Abstract
Abstract Objective: To determine whether poor free recall on WMS-IV Logical Delay (LM-II) results from limitations in encoding/storage and/or retrieval operations. We examined performance using the recently published 20-item 5-option multiple choice recognition measure (LM-REC). Participants and Method: 664 outpatient neuropsychological referrals, 60% women, 84% white non-Hispanic, average age 60.4±15.7 and education 14.9±2.9 years. Participants were administered a comprehensive battery (HRNES-R). Protocols were screened for performance invalidity. LM-REC was administered following the LM-II. Differences between scaled scores on LM-REC and LM-II were examined to differentiate between storage and retrieval difficulties. Results: LM-REC scores exceeded LM-II scores by 10 or more points (one standard deviation) in 44.7% of the sample, 15 or more points in 26.8%, and 20 or more in 16.8% of sample. Sample was divided into two groups based on degree of recognition benefit. Group 1 (n=297) had less than 10-point benefit, and Group 2 (n=226) had a benefit 315. Average scaled score on LM-II was 97.7±12.5, LM-REC was 101.5±12.2, normal range. Group 2 free recall on LM-II was 73±12.4, moderate impairment range, but its mean LM-REC score was 95.3±11.4, Borderline Range. Conclusions: LM-REC reduced error variance and measurement bias associated with guessing using the True-False WMS-IV recognition measure. A substantial subset of neuropsychological referrals performed poorly on free recall (LM-II) due to a retrieval problem. Free recall underestimated their storage efficiency in 44.7% of cases. Precise delineation of this information has important implications regarding the underlying neural substrate, pathology, and recommendations for intervention.
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