Temporal unfolding of declining episodic memory on the Free and Cued Selective Reminding Test in the predementia phase of Alzheimer's disease: Implications for clinical trials

Ellen Grober, Amy E. Veroff, Richard B. Lipton

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Introduction: Free and Cued Selective Reminding Test (FCSRT) performance identifies patients with preclinical disease at elevated risk for developing Alzheimer's dementia, predicting diagnosis better than other memory tests. Methods: Based on literature mapping FCSRT performance to clinical outcomes and biological markers, and on longitudinal preclinical data from the Baltimore Longitudinal Study of Aging, we developed the Stages of Objective Memory Impairment (SOMI) model. Five sequential stages of episodic memory decline are defined by Free Recall (FR) and Total Recall (TR) score ranges and years prior to dementia diagnosis. We sought to replicate the SOMI model using longitudinal assessments of 142 Einstein Aging Study participants who developed AD over 10 years. Results: Time to diagnosis was at least seven years if FR was intact, at least four years if TR was intact, and two years if TR was impaired, consistent with SOMI model predictions. The SOMI identified incipient dementia with excellent sensitivity and specificity. Discussion: The SOMI model provides an efficient approach for clinical trial cognitive screening in advance of more costly biomarker studies and ultimately in clinical practice, and provides a vocabulary for understanding AD biomarker patterns and for re-analysis of existing clinical trial data.

Original languageEnglish (US)
Pages (from-to)161-171
Number of pages11
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume10
DOIs
StatePublished - 2018

Keywords

  • Amnestic mild cognitive impairment
  • Biomarkers
  • Clinical trials
  • Dementia
  • Episodic memory impairment
  • Free and Cued Selective Reminding Test
  • Preclinical AD
  • Prodromal AD

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

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