Memory impairment on free and cued selective reminding predicts dementia

Abstract

Poor performance on free recall from FCSR predicts future dementia. These findings support the existence of a preclinical phase of dementia characterized by memory impairment, which is present for at least 5 years before diagnosis.

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).…”

“…Furthermore, the FCSRT has promise as a demographically neutral memory test because performance in nondemented elderly is unrelated to race or education (Grober et al, 1998;Ivnik et al, 1997). Memory testing is critical to dementia screening because impaired memory is one of its earliest manifestations (e.g., Elias et al, 2000;Grober et al, 2000;Linn et al, 1995;Saxton et al, 2004;Tierney et al, 2005) and because memory is the only cognitive domain that must be impaired to diagnose dementia (American Psychiatric Association, 1994). Postmortem series have demonstrated that memory decline precedes decline in mental status in early pathologically defined AD (Grober et al, 1999).…”

“…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).…”

“…Orientation (Folstein et al, 1975) CERAD Figure Copy (Welsh et al, 1994) FCSRT naming (Grober et al, 2000) Counting up, counting down (Blessed et al, 1968) Self-reported ADLS (Dartigues et al, 1997) Mood evaluation Geriatric Depression Scale (Yesavage et al, 1982(Yesavage et al, -1983 Informant interview Domain Semistuctured Clinical dementia Interview (Morris, 1993) mance was considered impaired if a participant gave up before completing the test.…”

“…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).…”