title: Development of a screening algorithm for Alzheimer's disease using categorical verbal fluency.
abstract: We developed a weighted composite score of the categorical verbal fluency test (CVFT) that can more easily and widely screen Alzheimer's disease (AD) than the mini-mental status examination (MMSE). We administered the CVFT using animal category and MMSE to 423 community-dwelling mild probable AD patients and their age- and gender-matched cognitively normal controls. To enhance the diagnostic accuracy for AD of the CVFT, we obtained a weighted composite score from subindex scores of the CVFT using a logistic regression model: logit (case)  = 1.160+0.474× gender +0.003× age +0.226× education level - 0.089× first-half score - 0.516× switching score -0.303× clustering score +0.534× perseveration score. The area under the receiver operating curve (AUC) for AD of this composite score AD was 0.903 (95% CI = 0.883 - 0.923), and was larger than that of the age-, gender- and education-adjusted total score of the CVFT (p<0.001). In 100 bootstrapped re-samples, the composite score consistently showed better diagnostic accuracy, sensitivity and specificity for AD than the total score. Although AUC for AD of the CVFT composite score was slightly smaller than that of the MMSE (0.930, p = 0.006), the CVFT composite score may be a good alternative to the MMSE for screening AD since it is much briefer, cheaper, and more easily applicable over phone or internet than the MMSE.
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Yeon Kyung
authors.initials: YK
authors.lastname: Chi
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Han
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Jeong
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Tae Hui
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Kyungbook National University Hospital, Daegu, Korea.
authors.forename: Jung Jae
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Dankook University Hospital, Cheonan, Korea.
authors.forename: Seok Bum
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea.
authors.forename: Joon Hyuk
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea.
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Yoon
authors.affiliation: Department of Psychiatry, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Jeong Lan
authors.initials: JL
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Ryu
authors.affiliation: Department of Neuropsychiatry, Kangwon National University Hospital, Chooncheon, Korea.
authors.forename: Jin Hyeong
authors.initials: JH
authors.lastname: Jhoo
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea ; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong Young
authors.initials: DY
authors.lastname: Lee
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea ; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea ; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea.
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000544:Alzheimer Disease / Q000175:diagnosis*; D019540:Area Under Curve; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013068:Speech Production Measurement / Q000379:methods*