Memory impairment on free and cued selective reminding predicts dementia.

Area of Science:

• Neurology
• Gerontology
• Cognitive Science

Background:

• Identifying individuals at high risk for dementia is crucial for early intervention.
• Memory impairment not attributable to other cognitive deficits can be identified using controlled memory tests.
• Inadequate control of testing conditions can lead to misidentification of dementia-related memory deficits.

Purpose of the Study:

• To determine the relative rates of dementia in individuals with and without memory impairment identified by baseline free recall using the Free and Cued Selective Reminding (FCSR) test.

Main Methods:

• Longitudinal study of 264 initially nondemented elderly volunteers from the Einstein Aging Study.
• Clinical and psychometric examinations conducted every 12 to 18 months for up to 10 years.
• Dementia diagnosis based on an algorithmic definition including Blessed Information Memory and Concentration score and evidence of functional decline.

Main Results:

• Thirty-two cases of incident dementia were observed during the follow-up period.
• Survival analyses revealed that subjects with impaired baseline free recall had significantly higher rates of dementia development (relative risk = 75.2) within 5 years compared to those with intact free recall.
• These findings remained significant after adjusting for age, gender, and education.

Conclusions:

• Impaired free recall performance on the FCSR test is a strong predictor of future dementia.
• The results support the existence of a preclinical phase of dementia characterized by memory impairment detectable at least 5 years prior to clinical diagnosis.