Rey Auditory Verbal Learning Test Performance Research Articles

Methods for assessment of rey auditory verbal learning test performance in memory clinic patients and healthy adults - at the cross-roads of learning theory and clinical utility

Background: Knowledge is still lacking regarding the preferred method for evaluation of learning in the Rey Auditory Verbal Learning Test (RAVLT). Validity of different methods was examined by the effect size in differentiating diagnostic stages in memory clinic patients versus healthy adults and the strength of association between RAVLT performance and brain atrophy. Method: The study included individuals with dementia (n = 247), Mild Cognitive Impairment (MCI, n = 709), Subjective Cognitive Impairment (SCI, n = 175) and cognitively unimpaired adults serving as healthy controls (HC, n = 102). All patients went through a comprehensive clinical examination and neuropsychological assessment of cognition including episodic memory gauged with RAVLT and brain imaging of medial temporal atrophy, cortical atrophy, and white matter hyperintensity. Results: The standard method for evaluation of learning in RAVLT (summed score over five trials) together with the late learning method (mean of trials 4 and 5) were the two most powerful methods according to group differentiation (discriminant validity). Both methods also showed considerable association with medial temporal atrophy (construct validity). The initial RAVLT performance represented by results on trial 1 and the constant in regression analysis with the power function provided information regarding attention that was important for the separation of SCI and HC. Conclusions: The most favorable clinical utility was indicated by discriminant and construct validity by total learning (standard method) including both attention- and learning-related parts and late learning of RAVLT performance, while theoretical understanding of mental processes involved in RAVLT performance was provided by the distinction between initial versus the subsequent learning performance.

Older adults at greater risk for Alzheimer’s disease show stronger associations between sleep apnea severity in REM sleep and verbal memory

BackgroundObstructive sleep apnea (OSA) increases risk for cognitive decline and Alzheimer’s disease (AD). While the underlying mechanisms remain unclear, hypoxemia during OSA has been implicated in cognitive impairment. OSA during rapid eye movement (REM) sleep is usually more severe than in non-rapid eye movement (NREM) sleep, but the relative effect of oxyhemoglobin desaturation during REM versus NREM sleep on memory is not completely characterized. Here, we examined the impact of OSA, as well as the moderating effects of AD risk factors, on verbal memory in a sample of middle-aged and older adults with heightened AD risk.MethodsEighty-one adults (mean age:61.7 ± 6.0 years, 62% females, 32% apolipoprotein E ε4 allele (APOE4) carriers, and 70% with parental history of AD) underwent clinical polysomnography including assessment of OSA. OSA features were derived in total, NREM, and REM sleep. REM-NREM ratios of OSA features were also calculated. Verbal memory was assessed with the Rey Auditory Verbal Learning Test (RAVLT). Multiple regression models evaluated the relationships between OSA features and RAVLT scores while adjusting for sex, age, time between assessments, education years, body mass index (BMI), and APOE4 status or parental history of AD. The significant main effects of OSA features on RAVLT performance and the moderating effects of AD risk factors (i.e., sex, age, APOE4 status, and parental history of AD) were examined.ResultsApnea–hypopnea index (AHI), respiratory disturbance index (RDI), and oxyhemoglobin desaturation index (ODI) during REM sleep were negatively associated with RAVLT total learning and long-delay recall. Further, greater REM-NREM ratios of AHI, RDI, and ODI (i.e., more events in REM than NREM) were related to worse total learning and recall. We found specifically that the negative association between REM ODI and total learning was driven by adults 60 + years old. In addition, the negative relationships between REM-NREM ODI ratio and total learning, and REM-NREM RDI ratio and long-delay recall were driven by APOE4 carriers.ConclusionGreater OSA severity, particularly during REM sleep, negatively affects verbal memory, especially for people with greater AD risk. These findings underscore the potential importance of proactive screening and treatment of REM OSA even if overall AHI appears low.

