Practice Effects on Story Memory and List Learning Tests in the Neuropsychological Assessment of Older Adults

Abstract

Two of the most commonly used methods to assess memory functioning in studies of cognitive aging and dementia are story memory and list learning tests. We hypothesized that the most commonly used story memory test, Wechsler's Logical Memory, would generate more pronounced practice effects than a well validated but less common list learning test, the Neuropsychological Assessment Battery (NAB) List Learning test. Two hundred eighty-seven older adults, ages 51 to 100 at baseline, completed both tests as part of a larger neuropsychological test battery on an annual basis. Up to five years of recall scores from participants who were diagnosed as cognitively normal (n = 96) or with mild cognitive impairment (MCI; n = 72) or Alzheimer's disease (AD; n = 121) at their most recent visit were analyzed with linear mixed effects regression to examine the interaction between the type of test and the number of times exposed to the test. Other variables, including age at baseline, sex, education, race, time (years) since baseline, and clinical diagnosis were also entered as fixed effects predictor variables. The results indicated that both tests produced significant practice effects in controls and MCI participants; in contrast, participants with AD declined or remained stable. However, for the delayed—but not the immediate—recall condition, Logical Memory generated more pronounced practice effects than NAB List Learning (b = 0.16, p < .01 for controls). These differential practice effects were moderated by clinical diagnosis, such that controls and MCI participants—but not participants with AD—improved more on Logical Memory delayed recall than on delayed NAB List Learning delayed recall over five annual assessments. Because the Logical Memory test is ubiquitous in cognitive aging and neurodegenerative disease research, its tendency to produce marked practice effects—especially on the delayed recall condition—suggests a threat to its validity as a measure of new learning, an essential construct for dementia diagnosis.

Test-retest reliability and minimal detectable change of the Contextual Memory Test in older adults with and without mild cognitive impairment

“…Participants may have remembered the items/contexts or learned the contextual strategy in the 1 st test and therefore improved their memory and meta-memory performance in the 2 nd test. This result was consistent with the findings of practice effects of cognitive tests on learning and memory in the literatures for healthy and cognitively-impaired adults [51,52]. To minimize the potential practice effects of CMT, we recommended using the dual-baseline approach.…”

“…We found generally better performance (i.e., higher scores and fewer prediction/estimation errors) in the 2 nd than the 1 st measurement in most CMT domains in both groups of participants. This finding indicates that there may be potentially practice effects of CMT in healthy and MCI participants [50,51]. Participants may have remembered the items/contexts or learned the contextual strategy in the 1 st test and therefore improved their memory and meta-memory performance in the 2 nd test.…”

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

“…Also, it is a known fact that neuropsychological test outcomes could be influenced by practice, or learning effects 40 , especially memory tests such as story and word list learning 41 (e.g., VVLT test). Therefore, specific attention should be on allocated to the number of training sessions and test execution.…”

Evaluation of MESSAGE communication strategy combined with group reminiscence therapy on elders with mild cognitive impairment in long‐term care facilities

“…Results of this study showed that increase in delayed memory may benefit from MoCA scale of 5 words in 3 repetitive memories generated by exercise. A longitudinal study showed that twice‐repeated practice effects affected memory of patients with MCI; through story‐memory and list‐learning tests, one study also showed significant effects of practice on delayed recall of MCI patients. Thus, based on practice effects and tolerance of elderly people to continuous intervention plan, group reminiscence program should be adjusted and improved in future studies.…”

“…Results of this study showed that increase in delayed memory may benefit from MoCA scale of 5 words in 3 repetitive memories generated by exercise. A longitudinal study 38 showed that twice-repeated practice effects affected memory of patients with MCI; through story-memory and list-learning tests, one study 39 Possibly, in long-term care facilities, admitted elderly people claim that they lack time perception. With increased degree of cognitive impairment, time-directed decline serves as sensitive indicator for cognitive function of patients.…”