Abstract
BackgroundDecline in verbal episodic memory is a core feature of amnestic mild cognitive impairment (aMCI). The delayed story recall (DSR) test from the Adult Memory and Information Processing Battery (AMIPB) discriminates MCI from normal aging and predicts its conversion to Alzheimer’s dementia. However, there is no study that validates the Chinese version of the DSR and reports cut-off scores in the Chinese population.MethodsA total of 631 subjects were screened in the memory clinics of Dongzhimen Hospital, Beijing University of Chinese Medicine, China. 249 were considered to have normal cognition (NC), 134 met diagnostic criteria for MCI according to the MCI Working Group of the European Consortium on Alzheimer's Disease, and 97 met criteria for probable Alzheimer’s disease (AD) according to the NINCDS/ADRDA criteria, 14 exhibited vascular dementia (VaD), and 50 had a diagnosis of another type of dementia. Receiver operating characteristic (ROC) curve analyses were used to calculate the story recall cutoff score for detecting MCI and AD. Normative data in the NC group were obtained as a function of age and education.ResultsIn this Chinese sample, the normative mean DSR score was 28.10 ± 8.54 in the 50–64 year-old group, 26.22 ± 8.38 in the 65–74 year-old group, and 24.42 ± 8.38 in the 75–85 year-old group. DSR performance was influenced by age and education. The DSR test had high sensitivity (0.899) and specificity (0.799) in the detection of MCI from NC using a cut-off score of 15.5. When the cutoff score was 10.5, the DSR test obtained optimal sensitivity (0.980) and specificity (0.938) in the discrimination of AD from NC. Cutoff scores and diagnostic values were calculated stratified by age and education.ConclusionsThe Chinese version of the DSR can be used as a screening tool to detect MCI and AD with high sensitivity and specificity, and it could be used to identify people at high risk of cognitive impairment.
Highlights
Decline in verbal episodic memory is a core feature of amnestic mild cognitive impairment
This study aims to evaluate the sensitivity and specificity of the Chinese version of the delayed story recall test, and to determine the optimal cutoff score for a clinical diagnosis of amnestic Mild cognitive impairment (MCI) or Alzheimer’s disease (AD) in the Chinese population
The original English version was translated by clinical psychologists, one bilingual, and all with an excellent command of English; the translations were handed to two specialists in neuropsychology, and two psychiatrists for their revision; they discussed and revised the first version translations; back translations were made from Chinese into English by a bilingual psychologist; a final Chinese version was made by clinical neuropsychology and psychiatry professionals
Summary
Decline in verbal episodic memory is a core feature of amnestic mild cognitive impairment (aMCI). The delayed story recall (DSR) test from the Adult Memory and Information Processing Battery (AMIPB) discriminates MCI from normal aging and predicts its conversion to Alzheimer’s dementia. Previous studies have shown that episodic memory tests such as paragraph recall are sensitive to MCI and very early cognitive impairment in older adults [8]. Delayed story recall performance can significantly predict progression from MCI to AD [9,10], and has high sensitivity and specificity for the early diagnosis of AD, and can discriminate very mild/early stage AD and non-demented elderly effectively [11]. Previous studies have shown that the story recall test is the strongest predictor of reported memory performance in daily life by elderly adults [15,16]. The advantages of the AMIPB story recall test is that it has detailed administration and scoring instructions, and normative data ranging from 18 to 75 years old
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