Severity of medial temporal atrophy and amnestic mild cognitive impairment: selecting type and number of memory tests.
OBJECTIVE
Medial temporal lobe atrophy (MTA) can be used as a biomarker of pathology that affects mechanisms of episodic memory. The authors compared the strength of this biomarker with performance on four memory measures and examined the influence of demographic factors including age, level of education, and primary language (English or Spanish).


METHODS
The Hopkins Verbal Learning Test-revised, Fuld Object Memory Evaluation (FOME), delayed memory for a story passage, and delayed visual reproduction of the Wechsler Memory Scale-revised tests were administered to 281 subjects who were diagnosed as having no cognitive impairment, mild cognitive impairment (MCI), impaired non-MCI, or dementia. MTA scores were obtained from visual ratings of the hippocampus, entorhinal cortex, and perirhinal cortex on coronal magnetic resonance imaging scans using a magnetization-prepared rapid gradient echo protocol.


RESULTS
Age was associated with scores on all memory measures and MTA. Level of educational attainment had no influence on FOME performance but had greater associations with scores on other memory measures. In regression models, FOME scores had the strongest relationship with MTA scores, accounting for 31% of the explained variability. Among subjects with MCI, an index representing the total number of memory tests that were impaired was also predictive of the severity of MTA scores.


CONCLUSIONS
Among four common tests of memory, the FOME was highly associated with MTA, and it exhibited minimal influences of education. Impairment on more than one memory test was more predictive of MTA than impairment on a single memory test.
Loewenstein
David A
DA
Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA. dloewenstein@att.net
Acevedo
Amarilis
A
Potter
Elizabeth
E
Schinka
John A
JA
Raj
Ashok
A
Greig
Maria T
MT
Agron
Joscelyn
J
Barker
Warren W
WW
Wu
Yougui
Y
Small
Brent
B
Schofield
Elizabeth
E
Duara
Ranjan
R
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004522:Educational Status; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007802:Language; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013702:Temporal Lobe / Q000473:pathology*