Rey Auditory Verbal Learning Test in idiopathic normal pressure hydrocephalus and Alzheimer’s disease

Objective: This study aims to evaluate the ability of the Rey Auditory Verbal Learning Test (RAVLT), to separate the early stages of idiopathic normal pressure hydrocephalus (iNPH) from Alzheimer’s disease (AD), both in comparison to each other and to healthy individuals (HI). Method: The RAVLT performance regarding learning, recall and recognition, was analyzed in three matched samples comprising 30 HI, 84 participants with AD and 84 with iNPH. The clinical samples were divided into two subgroups based on scores on the MMSE, High performers (27–30 points, n = 30) and Medium performers (18–26 points, n = 54). Results: Memory performance was significantly impaired in both clinical samples relative to HI, even in the comparisons with the subgroups consisting of only High-MMSE performers. Despite similar results on measures capturing learning, the iNPH patients outperformed AD patients on measures of recall and recognition. Conclusions: Learning impairment occurs early in iNPH and AD alike, when MMSE performance is still within normal limits. RAVLT measures of delayed recall and recognition are less affected in iNPH than in AD and may serve as differential diagnostic neuropsychological markers.

Marital Status of Never Married with Rey Auditory Verbal Learning Test Cognition Performance Is Associated with Mild Cognitive Impairment

A small number of robust studies have explored the association between cognitive tests and marital status levels of mild cognitive impairment (MCI) patients using the TADPOLE dataset. Rey Auditory Verbal Learning Test (RAVLT) cognition performance combined with marital status levels is associated with increased odds of MCI than either RAVLT in isolation. The cross-sectional association between RAVLT performance in immediate response, learning, forgetting, and perception of forgetting with marital status and MCI was evaluated using TADPOLE data. We included participants with MCI and normal cognition in our study. Based on our logistic regression model, four RAVLT subgroups are associated with MCI (low and high response performance, immediate response with learning, immediate response with learning and forgetting, immediate response with learning, forgetting, and perception of forgetting). We adjusted models for sex, age, race, marital status, education, ethnicity, APOE4 genotype, hippocampus, whole brain, ventricles, and ICV. A mean age of 77/67 years was observed in the sample (n = 6560), 44% of participants were females, and 58% had mild cognitive impairment. Subgroups whose ages are 61 to 70 (OR 0.26, 95% CI 0.15–0.45) and older (OR 0.07, 95% CI 0.04–0.12), as well as race: black/African American (OR 0.13, 95% CI 0.03–0.52), multiple races (OR 0.05, 95% CI 0.01–0.24), and never married (OR 0.2, 95% CI 0.12–0.34) were negatively associated with immediate response and forgetting subgroup tests. There is a need for studies that evaluate other cognitive tests in the TADPOLE dataset with missing data as a predictive tool that aligns with the factors associated with MCI.

The modified Ruche visuospatial learning test (RUCHE-M) for the assessment of visuospatial episodic memory in patients with temporal lobe epilepsy: Preliminary evidence for the investigation of memory binding

Introduction The Ruche test is a visuospatial form of the Rey auditory verbal learning test (RAVLT), with initial evidence of utility in the diagnosis of temporal lobe epilepsy (TLE)-related memory disorders. Aims To present the translation to Brazilian Portuguese and modification of the Ruche test (RUCHE-M) and compare the RUCHE-M and RAVLT performance between patients with right and left TLE. Methods Twenty-five neuropsychologists participated in instrument adaptation. Thirty-seven patients with right (n = 19) and left (n = 18) TLE participated. Data were compared with the Mann–Whitney U test. Results All specialists considered the final RUCHE-M to be adequate. The RUCHE-M forgetting speed index (FSI) score and several RAVLT scores differed significantly between patients with right and left TLE. Conclusion The RUCHE-M showed limited utility for the assessment of visuospatial episodic memory in patients with TLE. The manipulation of memory binding as demonstrated by FSI score seems to be a promising paradigm for the assessment of right hippocampal function.

Masking effect of high IQ on the Rey Auditory Verbal Learning Test in an adult sample with attention deficit/hyperactivity disorder

Objective High intelligence (IQ) adults with attention-deficit/hyperactivity disorder (ADHD) often perform better on neuropsychological tests relative to average IQ adults with ADHD, despite commensurate functional impairment. This study compared adults with ADHD and high versus average IQ on the Rey Auditory Verbal Learning Test (RAVLT) to specifically assess this proposed masking effect of IQ on verbal learning/memory performance among those undergoing neuropsychological evaluation. Method RAVLT performance between patients with ADHD and average versus high Test of Premorbid Function-estimated IQ were compared. Latent growth curve modeling (LGCM) evaluated learning acquisition across trials. Results RAVLT total learning, immediate, and delayed free recall performances were significantly better in the high IQ relative to the average IQ group. LGCM showed similar quadradic growth trajectories for both IQ groups. Both groups reported equivalent symptom severity and functional complaints in childhood and adulthood. Conclusions Adults with ADHD and high IQ performed normally on a verbal learning/memory test compared to adults with average IQ, who scored 0.5–1.0 standard deviations below the mean. These results suggest a masking of performance-based memory deficits in the context of higher IQ in adults with ADHD, supporting growing evidence that higher IQ masks neurocognitive deficits during the assessment of adults with ADHD.

