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Clinical Manifestations.

Paul Maruff1

  • 1Cogstate Ltd., Melbourne, VIC, Australia; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Updating the International Shopping List Test (ISLT) with age and sex-specific data significantly improves its sensitivity in detecting early Alzheimer's disease (AD) memory loss. This enhancement aids in earlier and more accurate diagnosis of mild cognitive impairment (MCI) due to AD.

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Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Background:

  • The International Shopping List Test (ISLT) is a key tool for assessing episodic memory dysfunction in Alzheimer's disease (AD).
  • Current ISLT normative data is limited, relying solely on age stratification, which may reduce its sensitivity in diverse populations.
  • Prodromal AD, characterized by mild cognitive impairment (MCI), requires sensitive diagnostic measures for early intervention.

Purpose of the Study:

  • To evaluate the sensitivity of the ISLT in detecting memory dysfunction in a prodromal AD cohort.
  • To compare the diagnostic sensitivity of existing ISLT normative data with updated data stratified by age and sex.
  • To determine if refined normative data improves the detection of MCI due to AD.

Main Methods:

  • The study included 321 adults with MCI (age 65-80, CDR=0.5) and 500 cognitively unimpaired (CU) adults with normal amyloid levels.
  • ISLT scores (immediate and delayed recall) were standardized using existing and updated normative data (5-year age strata and sex).
  • Sensitivity was calculated as the proportion of MCI participants classified with scores ≤-1SD, with comparisons made using McNemar's test.

Main Results:

  • Education level did not significantly influence ISLT scores in either CU or MCI groups.
  • Using updated normative data stratified by 5-year age groups and sex significantly improved ISLT sensitivity for detecting MCI.
  • Sensitivity increased from 83% to 91% for immediate recall, 81% to 91% for delayed recall, and 87% to 97% for combined recall (p<0.05).

Conclusions:

  • Stratifying ISLT normative data by 5-year age groups and sex enhances its sensitivity in identifying memory deficits in MCI due to AD.
  • The updated normative data provides a more accurate and sensitive measure for diagnosing early-stage Alzheimer's disease.
  • This refinement is crucial for improving early detection and potential intervention in individuals with prodromal AD.