The 'when' matters : evidence from memory markers in the clinical continuum of Alzheimer's disease

Forno, Gonzalo and Parra, Mario A. and Thumala, Daniela and Villagra, Roque and Cerda, Mauricio and Zitko, Pedro and Ibanez, Agustin and Lillo, Patricia and Slachevsky, Andrea (2022) The 'when' matters : evidence from memory markers in the clinical continuum of Alzheimer's disease. Neuropsychology. ISSN 0894-4105 (In Press)

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Abstract

Objective: Cognitive assessment able to detect impairments in the early neuropathological stages of Alzheimer's disease (AD) are urgently needed. The Visual Short-Term Memory Binding Task (VSTMBT) and the Free and Cued Selective Reminding Test (FCSRT) have been recommended by the Neurodegenerative Disease Working Group as promising tests to aid in the early detection of AD. In this study, we investigated their complementary value across the clinical stages of the AD continuum. Methods: 117 older adults with subjective cognitive complaint (SCC), 79 with mild cognitive impairment (MCI), 31 patients with AD dementia (ADD) and 37 cognitively unimpaired (CU) subjects, underwent assessment with the VSTMBT and the Picture version of the Spanish FCSRT. Results: After controlling for multiple comparisons, significant differences were found across groups. The VSTMBT was the only test that ‘marginally’ differentiated between CU and SCC (d = 0.47, p = 0.052). Moreover, whereas the FCSRT showed a gradient (CU = SCC) > MCI > ADD, the VSTMBT gradient was CU > SCC > (MCI = ADD) suggesting that conjunctive binding deficits assessed by the latter may be sensitive to the very early stages of the disease. Conclusions: Our results suggest that the VSTMBT and the FCSRT are sensitive to the clinical continuum of AD. Whereas the former detects changes in the early prodromal stages, the latter is more sensitive to the advanced prodromal stages of AD. These novel tests can aid in the early detection, monitor disease progression and response to treatment, and thus support drug development programs.

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