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P1‐439: THE FREE AND CUED SELECTIVE REMINDING TEST PREDICTS ALZHEIMER'S DISEASE NEUROPATHOLOGY
Author(s) -
Grober Ellen,
Wang Cuiling,
Hassenstab Jason,
Lipton Richard B.
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.06.1044
Subject(s) - neuropathology , psychology , dementia , free recall , receiver operating characteristic , audiology , recall , alzheimer's disease , medicine , disease , cognitive psychology
Background: The picture version of the Free and Cued Selective Reminding Test with Immediate Recall (pFCSRT+IR) is a widely-used episodic memory test that has participants identify items in response to category cues. Following free recall (FR) category cues are presented to assess cued recall. Total recall (TR) is the sum of FR and cued recall. FR and TR have been shown to identify prevalent dementia, incident dementia and AD, amnestic mild cognitive impairment (aMCI) and to be associated with AD biomarkers. Performance on the pFCSRT+IR was used to predict Alzheimer’s Disease (AD) neuropathology defined by Braak stage. Methods: 231 participants from the prospective Knight ADRC clinicopathologic series at Washington University were staged using the methods of Braak and Braak. The FR and TR scores from the test administration closest to death were used to predict AD neuropathology as defined by a Braak stage of IV or greater. Receiver operating characteristic (ROC) analyses were used to assess FR and TR as screens for AD neuropathology. Youden’s index was used to select optimal cut scores. Results: The post-mortem sample had a mean age at death of 85, 43% were female, mean education was 15 years, 54% had AD neuropathology, and the mean interval from last assessment to death was 2.2 years (max1⁄45 years). ROC analysis showed that both TR and FR predicted AD neuropathology with AUCs of 0.78 (95% CI: .72, .84) and 0.75 (95% CI: .69, .82) respectively. The AUC was not materially affected by adjustments for sex, education, age at death, or interval between last assessment and death for TR ( 0.79) or FR (0.78). The optimal cut score for TR was 44 (sen1⁄40.62/spec1⁄40.85), yielding an odds ratio of 9.5 (95% CI: 4.8,19.2). The optimal cut score for FR was 20 (sen1⁄40.73/spec1⁄40.72) yielding an odds ratio of 6.9 (95% CI: 3.8,12.5). Conclusions: Both FR and TR predict AD neuropathology.