COMPUTERIZED COGNITIVE TRAINING, WITH OR WITHOUT EXERCISE, TO PROMOTE COGNITIVE FUNCTION: A RANDOMIZED TRIAL

Given the world’s aging population, it is important to identify strategies that promote healthy cognitive aging. Computerized cognitive training (CCT) may be a promising method to combat cognitive decline in older adults. Moreover, physical exercise immediately prior to CCT might provide additional cognitive benefits. We conducted a randomized controlled trial to examine the effect of a CCT intervention, alone or preceded by physical exercise, on memory and executive functions in older adults. 124 community-dwelling older adults aged 65-85 years were randomly assigned to either 8-weeks of: 1) 3x/week group-based CCT plus 3x/week CCT sessions at home; 2) 3x/week group-based CCT combined with a 15-minute brisk walk (Ex-CCT) plus 3x/week Ex-CCT sessions at home; or 3)3x/week group-based sham exercise and education sessions (CON). At baseline and 8-weeks standard neuropsychological tests of verbal memory and learning and executive functions were administered, including the Rey Auditory Verbal Learning Test (RAVLT), Stroop test, Flanker test, Trail Making Tests (TMT B-A), and Dimensional Change Card Sort (DCCS) Test. At trial completion, there were no differences in RAVLT performance. Compared with CON, FBT and Ex-FBT participants significantly improved performance on the Stroop test (p = .001 and p = .023, respectively). Additionally, those randomized to Ex-CCT improved performance on the Flanker test (p = .002), TMT B-A (p = .047), and the DCCS Test (p = .023) compared with BAT. These findings suggest that an 8-week CCT program could benefit executive functions, and that implementing exercise immediately prior to CCT could provide broader benefits.

Bridging Representation Gaps in Big Data: An Alzheimer's Disease Neuroimaging Initiative (ADNI) Investigation

Abstract Objective Large-scale research consortium studies are increasingly used to help aid in early identification of age-related brain changes and neurodegenerative disease risk. Racial/ethnic minorities (REM) are severely underrepresented in publicly available datasets related to neurodegenerative disease. This is problematic given that the US older adult population will be comprised of 40% REM by 2050. As this population grows more diverse, it is crucial that Alzheimer’s disease (AD) risk factors are appropriately characterized and REM are represented in longitudinal research. The purpose of this study was to examine memory, Apolipoprotein E (APOE) status, and hippocampal volume (HV) data among REM participants in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. Participants and Method We sampled 91 Latinx and Non-Hispanic Black (NHB) ADNI participants, which included 41 controls (CN; 39% Latinx) and 50 individuals with mild cognitive impairment (MCI; 52% Latinx). Measures included Logical Memory (LM) Delay, Rey Auditory Verbal Learning Test (RAVLT), Alzheimer’s Disease Assessment Cognitive 13-item Scale (ADAS13), APOE e4 and APOE e2 status, and HV. Groups did not differ by age, education, or memory performance. None of the Latinx sample were e2 carriers, whereas 32% of NHB were e2 carriers. Results For NHB and Latinx MCI groups, LM Delay scores positively predicted greater HV (NHB: R2 = .17, p = .04; Latinx: R2 = .16, p = .04). Better RAVLT performance predicted greater HV for the Latinx MCI group but not for the NHB MCI group (Latinx: R2 = .13, p = .06). For NHB CN, e4 status and ADAS13 were positively correlated (r = .59, p = .002) but negatively correlated for Latinx CN (r = -.58, p = .002). APOE e2 and RAVLT percent forgetting were negatively correlated for NHB MCI (r = -.49, p = .01). Conclusions There appears to be differential risk associated with heterozygous e4 status in Latinx and NHB. APOE e2 may have been protective in the context of e4 in NHB. The degree to which e2 is protective in Latinx is unknown. Results highlight the need for improved REM representation in large-scale studies to understand genetic risk and protective factors in REM.

