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Severity of medial temporal atrophy and amnestic mild cognitive impairment: selecting type and number of memory tests
David A Loewenstein1, Amarilis Acevedo, Elizabeth Potter
1Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA. dloewenstein@att.net
Objective:
Medial temporal lobe atrophy (MTA) can be used as a biomarker of pathology that affects mechanisms of episodic memory. The authors compared the strength of this biomarker with performance on four memory measures and examined the influence of demographic factors including age, level of education, and primary language (English or Spanish).
Methods:
The Hopkins Verbal Learning Test-revised, Fuld Object Memory Evaluation (FOME), delayed memory for a story passage, and delayed visual reproduction of the Wechsler Memory Scale-revised tests were administered to 281 subjects who were diagnosed as having no cognitive impairment, mild cognitive impairment (MCI), impaired non-MCI, or dementia. MTA scores were obtained from visual ratings of the hippocampus, entorhinal cortex, and perirhinal cortex on coronal magnetic resonance imaging scans using a magnetization-prepared rapid gradient echo protocol.
Results:
Age was associated with scores on all memory measures and MTA. Level of educational attainment had no influence on FOME performance but had greater associations with scores on other memory measures. In regression models, FOME scores had the strongest relationship with MTA scores, accounting for 31% of the explained variability. Among subjects with MCI, an index representing the total number of memory tests that were impaired was also predictive of the severity of MTA scores.
Conclusion:
Among four common tests of memory, the FOME was highly associated with MTA, and it exhibited minimal influences of education. Impairment on more than one memory test was more predictive of MTA than impairment on a single memory test.
Insights
The Fuld Object Memory Evaluation (FOME) strongly correlates with medial temporal lobe atrophy (MTA), a key biomarker for memory decline. This memory test showed minimal impact from education levels, making it a reliable measure.
Area of Science:
- Neuroimaging and Cognitive Neuroscience
- Biomarker Development
- Episodic Memory Research
Background:
- Medial temporal lobe atrophy (MTA) serves as a biomarker for pathologies impacting episodic memory.
- Understanding the relationship between specific memory tests and MTA is crucial for accurate cognitive assessment.
Purpose of the Study:
- To compare the efficacy of four memory measures as biomarkers of MTA.
- To investigate the influence of demographic factors (age, education, language) on memory performance and MTA.
- To identify the most robust memory assessment for detecting MTA-related changes.
Main Methods:
- 281 subjects with varying cognitive statuses (cognitively normal, MCI, dementia) underwent memory testing.
- Memory assessments included the Hopkins Verbal Learning Test-revised, Fuld Object Memory Evaluation (FOME), story recall, and visual reproduction.
- Medial temporal lobe atrophy (MTA) was quantified via visual rating of the hippocampus, entorhinal cortex, and perirhinal cortex on MRI scans.
Main Results:
- Age was significantly associated with all memory measures and MTA.
- The Fuld Object Memory Evaluation (FOME) demonstrated the strongest association with MTA, explaining 31% of the variability.
- Among individuals with mild cognitive impairment (MCI), a higher number of impaired memory tests predicted greater MTA severity.
Conclusions:
- The Fuld Object Memory Evaluation (FOME) is a highly sensitive measure for detecting medial temporal lobe atrophy (MTA).
- FOME performance was minimally affected by educational background, enhancing its utility across diverse populations.
- Assessing impairment across multiple memory tests provides a more accurate prediction of MTA than single-test impairment.
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