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Updated: Jul 12, 2026

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
Early detection of memory impairment in Alzheimer's disease: a neurocognitive perspective on assessment
1School of Psychology, Psychiatry and Psychological Medicine, Monash University, Clayton, VIC, Australia. georgia.lowndes@med.monash.edu.au
Abstract:
We propose that the earliest neuropsychological detection of Alzheimer's disease (AD) can be informed by current views about the neuropathogenesis of AD and cognitive models of memory and its neurobiological substrates. The primary impairment in early AD is encoding/consolidation, resulting from medial temporal lobe (MTL) pathology. On theoretical and empirical grounds, paired associate learning (PAL) appears to be the ideal paradigm for detecting MTL dysfunction in early AD. It has not been embraced as a test of choice, however, and this critical review discusses why the paradigm may have not fulfilled its potential. We suggest that a new PAL variant, 'associate-recognition', may prove to be clinically efficacious.
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