B – 88 The Boston Naming Test and Age-Related Effects

Abstract Objective The Boston Naming Test (BNT) is widely used in neuropsychology to assess language and cognitive functioning. However, its validity for younger populations is increasingly questioned due to outdated stimuli. This study tested the hypothesis that younger individuals would be less likely than older individuals to correctly identify specific BNT items. Method We analyzed 1,642 clinical cases of adults aged 18 to 89 (M = 59.1, SD = 15.7) with diverse diagnoses from the National Neuropsychology Network. Only participants who began the BNT at item 30 and completed items 30-60 were included, consistent with standard administration for individuals without suspected impairment. A primary analysis of logistic regression was used to assess age-related differences in item-level performance on the BNT. The primary variables were participant age and accuracy on individual test items. Results Logistic regression revealed six items with lower accuracy among younger participants: knocker (p=.001, CI [1.011, 1.039]), accordion (p<.001, CI [1.010, 1.039]), yoke (p<.001, CI [1.020, 1.033]), trellis (p<.001, CI [1.038, 1.052]), palette (p<.001, CI [1.010, 1.024]), and abacus (p<.001, CI [1.013, 1.026]). Conclusion While older adults are often assumed to struggle with word retrieval, younger adults' poorer performance likely reflects reduced exposure rather than cognitive decline. This generational gap is expected to widen as language and culture continue evolving, while the test has not been updated since the 1980s. Additionally, scoring inconsistencies and ambiguous discontinue rules may further limit the BNT’s effectiveness in modern clinical practice. These findings highlight the need to modernize neuropsychological tools to ensure equitable assessment across generations.