FREE AND CUED SELECTIVE RECALL REMINDING TEST (FCSRT): STANDARDIZZAZIONE ITALIANA ED APPLICAZIONE IN UNA COORTE DI SOGGETTI CON MILD COGNITIVE IMPAIRMENT (MCI)

Abstract

Abstract Background The presence of episodic memory impairment is required for the diagnosis of Alzheimer’s dementia by all current diagnostic criteria. The new research criteria proposed by Dubois et al. (Lancet Neurol 6:734–746, 2007) require that the impairment should not improve significantly with cueing, recognition testing nor after the control of effective encoding. This is considered to be the core deficit of ‘‘prodromal Alzheimer’s disease’’. The Free and Cued Selective Reminding Test (FCSRT) is a memory test that allows in assessing these specific features of memory impairment. FCSRT has been proposed as a sensitive marker of the “hippocampal memory deficit” of early Alzheimer’s Disease (AD) (B. Dubois et al. Lancet Neurol 2010; 9:1118-1127). The aims of this research are: 1) To develop an italian version of the FCSRT and standardize normative data in a sample composed by 227 adult italians homogeneously distributed by age, sex and education (Part 1). 2) To assess the construct validity of FCSRT, in terms of convergent and divergent validity (Part 2). 3) To assess diagnostic accurancy of the FCSRT in a sample composed by Mild Cognitive Impairment (MCI) affected subjects (Part 3). Part 1 (P. Frasson et al. Neurological Sciences 2011; DOI 10.1007/s10072-011-0607-3) We report normative data for an Italian version of the FCSRT. The test is based on the 12 pictorial stimuli, 6 belonging to the living domain, and 6 to the nonliving domain. Six scores were derived from the performance of 227 healthy Italian adults, with age, sex and education homogenously distributed across subgroups: immediate free recall (IFR), immediate total recall (ITR), delayed-free recall (DFR), delayed total recall (DTR), Index of Sensitivity of Cueing (ISC), number of intrusions. In multiple regression analyses, age emerged as an influencing factor for both IFR and DFR, with older people obtaining lower scores. Education and gender appear to influence only IFR, with better performance by more educated subjects and females. Adjusted scores were used to determine inferential cutoff scores and to compute equivalent scores. Part 2 To assess its construct validity, the FCSRT was administered to 146 community-dwelling (females 57.5% , age 73 ± 7.8 yrs; education 8.8 ± 4.2 yrs) subjects with memory complaints attending two memory clinics (from the L. Sacco Hospital and the IRCCS S. Raffaele). Following both clinical and neuropsychological examination, the study population consisted of 15 patients with mild AD, 80 subjects with MCI, including 12 amnestic MCI, 27 non-amnestic MCI, 41 multiple domain MCI, and 51 subjects with Subjective Memory Impairment. To assess convergent validity five FCSRT scores (IFR, ITR, DFR, DTR) and ISC) were correlated with two episodic memory tests: Story Recall (SR) and Rey Auditory Verbal Learning test immediate (I-RAVLT) and delayed (D-RAVLT) scores. To assess divergent validity a factor analysis was performed including, in addition to the above mentioned memory tasks, the following…