Screening for dementia by memory testing

Abstract

Enhanced cued recall provides a simple and clinically useful memory test for identifying dementia in the elderly. Because this test induces semantic processing and coordinates encoding and retrieval for maximum recall, genuine memory deficits due to impairment of specific memory processes can be distinguished from apparent memory deficits due to use of inefficient strategies or impairment of other cognitive processes. Since genuine memory deficits in the elderly are usually associated with dementia, their identification is highly predictive of clinical dementia. The present study validates the use of enhanced cued recall as a screening test for dementia in 70 aged subjects. All but one person with a pure amnesia were correctly classified. Enhanced cued recall correctly classified 97% of the 120 subjects in this and the previous study. Enhanced cued recall shows learning not revealed by free recall, providing more accurate measurement of memory, and distinguishes demented from nondemented elderly more accurately than either free recall or recognition.

Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease

“…It is used in five major longitudinal aging studies besides the BLSA: (1) Einstein Aging Study (EAS; Grober et al, 1988); (2) Mayo Older Adults Normative Study (Petersen et al, 1995); (3) Berlin Aging Study (Lindenberger & Reischies, 1999); (4) Canadian Study of Health and Aging (Tuokko et al, 1995); and (5) Personnes Agees QUID (Sarazin et al, 2007). FCSR is also used in the Alzheimer's Disease Cooperative Study Instrumentation Protocol to identify persons with prevalent dementia and trigger clinical evaluations for incident dementia (Ferris et al, 2006).…”

“…FCSR differs from Selective Reminding, used in the BAS, in that category cues are used both in the study and test phases, controlling attention and cognitive processing. This test has excellent discriminative validity for dementia at cross-section and excellent predictive validity for incident dementia (Grober et al, 1988(Grober et al, , 2000(Grober et al, , 2008. We used learning as our measure of memory instead of delayed recall or retention because of prior data suggesting that learning defined as the sum of free recall across three test trials was sensitive to preclinical disease, whereas retention tested 30 min later was not (Grober & Kawas, 1997).…”

Neuropsychological strategies for detecting early dementia

“…All three were more sensitive to AD than non-AD dementias due to the focus on memory in both stages of the strategies. Tests like the FCSRT and the MIS, which use controlled learning, powerfully discriminate between normal aging and dementia (Buschke, 1984;Buschke et al, 1995Buschke et al, , 1999Gebner et al, 1997;Grober et al, 1988Grober et al, , 2000Grober & Kawas, 1997;Ferris et al, 2006, Neuropsychological strategies for detecting early dementia 137 Peterson et al, 1994Peterson et al, , 1995Tounsi et al, 1999;Tuokko & Crockett, 1989). FCSRT, the memory test used here, has high sensitivity and specificity for the identification of dementia (Ferris et al, 2006;Gebner et al, 1997;Grober et al, 1988;Peterson et al, 1994;Tuokko & Crockett, 1989), and preclinical dementia (Grober & Kawas, 1997;Grober et al, 2000;Peterson et al, 1995;Robert et al, 2006;Sarazin et al, 2007).…”

“…Finally, other causes of acquired memory impairment in the elderly are rare (Fratiglioni et al, 1991;Cummings and Benson, 1992). Therefore, in the absence of other identifiable etiologies, the identification of impaired memory is highly predictive of a diagnosis of dementia (Grober & Buschke, 1987;Grober et al, 1988Grober et al, , 2000Grober & Kawas, 1997).…”

“…A traditional approach is to use tests of global cognitive function such as the Mini-Mental State Exam (MMSE: Folstein et al, 1975) or the Blessed-Information-Memory-Concentration Test (BIMC: Blessed et al, 1968) to assess the severity of cognitive impairment (Tombaugh and McIntyre, 1992). A second approach is to measure memory, the only cognitive domain where impairment is required for diagnosis with a test that controls attention and cognitive processing to identify memory impairment that is not secondary to other cognitive deficits (Grober & Buschke, 1987;Grober et al, 1988Grober et al, , 2000Grober et al, , 2008Grober & Kawas, 1997). A third approach is briefly to measure several specific cognitive domains such as memory, attention-executive function, and visuospatial ability (Borson et al, 2005;Kilada et al, 2005;Lipton et al, 2003).…”