Identifying patients at high and low risk of cognitive decline using Rey Auditory Verbal Learning Test among middle-aged memory clinic outpatients.
OBJECTIVE
To investigate whether application of cutoff levels in an episodic memory test (Rey Auditory Verbal Learning Test, RAVLT) is a useful method for identifying patients at high and low risk of cognitive decline and subsequent dementia.


METHODS
224 patients with memory complaints (mean age = 60.7 years, mean MMSE = 28.2) followed-up at a memory clinic over approximately 3 years were assigned retrospectively to one of three memory groups from their baseline results in RAVLT [severe (SIM), moderate (MIM) or no impairment (NIM)]. These groups were investigated regarding cognitive decline.


RESULTS
Patients assigned to SIM showed significant cognitive decline and progressed to dementia at a high rate, while a normal performance in RAVLT at baseline (NIM) predicted normal cognition after 3 years. Patients with MIM constituted a heterogeneous group; some patients deteriorated cognitively, while the majority remained stable or improved.


CONCLUSIONS
The application of cutoff levels in RAVLT at baseline showed that patients with severely impaired RAVLT performance were at a high risk of cognitive decline and progression to dementia, while patients with normal RAVLT results did not show cognitive decline during 3 years. Furthermore, the initial degree of memory impairment was decisive in the cognitive prognosis 3 years later.
Andersson
Christin
C
NEUROTEC Department, Division of Clinical Geriatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden. christin.andersson@neurotec.ki.se
Lindau
Maria
M
Almkvist
Ove
O
Engfeldt
Peter
P
Johansson
Sven-Erik
SE
Eriksdotter Jonhagen
Maria
M
D000161:Acoustic Stimulation / Q000379:methods; D000553:Ambulatory Care; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013067:Speech Perception; D014706:Verbal Learning