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Related Experiment Video

Updated: Feb 13, 2026

Lexical Decision Task for Studying Written Word Recognition in Adults with and without Dementia or Mild Cognitive Impairment
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Word-list intrusion errors predict progression to mild cognitive impairment.

Kelsey R Thomas1, Joel Eppig2, Emily C Edmonds3

  • 1Veterans Affairs San Diego Healthcare System.

Neuropsychology
|March 13, 2018
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Summary

Intrusion errors on the Rey Auditory Verbal Learning Test (AVLT) can predict the progression to mild cognitive impairment (MCI) and mild dementia in individuals with normal cognition. These errors indicate subtle cognitive changes before they are detected by standard tests.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Gerontology

Background:

  • Preclinical Alzheimer's disease (AD) is characterized by positive AD biomarkers with normal cognition, preceding mild cognitive impairment (MCI).
  • Subtle cognitive deficits in preclinical AD may be detectable through neuropsychological test process and error scores.
  • Identifying individuals at risk for MCI is crucial for early intervention strategies.

Purpose of the Study:

  • To determine if baseline process scores on the Rey Auditory Verbal Learning Test (AVLT) predict progression to MCI.
  • To assess the predictive value of AVLT process scores for progression to mild dementia (Clinical Dementia Rating score of 1).
  • To evaluate the utility of AVLT intrusion errors in detecting preclinical cognitive changes.

Main Methods:

  • A cohort of 525 cognitively normal participants from the Alzheimer's Disease Neuroimaging Initiative was followed for up to 5 years.
  • Cox regressions were employed to analyze the predictive power of baseline AVLT process scores (intrusion errors, learning slope, proactive and retroactive interference).
  • Models accounted for demographic factors, apolipoprotein E ε4 status, CSF AD biomarkers, and other clinical variables.

Main Results:

  • Baseline AVLT intrusion errors significantly predicted progression to MCI (HR=1.04, p=.008) and improved model fit.
  • AVLT intrusion errors also predicted progression to a Clinical Dementia Rating score of 1 (HR=1.10, p=.016), enhancing model prediction.
  • These findings indicate that intrusion errors offer unique predictive value beyond standard cognitive measures.

Conclusions:

  • Intrusion errors on the AVLT provide valuable, unique information for predicting the transition from normal cognition to MCI and mild dementia.
  • AVLT intrusion errors appear to reflect subtle cognitive changes and inefficiencies that precede impairments detected by total scores on neuropsychological tests.
  • This suggests that detailed analysis of error patterns in neuropsychological testing can aid in the early detection of cognitive decline in Alzheimer's disease.