’âge montre qu’il faut utiliser des seuils différents des seuils traditionnels : pour le Score Total, les seuils sont de 10 (60 ans), 9 (70 ans) et 8 (80 ans), alors que pour le Score Total Pondéré, les seuils sont de 17 (60 ans), 16 (70 ans) et 14 (80 ans). Le Score Total Pondéré (qui double les rappels libres) est toujours plus pertinent que le Score Total pour repérer les patients avec MA. Les résultats quantitatifs et qualitatifs du T5 M opposent nettement les sujets âgés normaux et les patients avec forme légère de MA. Les sujets normaux ont un bon encodage ainsi qu’un stockage et une consolidation satisfaisants (peu d’oubli, bonne réactivité aux indices), les intrusions sont exceptionnelles. À l’inverse, les patients avec MA ont un encodage un peu faible et un trouble sévère du stockage et de la consolidation (mauvaise réactivité aux indices, oubli important), ils font très fréquemment des intrusions, en particulier lors des rappels indicés : ce profil est caractéristique du syndrome amnésique hippocampique de la MA.
Il est possible de réaliser une analyse quantitative et qualitative du T5 M : un score composite (préférentiellement le Score Total Pondéré) discrimine rapidement normaux et patients alors que l’analyse des intrusions et des deux scores intermédiaires (Score d’apprentissage et Score de mémoire) permet d’interpréter la nature des processus mnésiques altérés en révélant le syndrome amnésique hippocampique d’une MA.
The five-word test (5WT) is a serial verbal memory test with semantic cuing. It is proposed to rapidly evaluate memory of aging people and has previously shown its sensitivity and its specificity in identifying patients with AD. It measures the efficacy of free and cued recalls during a procedure of immediate and delayed recalls.
The 5WT was compared in a group of 202 normal subjects and a group of 302 mild AD patients (MMS of 20 or more) aged from 60 to 92 years, in three age classes (60 years, 70 years, 80 years). Nine scores were measured (Total Score, Total Weighted Score, Free Immediate Recall, Learning Score = total of Immediate Recalls, Free Delayed Recall, Memory Score = total of Delayed Recalls, Forgetting Rate, Percentage of Immediate Cuing, Percentage of Delayed Cuing) as well as the presence of intrusions. For each age class, Receiver Operating Characteristic curves determined the most significant cut-off scores.
For each score of the 5WT, AD patients differed significantly from controls. The cut-off scores were not the same according to age. For the Total Score, the cut-off scores were 10 (60 years), 9 (70 years) and 8 (80 years), whereas the cut-off scores of the Total Weighted Score were 17 (60 years), 16 (70 years) and 14 (80 years). As suggested by Cowppli-Bony et al. (2005), the Total Weighted Score (which gives a higher coefficient to free recalls) was better than the Total Score for discriminating mild AD. The 5WT is useful to discriminate normal controls and mild AD patients. Normal aged subjects displayed good encoding, efficient stocking and consolidation (few forgetting, efficient cued recall), intrusions were rare. Mild AD patients were characterized by weak encoding of words and severe deficit for stocking and consolidation (important forgetting, impaired cued recall), they made numerous intrusions. This psychometric profile is characteristic of the amnestic hippocampal syndrome found in AD.
The 5WT is a simple and reliable test for investigating memory in elderly people above 60 years old. According to age, different cut-offs are needed for the Total Score and the Total Weighted Score, the latter appearing more discriminating than the Total Score for the diagnosis of mild AD. It is also interesting to evaluate the presence of intrusions. Lastly, it is important to consider the forgetting rate (between Learning and Memory Scores) in order to confirm the presence of a hippocampal amnesia.

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Étalonnage du test des cinq mots dans une population de sujets sainsStandardization of the 5-word test in a group of 191 normal subjects aged 50 to 90 years

Résumé

Introduction

Observations

Conclusion

Summary

Introduction

Observations

Conclusion

Rev Neurol (Paris)

The Lancet

J Psych Res

Lancet

Instrumental activities of daily living as a screening tool for cognitive impairment and dementia in elderly community dwellers

J Am Geriatr Soc

L’histoire du lion (considérations sur la fabulation)

Semaine des Hôpitaux

De l’essentiel aux détails: le rappel des structures narratives par des sujets âgés normaux et dements

BRULEX: Une base de données lexicales informatisée pour le français écrit et parlé

L’Année Psychologique

Le Mild Cognitive Impairment (déficit cognitif léger): diagnostic et conduite à tenir en pratique clinique courante. À propos de l’expérience de 29 cas

La Revue de Gériatrie

Diagnostic d’une aphasie progressive primaire non fluente en pratique clinique courante

Rev Neurol (Paris)

Plaintes de mémoire en médecine de ville: présentation et prise en charge

La Revue de Gériatrie

Une batterie rapide de dénomination (BARD) en consultation mémoire

La Revue Francophone de Gériatrie et de Gérontologie

La maladie d’Alzheimer un problème de Santé Publique: oui… Une priorité ?

Rev Neurol (Paris)

Early detection of cognitive decline in higher cognitively functioning older adults: sensitivity and specificity of a neuropsychological screening battery

Neuropsychology