Understanding failure of visual paired associate learning in amnestic mild cognitive impairment

Impairment in visual paired associate learning occurs often in with amnestic mild cognitive impairment (aMCI), a condition considered to be an early stage of Alzheimer's disease (AD). To date, studies of aMCI have characterized impaired visual paired associate learning only in terms of summary scores such as total errors or total trials to criterion. The aim of this study was to determine the nature and magnitude of errors made on a continuous paired associate learning (CPAL) task designed to allow analysis of the component processes involved in paired associate learning. Twenty-one individuals with aMCI and 54 healthy age-matched older adults (HC) performed the CPAL task in which they had to learn six pattern-location pairings over six trials. Results suggested that aMCI patients performed significantly worse on the CPAL, both in learning rate and in error accumulation. Qualitative analyses of CPAL performance revealed that in aMCI there were significantly more errors on all indices except perseverative errors. When expressed as a percentage of total errors, abnormalities occurred only for within-search and exploratory errors. These findings suggest that poor performance on visual paired associate learning tasks in aMCI reflects impairments in both learning and executive function.