New Yes/No Recognition Memory Analysis on the California Verbal Learning Test-3: Clinical Utility in Alzheimer's and Huntington's Disease

Abstract

Objectives: The third edition of the California Verbal Learning Test (CVLT-3) includes a new index termed List A versus Novel/Unrelated recognition discriminability (RD) on the Yes/No Recognition trial. Whereas the Total RD index incorporates false positive (FP) errors associated with all distractors (including List B and semantically related items), the new List A versus Novel/Unrelated RD index incorporates only FP errors associated with novel, semantically unrelated distractors. Thus, in minimizing levels of source and semantic interference, the List A versus Novel/Unrelated RD index may yield purer assessments of yes/no recognition memory independent of vulnerability to source memory difficulties or semantic confusion, both of which are often seen in individuals with primarily frontal-system dysfunction (e.g., early Huntington's disease [HD]).

Methods: We compared the performance of individuals with Alzheimer's disease (AD) and HD in mild and moderate stages of dementia on CVLT-3 indices of Total RD and List A versus Novel/Unrelated RD.

Results: Although AD and HD subgroups exhibited deficits on both RD indices relative to healthy comparison groups, those with HD generally outperformed those with AD, and group differences were more robust on List A versus Novel/Unrelated RD than on Total RD.

Conclusions: Our findings highlight the clinical utility of the new CVLT-3 List A versus Novel/Unrelated RD index, which (a) maximally assesses yes/no recognition memory independent of source and semantic interference; and (b) provides a greater differentiation between individuals whose memory disorder is primarily at the encoding/storage level (e.g., as in AD) versus at the retrieval level (e.g., as in early HD). (JINS, 2018, 24, 833-841).

Keywords: Alzheimer disease; Huntington disease; Memory and learning tests; Memory disorders; Neuropsychological tests; Recognition.

Figure 1

Mean (standard error) raw scores on the Total RD and List A vs. Novel/Unrelated RD indices in the Alzheimer’s disease-moderate (AD-mod), Alzheimer’s disease-mild (AD-mild), Huntington’s disease-moderate (HD-mod), and Huntington’s disease-mild (HD-mild) groups.

Figure 2

Mean (standard error) scaled scores on the Total RD and List A vs. Novel/Unrelated RD indices in the Alzheimer’s disease-moderate (AD-mod), Alzheimer’s disease-mild (AD-mild), Huntington’s disease-moderate (HD-mod), and Huntington’s disease-mild (HD-mild) groups.

Figure 3

Flowchart outlining the pattern of performance that may be expected with raw scores on the CVLT-3 Total RD and List A vs. Novel/Unrelated RD indices in Huntington’s disease and Alzheimer’s disease.