Development of a psychometrically equivalent short form of the Face-Name Associative Memory Exam for use along the early Alzheimer's disease trajectory

Abstract

Neuropsychologists are developing more challenging and specific tests to detect early and subtle changes in cognition related to preclinical Alzheimer's disease (AD). The 16-item Face-Name Associative Memory Exam (FNAME-16) is a challenging paired associative memory test able to detect subtle memory changes associated with biomarker evidence of preclinical AD. However, as individuals progress along the AD trajectory, measures that are sensitive at the preclinical stage may become too challenging by the stage of Mild Cognitive Impairment (MCI). Our goal was to develop a modified version of the face-name and face-occupation paired associative memory task (FNAME-12) with fewer stimuli and additional learning trials suitable for use in MCI. We administered the FNAME-12A, an alternate version FNAME 12B, the original FNAME-16, and a series of other neuropsychological measures to 65 clinically normal (CN) older adults (aged 65 to 85) and a subsample characterized by MCI (n = 18). The FNAME-12 exhibited psychometric equivalence with the FNAME-16 (r = .77, p < .001) and was correlated with other measures of episodic and semantic memory. The alternate form, FNAME-12B, was highly correlated with FNAME-12A (r = .76, p < .001). Mean performance on the FNAME 12A, stratified by education, was generated. The task could be completed by our MCI group yet remained challenging in the CN group, providing evidence for its utility along the AD trajectory.

Keywords: Associative memory; Mild Cognitive Impairment; Neuropsychology; Preclinical Alzheimer’s disease; Test development..

Figure 1

Sample of 12-item FNAME procedure: Participants underwent 2 exposures to all 12 face, name, and occupation (Learning 1 and 2) groupings. Following each exposure, they were asked for name (IRN) and occupation (IRO) associated with each face. After a 5 minute short delay, they were asked for the name (CRN) and occupation (CRO) associated with each face. Following a 30-minute delay, they were asked to identify the previously learned face from 2 pictures (FacR). They were again asked for name (CRN30) and occupation (CRO30) associated with each face. For incorrect responses on CRN30 or CRO30, the participant was asked to select the name and/or occupation associated with the face amongst 3 items (MCN/MCO).

Figure 2

Total Score on FNAME-12A and its relationship to Education and Age in CN Older Adults