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Comparison of four verbal memory tests for the diagnosis and predictive value of mild cognitive impairment
Dina Silva1, Manuela Guerreiro, João Maroco
1Dementia Clinics, Faculty of Medicine, University of Lisbon, Lisbon.
Background:
Mild cognitive impairment (MCI) is considered to be an early stage of a neurodegenerative disorder, particularly Alzheimer's disease, and the clinical diagnosis requires the objective demonstration of cognitive deficits. The aim of the present study was to evaluate the predictive value of MCI for the conversion to dementia when using four different verbal memory tests (Logical Memory, LM; California Verbal Learning Test, CVLT; Verbal Paired-Associate Learning, VPAL; and Digit Span, DS) in the MCI criteria.
Methods:
Participants were consecutive patients with subjective cognitive complaints who performed a comprehensive neuropsychological evaluation and were not demented, observed in a memory clinic setting.
Results:
At baseline, 272 non-demented patients reporting subjective cognitive complaints were included. During the follow-up time (3.0 ± 1.9 years), 58 patients converted to dementia and 214 did not. Statistically significant differences between the converters and non-converters were present in LM, VPAL, and CVLT. A multivariate Cox regression analysis combining the four memory tests revealed that only the CVLT test remained significant as a predictor of conversion to dementia. Non-demented patients with cognitive complaints diagnosed as having MCI according to abnormal (<1.5 SD) learning in the CVLT test had a 3.61 higher risk of becoming demented during the follow-up.
Conclusion:
The verbal memory assessment using the CVLT should be preferred in the diagnostic criteria of MCI for a more accurate prediction of conversion to dementia.
Insights
The California Verbal Learning Test (CVLT) is a better predictor of dementia conversion in individuals with mild cognitive impairment (MCI) than other memory tests. Using CVLT in MCI criteria improves dementia risk prediction.
Area of Science:
- Neuroscience
- Gerontology
- Cognitive Psychology
Background:
- Mild cognitive impairment (MCI) is an early stage of neurodegenerative disorders like Alzheimer's disease.
- Clinical diagnosis of MCI requires objective evidence of cognitive deficits.
- Evaluating predictive value of different verbal memory tests for MCI conversion is crucial.
Purpose of the Study:
- To assess the predictive value of four verbal memory tests for dementia conversion in MCI patients.
- To determine which memory test is most effective in identifying individuals at high risk of developing dementia.
- To refine diagnostic criteria for MCI for improved prognostic accuracy.
Main Methods:
- Included 272 non-demented patients with subjective cognitive complaints in a memory clinic.
- Conducted comprehensive neuropsychological evaluations and followed patients for 3.0 ± 1.9 years.
- Utilized Logical Memory (LM), California Verbal Learning Test (CVLT), Verbal Paired-Associate Learning (VPAL), and Digit Span (DS) tests.
Main Results:
- 58 out of 272 patients converted to dementia during follow-up.
- Significant differences in LM, VPAL, and CVLT between converters and non-converters.
- CVLT was the only significant predictor of dementia conversion (HR=3.61) in multivariate analysis.
Conclusions:
- The California Verbal Learning Test (CVLT) demonstrates superior predictive value for dementia conversion in MCI.
- CVLT-based assessment should be prioritized in MCI diagnostic criteria for enhanced accuracy.
- Improved prediction of dementia conversion can aid in early intervention strategies.
