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Memory impairment in Alzheimer's disease: replication and extension of the delayed word recall (DWR) test

Published online by Cambridge University Press:  13 June 2014

Robert F Coen ,
Gregory RJ Swanwick ,
Conor Maguire ,
Michael Kirby ,
Brian A Lawlor ,
J Bernard Walsh  and
D Coakley
D Coakley
Affiliation:
Mercer's Institute for Research on Ageing, St James's Hospital, Dublin 8, Ireland
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Abstract

Objective: The original DWR test, which measured delayed free recall, was reported to have high predictiveaccuracy in discriminating Alzheimer's disease (AD) patients from control subjects (overall accuracy of 95%).Comparison of differential performance in free recall and recognition of the same material may be of clinical interest. In the present study a delayed recognition component was added to the DWR test and the utility of both measures in discriminating AD patients from control subjects was evaluated.

Procedure: This extended version of the DWR test was administered to 66 patients meeting NINCDS/ADRDA criteria for probable AD and 42 control subjects.

Results: In a comparison between 42 of these patients (MMSE range 18–29), and 42 age matched healthy controls, both the delayed free recall and recognition measures were highly accurate in distinguishing patients from controls. The free recall measure achieved 98% sensitivity, specificity and overall accuracy, while the recognition measure yielded 98% sensitivity, 95% specificity, and 96% overall accuracy. The recognition performance of all 66 patients, ranging in severity from very mild to severe (MMSE range 11–29), was also evaluated to determine its relationship, if any, to measures of global cognitive impairment. While therecognition measure correlated poorly with MMSE and CAMCOG there was a modest but significant correlation with the CAMCOG memory subscale.

Conclusions: In this study of highly selected AD patients both the free recall and recognition measures were sensitive and specific indicators of AD compared to control subjects. Recognition performance appears to be more closely related to degree of amnesia than to degree of global cognitive impairment.

Keywords

Alzheimer's diseaseDelayed recallDelayed recognition
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 13 , Issue 2 , June 1996 , pp. 55 - 58
Copyright
Copyright © Cambridge University Press 1996