Female advantage in verbal memory: Evidence of sex-specific cognitive reserve.

We investigated sex differences in verbal memory across different levels of neural dysfunction, measured by temporal lobe glucose metabolic rates (TLGluMR). Three hundred ninety controls and 672 participants with amnestic mild cognitive impairment (aMCI) and 254 with Alzheimer disease (AD) dementia from the Alzheimer's Disease Neuroimaging Initiative completed the Rey Auditory Verbal Learning Test (RAVLT) and [18F]-fluorodeoxyglucose-PET. Cross-sectional analyses were conducted using linear regression to examine the sex by TLGluMR interaction on RAVLT performance in the overall sample and within diagnostic groups adjusting for age, education, and APOE ε4 genotype. Across groups, female sex and higher TLGluMR and their interaction were associated with better verbal memory (p values ≤ 0.005). The female advantage in verbal memory varied by TLGluMR such that the advantage was greatest among individuals with moderate to high TLGluMR and minimal or absent among individuals with lower TLGluMR. Diagnosis-stratified analyses revealed that this interaction was driven by the aMCI group (p values = 0.009). The interaction was not significant in control and AD dementia groups. Women show better verbal memory than men in aMCI despite similar levels of brain hypometabolism. The lifelong advantage that females show over males in verbal memory might represent a form of cognitive reserve that delays verbal memory decline until more advanced pathology, as indexed by TLGluMR. This issue is clinically important because verbal memory scores are used in diagnosing aMCI and AD dementia.

Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy.

To examine sex differences in the relationship between clinical symptoms related to Alzheimer disease (AD) (verbal memory deficits) and neurodegeneration (hippocampal volume/intracranial volume ratio [HpVR]) across AD stages. The sample included 379 healthy participants, 694 participants with amnestic mild cognitive impairment (aMCI), and 235 participants with AD and dementia from the Alzheimer's Disease Neuroimaging Initiative who completed the Rey Auditory Verbal Learning Test (RAVLT). Cross-sectional analyses were conducted using linear regression to examine the interaction between sex and HpVR on RAVLT across and within diagnostic groups adjusting for age, education, and APOE ε4 status. Across groups, there were significant sex × HpVR interactions for immediate and delayed recall (p < 0.01). Women outperformed men among individuals with moderate to larger HpVR, but not among individuals with smaller HpVR. In diagnosis-stratified analyses, the HpVR × sex interaction was significant in the aMCI group, but not in the control or AD dementia groups, for immediate and delayed recall (p < 0.01). Among controls, women outperformed men on both outcomes irrespective of HpVR (p < 0.001). In AD dementia, better RAVLT performance was independently associated with female sex (immediate, p = 0.04) and larger HpVR (delayed, p = 0.001). Women showed an advantage in verbal memory despite evidence of moderate hippocampal atrophy. This advantage may represent a sex-specific form of cognitive reserve delaying verbal memory decline until more advanced disease stages.

Executive dysfunction affects word list recall performance: Evidence from amyotrophic lateral sclerosis and other neurodegenerative diseases.

The Rey Auditory Verbal Learning Test (RAVLT) is widely used in clinical practice to evaluate verbal episodic memory. While there is evidence that RAVLT performance can be influenced by executive dysfunction, the way executive disorders affect the serial position curve (SPC) has not been yet explored. To this aim, we analysed immediate and delayed recall performances of 13 non-demented amyotrophic lateral sclerosis (ALS) patients with a specific mild executive dysfunction (ALSci) and compared their performances to those of 48 healthy controls (HC) and 13 cognitively normal patients with ALS. Moreover, to control for the impact of a severe dysexecutive syndrome and a genuine episodic memory deficit on the SPC, we enrolled 15 patients with a diagnosis of behavioural variant of frontotemporal dementia (bvFTD) and 18 patients with probable Alzheimer's disease (AD). Results documented that, compared to cognitively normal subjects, ALSci patients had a selective mid-list impairment for immediate recall scores. The bvFTD group obtained low performances with a selectively increased forgetting rate for terminal items, whereas the AD group showed a disproportionately large memory loss on the primary and middle part of the SPC for immediate recall scores and were severely impaired in the delayed recall trial. These results suggested that subtle executive dysfunctions might influence the recall of mid-list items, possibly reflecting deficiency in control strategies at retrieval of word lists, whereas severer dysexecutive syndrome might also affect the recall of terminal items possibly due to attention deficit or retroactive interference.

