Worth the Wait: Delayed Recall after 1 Week Predicts Cognitive and Medial Temporal Lobe Trajectories in Older Adults

Abstract

Objective: We evaluated whether memory recall following an extended (1 week) delay predicts cognitive and brain structural trajectories in older adults. Method: Clinically normal older adults (52–92 years old) were followed longitudinally for up to 8 years after completing a memory paradigm at baseline [Story Recall Test (SRT)] that assessed delayed recall at 30 min and 1 week. Subsets of the cohort underwent neuroimaging (N = 134, mean age = 75) and neuropsychological testing (N = 178–207, mean ages = 74–76) at annual study visits occurring approximately 15–18 months apart. Mixed-effects regression models evaluated if baseline SRT performance predicted longitudinal changes in gray matter volumes and cognitive composite scores, controlling for demographics. Results: Worse SRT 1-week recall was associated with more precipitous rates of longitudinal decline in medial temporal lobe volumes (p = .037), episodic memory (p = .003), and executive functioning (p = .011), but not occipital lobe or total gray matter volumes (demonstrating neuroanatomical specificity; p > .58). By contrast, SRT 30-min recall was only associated with longitudinal decline in executive functioning (p = .044). Conclusions: Memory paradigms that capture longer-term recall may be particularly sensitive to age-related medial temporal lobe changes and neurodegenerative disease trajectories.

XGBoost for Interpretable Alzheimer’s Decision Support

“…The XGBoost classifier performed well in predicting AD risk, selecting three features (i.e., Everyday Cognition Questionnaire (Study partner) -Total, Alzheimers Disease Assessment Scale (13 items) and Delayed Total Recall) with AUC ROC values consistently above 97% (Figure 1, surpassing the performance of the latest AD-specific model (Rye et al 2022). Our findings support the idea that memory paradigms, such as delayed total recall, can serve as effective measures to track neurodegenerative disease trajectories (Lindbergh et al 2021). Moreover, these features may be sensitive to neurodegenerative disease trajectories more so than Mini-Mental State Examination or Montreal Cognitive Assessment.…”

Association of Genetic Variants Linked to Late-Onset Alzheimer Disease With Cognitive Test Performance by Midlife

“…Third, the UK Biobank cognitive test battery was not comprehensive and omitted measures that may be sensitive to early cognitive changes in AD, such as tests of episodic memory that capture long-delay recall and recognition, 63 , 64 and measures of verbal fluency, 23 language, 65 , 66 and working memory 67 or other approaches. 68 With more sensitive measures, we may have detected even earlier changes. Fourth, caution in interpreting test differences is merited because the samples differed in size and composition.…”

“…Second, we restricted analysis to individuals with European ancestry—the predominant population of previous AD-GRS studies—and our results may not reflect patterns in other populations. Third, the UK Biobank cognitive test battery was not comprehensive and omitted measures that may be sensitive to early cognitive changes in AD, such as tests of episodic memory that capture long-delay recall and recognition, and measures of verbal fluency, language, and working memory or other approaches . With more sensitive measures, we may have detected even earlier changes.…”

A review of accelerated long-term forgetting in Alzheimer’s disease: Current situation and prospects.

“…They emphasize the importance of avoiding floor and ceiling effects which may arise due to the long delays employed and variability across individuals in premorbid IQ, learning strategies, motivation and habituation to test situations. Moreover, in order to avoid rehearsal, it is desirable not to inform subjects that they will be asked again after some time about the newly learned information (C. Butler et al, 2009;Lindbergh et al, 2021;Weston et al, 2018;Zimmermann & Butler, 2018). For the first time, Alviarez-Schulze et al ( 2022) have shown evidence on the relevance of warning or not warning subjects of long-term reassessment of newly learned information by revealing that subjects who were informed of a future assessment after 1 week showed less long-term forgetting.…”