Differential memory test sensitivity for diagnosing amnestic mild cognitive impairment and predicting conversion to Alzheimer's disease

Laura A. Rabin, Nadia Paré, Andrew J. Saykin, Michael J. Brown, Heather A. Wishart, Laura A. Flashman, Robert B. Santulli

Research output: Contribution to journalArticle

133 Scopus citations

Abstract

Episodic memory is the first and most severely affected cognitive domain in Alzheimer's disease (AD), and it is also the key early marker in prodromal stages including amnestic mild cognitive impairment (MCI). The relative ability of memory tests to discriminate between MCI and normal aging has not been well characterized. We compared the classification value of widely used verbal memory tests in distinguishing healthy older adults (n = 51) from those with MCI (n = 38). Univariate logistic regression indicated that the total learning score from the California Verbal Learning Test-II (CVLT-II) ranked highest in terms of distinguishing MCI from normal aging (sensitivity = 90.2; specificity = 84.2). Inclusion of the delayed recall condition of a story memory task (i.e., WMS-III Logical Memory, Story A) enhanced the overall accuracy of classification (sensitivity = 92.2; specificity = 94.7). Combining Logical Memory recognition and CVLT-II long delay best predicted progression from MCI to AD over a 4-year period (accurate classification = 87.5%). Learning across multiple trials may provide the most sensitive index for initial diagnosis of MCI, but inclusion of additional variables may enhance overall accuracy and may represent the optimal strategy for identifying individuals most likely to progress to dementia.

Original languageEnglish (US)
Pages (from-to)357-376
Number of pages20
JournalAging, Neuropsychology, and Cognition
Volume16
Issue number3
DOIs
StatePublished - May 2009

Keywords

  • Alzheimer's disease
  • Assessment
  • Classification
  • Memory
  • Mild cognitive impairment

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Experimental and Cognitive Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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