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References

1.Jorm, AF. The epidemiology of Alzheimer's disease. London; Chapman & Hall, 1990.Google Scholar
2.Hyman, BT, Van Hoesen, GW, Damasio, AR, Barnes, CL. Alzheimer's disease: cell specific pathology isolates the hippocampal formation. Science 1984; 222: 1168–70.CrossRefGoogle Scholar
3.de Leon, T, George, AE, Stylopoulos, LA, Smith, G, Miller, DC. Early marker for Alzheimer's disease: the atrophic hippocampus. Lancet 1989: 672–73.CrossRefGoogle ScholarPubMed
4.Perry, EK, Perry, RH. The cholinergic system in Alzheimer's disease; in Roberts, PJ (ed). Biochemistry of dementia. Chichester: John Wiley & Sons, 1980: 135–83.Google Scholar
5.Bartus, RT, Dean, RL, Beer, B, Lippa, AS. The cholinergic hypothesis of geriatric memory dysfunction. Science 1982; 217: 408–17.CrossRefGoogle ScholarPubMed
6.Albert, MS, Moss, MB, Milberg, W. Memory testing to improve the differential diagnosis of Alzheimer's disease; in Iqbal, K, Wisniewski, HM, Winblad, B (eds). Alzheimer's disease and related disorders. New York: Alan R Liss, 1989; 55–69.Google Scholar
7.Wilson, RS, Bacon, LD, Fox, JH, Kaszniak, AW. Primary memory and secondary memroy in dementia of the Alzheimer type. Journal of Clinical Neuropsychology 1983; 5: 337–44.CrossRefGoogle Scholar
8.Hart, RP, Kwentus, JA, Harkins, SW, Taylor, JR. Rate of forgetting in mild Alzheimer's-type dementia. Brain and Cognition 1988; 7: 31–38.CrossRefGoogle ScholarPubMed
9.Butters, N, Salmon, DP, Cullum, CM, Cairns, P, Troster, AI, Jacobs, D. Differentiation of amnesiac and demented patients with the Wechsler Memory Scale– Revised. Clin Neuropsychol 1988; 2: 133–48.CrossRefGoogle Scholar
10.Corkin, S, Growdon, J, Nissen, MJ, Huff, FJ, Freed, DM, Sagar, HJ. Recent advances in the neuropsychological study of Alzheimer's disease; in Wurtman, RJ, Corkin, S, Growdon, JH (eds). Alzheimer's disease: advances in basic research and therapies. Centre for Brain Sciences and Metabolism Trust, 1984; 75–94.Google Scholar
11.Kopelman, MD. Rates of forgetting in Alzheimer-type dementia and Korsakofs Syndrome. Neuropsychologia 1985; 23: 623–38.CrossRefGoogle ScholarPubMed
12.Welsh, KA, Butters, N, Hughes, J, Mohs, R, Heyman, A. Detection of abnormal memory decline in mild cases of Alzheimer's disease using CERAD neuropsychological measures. Arch Neurol 1991; 48: 278–81.CrossRefGoogle ScholarPubMed
13.Welsh, KA, Butters, N, Hughes, J, Mohs, R, Heyman, A. Detection and staging of dementia in Alzheimer's disease. Use of the neuropsychological measures developed for the Consortium to Establish a Registry for Alzheimer's disease. Arch Neurol 1992; 49: 448–52.CrossRefGoogle ScholarPubMed
14.Lachner, G, Satzger, W, Engel, M. Verbal memory tests in the differential diagnosis of depression and dementia: discriminative power of seven test variations. Arch Clin Neuropsychol 1994; 9: 1–13.CrossRefGoogle ScholarPubMed
15.Kaszniak, AW, Poon, LW, Riege, W: Assessing memory deficits: an information-processing approach; in Poon, LW (ed). Handbook for clinical memory assessment of older adults. Washington DC: American Psychological Association, 1986; 168–88.CrossRefGoogle Scholar
16.Knopman, DS, Ryberg, S. A verbal memory test with high predictive accuracy for dementia of the Alzheimer type. Arch Neurol 1989: 46: 141–45.CrossRefGoogle ScholarPubMed
17.Folstein, MF, Folstein, SE, McHugh, PR: MiniMental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12: 189–98.CrossRefGoogle Scholar
18.Michon, A, Deweer, B, Pillon, B, Agid, Y, Dubois, B. Relation of anosognosia to frontal lobe dysfunction in Alzheimer's disease. J Neurol Neurosurg Psychiatry 1994; 57: 805–9.CrossRefGoogle ScholarPubMed
19.Swanwick, GRJ, Coen, RF, O'Mahony, D, Tully, M, Bruce, I, Buggy, F, Lawlor, BA, Walsh, JB, Coakley, D. A memory clinic for the assessment of mild dementia. IMJ (in press).Google Scholar
20.McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM. Clinical diagnosis of Alzheimer's disease: Report of the NINCDS/ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984; 34: 939–44.CrossRefGoogle ScholarPubMed
21.Hachinsk, VC, Illif, LD, Zilhka, E, Du Boulay, GH, McAllister, VL, Marshall, J, Ross Russell, RW, Symon, L. Cerebral blood flow in dementia. Arch Neurol 1975; 32: 632–37.CrossRefGoogle Scholar
22.Spitzer, RL (ed). Diagnostic and Statistical Manual of Mental Disorders, 3rd rev ed. Washington DC: American Psychiatric Association, 1987.Google Scholar
23.Roth, M, Huppert, FA, Tym, E, Mountjoy, CQ. CAMDEX: the Cambridge Examination for Mental Disorders in the Elderly. Cambridge: Cambridge University Press, 1988.Google Scholar
24.Morris, JC, Heyman, A, Mohs, RC, Hughes, JP, van Belle, G, Fillenbaum, G, Mellits, ED, Clark, C. The Consortium to Establish a Registry for Alzheimer's disease (CERAD). Part 1. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology 1989; 39: 1159–65.Google Scholar
25.Freedman, M, Leach, L, Kaplan, E, Winocur, G, Shulman, KI, Delis, DC. Clock drawing, a neuropsychological analysis. New York: Oxford University Press, 1994.Google Scholar
26.Williams, BW, Mack, W, Henderson, VW. Boston Naming Test in Alzheimer's disease. Neuropsychologia 1989; 27(8): 1073–79.CrossRefGoogle ScholarPubMed
27.Raven, JC. Colored Progressive Matrices. Revised. London: HK Lewis Co, 1969.Google Scholar
28.Coen, RF, Kinsella, A, Lambe, R, Kenny, M, Darragh, A. Creating equivalent word lists for the Buschke Selective Reminding Test. Human Psychopharmacol 1990;5:47–51.CrossRefGoogle Scholar
29.Hart, S, Semple, JM. Neuropsychology and the Dementias. London: Taylor & Francis, 1990.Google Scholar
30.Beardsall, L, Huppert, FA. A comparison of clinical, psychometric and behavioural memory tests: findings from a community study of the early detection of dementia. Int J Geri Psychiatry 1991; 6: 295–306.CrossRefGoogle Scholar
31.Wechsler, D. Wechsler Memory Scale– Revised (WMS–R). New York: Psychological Corporation, 1987.Google Scholar
32.Geffen, G, Bate, A, Wright, M, Rozenbilds, U, Geffen, L. A comparison of cognitive impairments in dementia of the Alzheimer type and depression in the elderly. Dementia 1993; 4: 294–300.Google ScholarPubMed
33.Joachim, CL, Morris, JH, Selkoe, DJ. Clinically diagnosed Alzheimer's disease: autopsy results in 150 cases. Ann Neurol 1988; 24: 50–6.CrossRefGoogle ScholarPubMed
34.Tierney, MC, Fisher, RH, Lewis, AJ, Zorzitto, ML, Snow, WG, Reid, DW, Nieuwstraten, P. The NINCDS-ADRDA work group criteria for the clinical diagnosis of Alzheimer's disease: a clino-pathologic study of 57 cases. Neurol 1988; 38: 359–64.CrossRefGoogle Scholar