Clinical Manifestations.

Area of Science:

• Neuroscience
• Cognitive Psychology
• Clinical Diagnostics

Background:

• Narrative recall tests are valuable for differentiating cognitive impairment but often require long delays (30 minutes), limiting clinical utility.
• Existing narratives may not be sensitive enough for detecting very early-stage cognitive decline.
• The "Puppy Escape" narrative was developed to address the need for shorter delay recall measures.

Purpose of the Study:

• To develop and validate a novel narrative recall task, "Puppy Escape," for assessing cognitive impairment with a 15-minute delay.
• To incorporate a weighted scoring system accounting for both verbatim and paraphrased recall.
• To evaluate the narrative's effectiveness in differentiating cognitively normal individuals from those with preclinical Alzheimer's disease (pAD) and mild cognitive impairment (MCI).

Main Methods:

• 93 participants (60 cognitively normal, 8 preclinical AD, 25 MCI) were recruited.
• The "Puppy Escape" narrative was presented via multimodal encoding (audio narration with visual text).
• Analyses included ANOVAs, logistic regressions, and machine learning models utilizing lexical and audiometric data with weighted scoring.

Main Results:

• Significant differences in immediate recall were found between cognitively normal (CN) and MCI/pAD groups (p < .001).
• Delayed recall (15 minutes) also showed significant differences between CN and MCI groups (p < .001).
• Machine learning models achieved high accuracy (72.7% sensitivity, 94.0% specificity, AUC 0.870) in differentiating diagnostic groups.

Conclusions:

• The "Puppy Escape" narrative is effective for cognitive assessment with a short 15-minute delay.
• Its length and multimodal presentation enhance detection of subtle cognitive decline, particularly in mild cognitive impairment.
• The freely available narrative shows promise for early detection of cognitive impairment in clinical settings.