The California Verbal Learning Test and other standard clinical neuropsychological tests to predict conversion from mild memory impairment to dementia

Abstract

This study describes the neuropsychological assessment of 34 patients with questionable Alzheimer's disease (QAD) followed up for 3 years. Several measures were selected from the California Verbal Learning Test (CVLT) and compared to other cognitive tasks to assess the best neuropsychological indices for (a) detecting early memory impairment in QAD and (b) predicting conversion to AD. Concerning detection, the results indicated that a recall measure depending on semantic categorization (short-delay cued recall) signaled a memory deficit in stable QAD patients, suggesting that episodic and semantic memory problems are involved in the early cognitive impairments of stable QAD patients. However, the conversion to AD was best predicted by the initial performance at the recency index (score reflecting high reliance on working memory), corroborating the idea that AD patients (even at the questionable stage) essentially rely on preserved phonological loop functioning in memory tasks. Finally, an additional impairment in visuospatial memory (Rey's figure) provided a good discriminant value to distinguish converters from stable QAD patients, showing that various cognitive disabilities deteriorate in AD.

Repeated retrieval during working memory is sensitive to amnestic mild cognitive impairment

“…NOC participants were healthy UK-ADC cohort volunteers (n = 4) or referrals to the memory clinic for evaluation who did not receive a clinical diagnosis and were considered NOC based on criteria listed below (n = 14). In keeping with contemporary clinical criteria (Albert et al, 2011; Arsenault-Lapierre et al, 2011; Lekeu et al, 2010; Reid & Maclullich, 2006), aMCI was indicated by A) absence of dementia, B) absence of cognitive, clinical, or behavioral symptoms consistent with sources of non-amnestic cognitive impairment, and C) objective memory impairment evidenced by performance more than 1.5 standard deviations below age-standardized normal values on at least one of several memory measures including Wechsler Memory Scale Logical Memory (WMS-R), the California Verbal Learning Test (CVLT-II), and the Benton Visual Retention Test (BVRT-5, Forms C & D). AD was diagnosed using Alzheimer’s Disease Dementia Workgroup criteria, which hold, briefly, that insidious-onset dementia is present in the absence of another psychiatric or neurological condition (McKhann et al, 2011).…”

Trajectories of Alzheimer disease‐related cognitive measures in a longitudinal sample

“…In one study, the Rey Auditory Verbal Learning Test (RAVLT) short delayed recall was the most significant neuropsychological test in 5- and 10-year follow-ups to emerge as a predictor of AD (17). In another, short-delay cued recall score on the CVLT(18) was the neuropsychological test that best discriminated stable and declining questionable AD subjects from controls (19). In yet another study, both the total learning and delayed recall scores of the RAVLT predicted progression to AD and classified between MCI and normal aging (20), and another group of investigators found long delayed total recall (CVLT free and cued) combined with Mini-Mental State Examination to be the best predictor of MCI progression onto AD (21).…”

Practice Effects and Amyloid Deposition

“…Third, as a novel memory task, we have previously found it to have large practice effects in older adults and these practice effects have predicted future cognitive functioning in prior studies 20, 23, 24 . Finally, visual spatial tasks, including those assessing memory, appear to be sensitive to various dementing conditions 32–35 . Although alternate forms are available for the BVMT-R, they were not used in this study to maximize practice effects.…”