Cued recall and early identification of dementia

The early detection of dementia carries implications for clinical management for patients and their families and is of utmost concern if an effective pharmacological treatment is to be found. The utility of an enhanced cued recall paradigm for predicting dementia in a group of elderly subjects was examined. Forty-five subjects referred for clinical evaluation who did not meet the criteria for dementia at initial assessment were reassessed 12-18 months later. Eighteen of these subjects were diagnosed as having possible or probable Alzheimer Disease at reassessment and the diagnostic status of 27 remained unchanged. At initial assessment the 'change' group performed more poorly than the 'no change' group on measures of retrieval, acquisition and retention derived from the cued recall procedure. As would be expected, the performance of the 'no change' group remained stable over time whereas the performance of the 'change' group deteriorated, resembling the performance of a group of subjects with mild possible or probable Alzheimer disease. When the sensitivity and specificity of the memory variables were examined, the retrieval measure (i.e., free recall) appeared most useful as an early predictor of dementia. Continued longitudinal evaluations of subjects with questionable dementia are needed to address more fully the natural history of early memory changes associated with dementia.