Story recall and word lists: differential and combined utilities in predicting cognitive diagnosis

Verbal memory assessment metrics are an essential component of cognitive screening tools. We compared the relative utilities of word list and story recall metrics in predicting cognitive functioning in nondemented and demented nursing home patients. We selected memory metrics from the Brief Cognitive Assessment Tool (BCAT) and the Brief Interview for Mental Status (BIMS). The BCAT incorporates both word lists and story recall metrics, while the BIMS only has a word list feature.

Two hundred and thirty-nine individuals residing in a Maryland skilled nursing facility were referred for neurocognitive evaluation over a one-year period. These residents met inclusion criteria for retrospective data analysis by completing the BCAT and BIMS and were aged 60 or older.

For the entire sample and for demented individuals, all four verbal memory metrics significantly predicted cognitive diagnosis. For nondemented individuals, only the BCAT delayed word list significantly predicted cognitive diagnosis. There appears to be enhanced utility in using both verbal memory metric types, as the inclusion of word list and story recall was a stronger predictor of cognitive diagnosis than any individual verbal memory metric.

This study highlights the importance of using cognitive screening tools that contain both story recall and word list metrics. This is particularly true in long-term care settings where the base rate of cognitive impairment is high.