Recall discriminability: Utility of a new CVLT–II measure in the differential diagnosis of dementia

Abstract

Memory tests that are in a recall format have almost universally measured accuracy in terms of the number of target items reported by the examinee. However, this traditional scoring method can, in certain cases, result in artificially inflated memory accuracy scores. That is, just as a "yes" response bias and high false-positive rate on recognition testing can artificially inflate a patient's hit rate, so, too, a liberal response bias and high intrusion rate on recall testing can artificially inflate a patient's level of target recall. Recognition tests correct for this problem by using a discriminability measure that provides a single score of hit rate relative to false-positive rate; however, recall tests rarely provide a single score of recall accuracy that corrects for intrusion rate. In the present study, we examined the utility of a new recall discriminability measure that analyzes target recall relative to intrusion rate. Patients with Alzheimer's disease (AD) or Huntington's disease (HD) were administered the CVLT-II, which provides both the traditional measure of target recall and a new measure of recall discriminability. The results indicate that the new recall discriminability measure was superior to the traditional level of target recall measure in distinguishing the recall performance of AD and HD patients. Implications of these results for clinical practice and theories of memory disorder in dementia are discussed.

Minimizing Misdiagnosis: Psychometric Criteria for Possible or Probable Memory Impairment

“…The 3 memory tests used in this study have immediate recall, delayed recall, and recognition memory components (although normative scores are available for only 2 of the recognition measures). Memory tests for stories [46][47][48] , designs [46,49] , and word lists [47,[50][51][52] are widely used in AD research. Given that these WMS-III tests are co-normalized, they seem particularly useful in clinical practice and research involving patients with prodromal AD.…”

Usefulness of Discriminability and Response Bias Indices for the Evaluation of Recognition Memory in Mild Cognitive Impairment and Alzheimer Disease

“…Researchers suggest different explanations for these findings. For example, diminished discrimination between targets and distractors may reflect a fundamental memory deficit, whereas the conservative or liberal response bias may be related to motivation [28] or frontal lobe dysfunction [21] in AD patients. However, these findings are not universal, and available data about the utility of these measures in terms of classification or differential diagnosis in AD spectrum are lacking.…”

Normative and retest data on the RBANS cortical/subcortical index in older adults

“…For example, Alzheimer's disease is a prototypical cortical dementia (Delis et al, 2005;Paulsen et al, 1995b;Peavy et al, 1994), with impairments in higher level cortical functions (e.g., aphasia, apraxia, agnosia). Conversely, subcortical dementias are characterized by a relative sparing of these higher level functions, but can present with deficits in psychomotor speed, visual-spatial abilities, and executive functioning.…”