The token test: Validity and diagnostic power in Alzheimer's disease

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Abstract
The Token Test was introduced by DeRenzi and Vignolo (1962) with the intent of providing a sensitive and specific measure of auditory comprehension. Nevertheless, many nonlinguistic factors are also important in determining test performance. We assessed Token Test performance in patients classified as “probable Alzheimer's disease” according to National Institute of Neurological and Communicative Disorders and Stroke‐Alzheimer's Disease and Related Disorders Association criteria. We used a short version of the Token Test, the Mini‐Mental State Examination (MMSE, an indicator of global cognitive integrity), and a battery of tests designed to measure many specific neuropsychological functions. We show that this version of the Token Test correlates weakly with a measure of simple auditory‐verbal comprehension but highly with the MMSE. On the basis of an item analysis, it is suggested that demented patients do poorly on the Token Test mainly due to perseveration rather than due to difficulty with auditory‐verbal comprehension.