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NINCDS/ADRDA . Sensitivity . Specificity . Hopkins Verbal Learning Test . Alzheimer's disease . Dementia. Verbal memory . MMSE . Screening
Abstract
The present study investigated the sensitivity and specificity of the Hopkins Verbal Learning Test (HVLT) for demented patients (n = 82, using NINCDS criteria) and 114 healthy controls - equivalent in age, years of education and gender-ratio-from the Oxford Project to Investigate Memory and Ageing. The HVLT 'Total Recall' score had 87% sensitivity and 98% specificity for dementia using a cut-off score of 14.5. Using a 'Memory' score (the sum of the 'Total Recall' and the 'Discrimination Index') with a cut-off score of 24.5 gave a 91% sensitivity and 98% specificity for Alzheimer's disease cases when compared to controls. Unlike the MMSE, the HVLT has no ceiling effects and does not have to be adjusted for education. We conclude that the HVLT is an easy to administer, quick and well tolerated tool for the screening of dementia.
Introduction
Dementia is characterised by a decline in memory and other cognitive functions, which impact on social and occupational performance. It is primarily a clinical diagnosis, which cannot be determined by laboratory findings alone [1]. When screening for dementia in large population studies and intervention trials, the tests used should ideally be short, reliable and easy to administer. The Hopkins Verbal Learning Test (HVLT) is claimed to fulfil these criteria. While most verbal memory tests are lengthy and complex, the HVLT is brief, is well tolerated by patients and was found to have no ceiling effects [2]. By comparison, the Cambridge Cognitive Examination (CAMCOG), a test battery developed to assess early dementia in older people [31, takes approximately 30 to 60 min to administer. An advantage of the HVLT over the widely used 5-10 min Mini-Mental State Examination (MMSE) in the assessment of dementia [41 is its 6 equivalent or parallel forms, which allows serial testing with minimal learning effects [5-81. In addition, the HVLT (like the CAMCOG) has a slightly higher sensitivity than the MMSE to detect mildly demented subjects [91.
The HVLI has been found to have a particularly high sensitivity and specificity for Alzheimer's disease (AD), the most common form of dementia [2, 10, 11]. The original validation...