The Rey Auditory Verbal Learning Test: Normative Data Developed for the Venezuelan Population

The Rey Auditory Verbal Learning Test (RAVLT) is a neuropsychological tool widely used to assess functions such as attention, memory, and learning ability in the auditory-verbal domain. Norms for the test have been developed in many different languages and they show different relationships with demographic variables. The main objective of this research was to develop specific norms for the Venezuelan population, with particular focus on the influences of age, education, gender, and socioeconomic status. A Spanish version of the test was administered to a quota sample of 629 healthy adults. Pearson's correlation analysis (p < .001) showed a significant association between RAVLT performance and age (r = -.401), education (r = .386), and socioeconomic status (r = -.196), but not between RAVLT performance and gender (r = -.054). Due to the strength of the correlations, only age and education were considered in the development of final norms.

Age and synchrony effects in performance on the Rey Auditory Verbal Learning Test

There is evidence that individuals perform better on some memory tasks when tested at their preferred time of day, a phenomenon named the synchrony effect. There is also evidence of a predictable change from evening to morning preference during the adult life span. Together, these findings suggest that age effects on memory measures may be overestimated when time of testing is ignored. The aim of this study was to investigate whether synchrony effects could partially explain the well-documented age-related decline in performance on the Rey Auditory Verbal Learning Test (RAVLT). Groups of 42 younger adults (aged 18-33 years) and 42 older adults (aged 55-71 years) were administered the RAVLT at either their optimal (n = 21) or non-optimal (n = 21) time of day. Although both age groups benefited moderately from being tested at their optimal time, this effect was greater for older participants and extended to all facets of RAVLT performance except proactive interference. However, younger adults outperformed older adults on three of the five RAVLTs. These findings add to existing evidence of synchrony effects, particularly in memory functioning of older adults, and highlight the need for clinicians to consider optimal time of testing when administering and interpreting the RAVLT.

The Rey Auditory Verbal Learning Test: Normative data for the Brazilian population and analysis of the influence of demographic variables.

Rey Auditory Verbal Learning Test (RAVLT) is an efficient neuropsychological instrument for testing episodic declarative memory. Performance on this test can be influenced by demographic and cultural variables. The objective of the present study was to analyze the influence of demographics variables, such as age, gender, and education, on RAVLT performance in young and elderly adults. A Portuguese version of the RAVLT was administered to 302 healthy participants. Subjects were from both genders, ranging in age from 17 to 85 years (mean 50.6 ± 15.9 years) and in education from 1 to 20 years (mean 11.3 ± 3.7 years). Participants were grouped by age: 17-34 years old, 34-49 years old, 50-64 years old, and 65-85 years old. Pearson's Correlation analysis showed a significant association between RAVLT performance and both age and education ( p < .001), but not between RAVLT performance and gender. Two-way analysis of variance revealed significant effects of age on all RAVLT measurements and significant effects of years of education on all measurements, with the exception of recognition. The present data indicate that participant age and education significantly influence performance on the RAVLT. Keywords: memory, neuropsychological tests, neuropsychology.

Elevated cortisol and learning and memory deficits in cocaine dependent individuals: Relationship to relapse outcomes

Cocaine dependence is characterized by stress system dysregulation, including elevated cortisol activity, emotional negativity, and behavioral disinhibition. High levels of stress and glucocorticoids are also known to affect learning, memory and executive function. Therefore, we examined the relationships between chronic cocaine use, elevated distress and learning and memory dysfunction in abstinent cocaine dependent (CD) individuals, and whether these measures were associated with cocaine relapse outcomes. Stress was assessed in 36 inpatient treatment engaged CD individuals and 36 demographically matched healthy control (HC) participants using the Perceived Stress Scale (PSS) and repeated morning salivary cortisol levels over three consecutive days. The Rey Auditory Verbal Learning Test (RAVLT) was conducted to measure verbal learning, memory, and executive function. Prospective assessment of cocaine use outcomes during 90 days following discharge from inpatient treatment was also conducted. CD patients showed higher levels of distress compared to controls in PSS scores and cortisol levels. They also demonstrated a significantly reduced learning curve, and fewer correct responses and more errors on recognition. Elevated cortisol was significantly associated with worse RAVLT performance in CD patients. Poor memory scores, but not distress measures, were significantly associated with greater cocaine use after inpatient treatment. These findings are the first to demonstrate that learning and memory deficits in CD individuals are associated with enhanced cortisol and with cocaine use outcomes after inpatient treatment. The findings are consistent with recent addiction models suggesting that chronic cocaine-related neuroadaptations affects learning and memory function, which in turn, influences drug use outcomes.

