ABSTRACT
Differential performance on measures of episodic and semantic memory were examined in AD, cortical vascular dementia (CVaD), subcortica] vascular dementia (SVaD), and controls. Groups were matched on age, education, and gender; dementia groups also were matched on severity. Recognition/retrieval differences were found only between SVaD and AD groups, not between CVaD and AD. Thus, recognition/retrieval differences are likely secondary to subcortical pathology rather than to vascular etiology per se. Similarly, significant numbers of memory errors were associated with cortical pathology, regardless of etiology. Error rate differences were found only between SVaD and AD groups, not between CVaD and AD. Finally, rapid forgetting was unique to AD; however, since no difference was found between SVaD and AD, rapid forgetting may occur only as AD progresses. No semantic memory measure differentiated AD from either CVaD or SVaD subjects. Results suggest that some previously reported episodic differences may be due to cortical versus white matter subcortical pathology, rather than to AD versus vascular etiology.
Subject(s)
Alzheimer Disease/diagnosis , Dementia, Vascular/diagnosis , Mental Recall , Neuropsychological Tests/statistics & numerical data , Verbal Learning , Aged , Aged, 80 and over , Alzheimer Disease/psychology , Dementia, Vascular/psychology , Diagnosis, Differential , Disease Progression , Female , Humans , Male , Psychometrics , Reproducibility of ResultsABSTRACT
The present study investigates the validity of a recently developed measure for estimating premorbid cognitive abilities. The Spot-the-Word Test involves presenting participants with pairs of items comprised of one word and one nonword, and requiring the subject to identify the word. Participants were 61 community-residing healthy older adults ranging in age from 60 to 91 years. Results indicated that education had a small but significant effect on Spot-the-Word performance. However, gender and age did not. Significant correlations were observed between Spot-the-Word scores and scores on other measures used to estimate premorbid abilities, suggesting adequate convergent validity. Furthermore, small and nonsignificant correlations were observed between Spot-the-Word scores and sensitive neuropsychological variables suggesting adequate discriminant validity. Recommendations for future research are discussed.
ABSTRACT
OBJECTIVE: The validity of supplementing the three-item recall portion of the Mini-Mental State Examination (MMSE) with a cued recall procedure to help specify the nature of patients' memory problems was examined. METHOD: Subjects were 247 individuals representing three diagnostic groups: Alzheimer's disease (AD), subcortical vascular ischemic dementia (SVaD), and normal controls. Individuals were administered a battery of neuropsychological tests, including the MMSE, as part of a comprehensive evaluation for the presence of dementia or other neurologic disorder. RESULTS: MMSE performance differed among groups. The three-item free recall performance also differed among groups, with post hoc analyses revealing the AD and SVaD groups were more impaired than controls but did not differ significantly from each other. Following a cued recall procedure of the MMSE three-items, groups differed, with post hoc analyses showing that AD patients failed to benefit from cues, whereas SVaD patients performed significantly better and comparable to control subjects. Significant correlations between the MMSE three-item cued recall performance and other memory measures demonstrated concurrent validity. CONCLUSIONS: Consistent with previous research indicating that SVaD is associated with memory encoding and retrieval deficits, whereas AD is associated with consolidation and storage problems, the present study supported the validity of the cued recall procedure of the three items on the MMSE in helping to distinguish between patients with AD and those with a vascular dementia with primarily subcortical pathology; however, despite these findings, a more extensive battery of neuropsychological measures is still recommended to consistently assess subtle diagnostic differences in these memory processes.
Subject(s)
Alzheimer Disease/psychology , Dementia, Vascular/psychology , Mental Recall , Mental Status Schedule/standards , Aged , Aged, 80 and over , Alzheimer Disease/classification , Alzheimer Disease/diagnosis , Dementia, Vascular/classification , Dementia, Vascular/diagnosis , Diagnosis, Differential , Female , Humans , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Estimating a person's premorbid cognitive abilities is common practice as part of a dementia assessment. Vocabulary has traditionally served as a "hold" measure because of its relative resilience to neurologic impairment and aging and its high correlation with overall intellectual functioning. Normative data for the Vocabulary subtest of the Shipley Institute of Living Scale (SILS) only go to age 64. This study describes the relations among age, gender, education, and SILS Vocabulary subtest performance. Normative data and Wechsler Adult Intelligence Scale-Revised equivalent Full-Scale IQ scores are reported for SILS Vocabulary subtest performance for a sample of 383 nonimpaired community-dwelling older adults, ranging in age from 60 to 94. Results expand the utility of the Vocabulary subtest of the SILS in providing an estimated level of premorbid cognitive ability.