Cognitive Predictors of Response to Treatment for Depression in Multiple Sclerosis

Cognitive Predictors of Response to Treatment for Depression in Multiple Sclerosis

Effect of two prednisone exposures on mood and declarative memory

Corticosteroids are essential for life and an integral part of the stress response. However, in excess, corticosteroids can be associated with a variety of effects on the brain including hippocampal atrophy and even neuronal death, mood changes, and declarative memory impairment. The magnitude of mood change in patients receiving prednisone is reportedly associated with previous lifetime corticosteroid exposure, consistent with a sensitization or kindling process whereby greater effects are observed with repeated exposure. To our knowledge, the effect of multiple corticosteroid exposures on mood and memory has not been previously examined prospectively in animals or humans. In this study, 30 human volunteers, with no history of systemic prescription corticosteroid therapy, were given (in random order using a crossover design) two 3-day exposures of prednisone (60 mg/day) and one of identical placebo, with 11-day washouts between each medication exposure. Before and after each 3-day prednisone/placebo exposure, declarative memory was assessed using different versions of the Rey Auditory Verbal Learning Test (RAVLT) to minimize practice or learning effects, while mood was assessed with the 21-item Hamilton Rating Scale for Depression, Young Mania Rating Scale and Internal State Scale. No significant mood changes were found. However, a significant decrease in aspects of RAVLT performance was observed after the first prednisone exposure consistent with a decline in declarative memory performance. The decline in RAVLT performance was significantly smaller after the second prednisone exposure as compared to the initial prednisone exposure. Thus, a second prednisone exposure was associated with an attenuated prednisone-effect on declarative memory. These data suggest tolerance or habituation, rather than sensitization, to prednisone effects on declarative memory during a second exposure. Implications and possible explanations for the findings are discussed.

Differential effects of lead exposure on components of verbal memory

Aims: To determine if verbal learning and memory requiring acquisition and retention of information is differentially affected by lead exposure. Methods: The Rey Auditory Verbal Learning Test (RAVLT), a test...

Detecting Simulated Memory Impairment with the Rey Auditory Verbal Learning Test: Implications of Base Rates and Study Generalizability

The accuracy of the Rey Auditory Verbal Learning Test (RAVLT) for detecting simulated neuropsychological impairment was investigated using discriminant function analyses and cross-validation procedures. In Study 1, a discriminant function analysis, using six RAVLT variables, correctly classified 80% of 50 simulating and 50 non-simulating participants. Base rates were changed and this discriminant function was tested in Study 2 with a 33% base rate of simulation. The discriminant function correctly classified 75% of 20 simulators and 90% of 40 non-simulators, yielding an overall classification rate of 85%. To determine the generalizability of this discriminant function to a clinical sample, Study 3 compared the RAVLT performance of 20 simulating participants to that of 40 motor vehicle accident (MVA) patients. The discriminant function from Study 1 incorrectly classified 60% of the MVA patients and yielded an overall correct classification rate of 48%. The limitations associated with generalizing from analog research and the implications of varying base rates on classification accuracy are discussed.

Rey Auditory-Verbal Learning Test performance of patients with and without memory impairment.

Investigated performance on the Rey Auditory Verbal Learning Test (AVLT) of 92 psychiatric and neurological patients classified as memory-impaired (N = 45) or non-memory-impaired (N = 47). The groups were comparable on age and education. Relative to the non-memory-impaired Ss, performance of the memory-impaired patients was significantly lower on all AVLT scores, ps less than .01. The AVLT appears to hold promise as a quick screening measure for the clinical evaluation of patients with suspected verbal learning and memory impairments.