How many items from a word list can Alzheimer's disease patients and normal controls recall? Do they recall in a similar way?

Chaves, Marcia Lorena Fagundes; Camozzato, Ana Luiza

doi:10.1590/S1980-57642008DN10100009

Abstract

The serial position effect occurs when individuals are asked to recall a list of information that exceeds normal attention span. Alzheimer's disease (AD) patients show lower scores on word span recall tests when compared to healthy aging subjects, younger individuals or depressed patients.

Objective:

To evaluate the immediate free recall and the serial position effect of a 10-word list, emotionally neutral in tone, in Alzheimer's disease (AD) patients and two age-groups of healthy controls.

Methods:

The free word recall test was applied in a sample of 44 mild AD outpatients and 168 >50 year and 173 ≤50 year-old healthy controls. The span of recalled words and order of recollection of each item was recorded. Scores for serial position effect were analyzed. MMSE scores were recorded for all participants. Descriptive statistics and the ANOVA with Tukey test were performed.

Results:

The controls scored significantly better than AD patients on the MMSE and word span (p=0.0001). Older controls word span mean ±SD was 5.65±1.75, younger controls was 5.99±1.27, and AD patients was 2.86±1.42. The best recalled item in all groups was the first item of the list. Primacy was observed across the three groups, although AD patients presented lower scores. Recency was diminished among AD patients compared to control groups.

Conclusions:

Primacy effect was observed in AD patients as well as in both normal control groups. Recency effect was presented by the normal control groups but was extremely poor among AD patients. The first item was universally best retrieved.

Key words:
immediate recall; neuropsychological tests; memory; Alzheimer's disease; elderly; aging.

Resumo

O efeito de posição de palavras numa lista (posição serial) ocorre quando o indivíduo é solicitado a recuperar informação que excede sua capacidade de atenção. Pacientes com doença de Alzheimer (DA) apresentam escores mais baixos nos testes de recuperação de palavras, quando comparados com idosos sadios ou pacientes com depressão.

Objetivo:

Avaliar a evocação imediata livre e o efeito da posição serial de uma lista de 10 palavras, de conteúdo emocional neutro, em pacientes com doença de Alzheimer (DA) e dois grupos etários de controles saudáveis.

Métodos:

O teste de evocação livre de palavras foi aplicado em uma amostra de 44 pacientes com DA leve ambulatoriais e 168 controles saudáveis com idade >50 anos e 173 com idade ≤50 anos. O escore da evocação de palavras e a ordem de evocacão de cada item foram registrados. Escores para o efeito da posição seriada foram analisados. O Mini Exame do Estado Mental foi também obtido de todos os participantes. Análise descritiva e ANOVA de uma via com teste de Tukey post hoc foram realizados.

Resultados:

Os controles obtiveram escores significativamente mais altos do DA no MEEM e span de palavras (p=0.0001). A extensão de palavras dos controles mais velhos mostrou uma média±DP 5,65±1,75, controls mais jovens foi 5,99±1,27, e pacientes com DA foi 2,86±1,42. O item melhor lembrado em todos os grupos foi o primeiro da lista. O efeito de primazia foi observado nos três grupos, ainda que pacientes com DA tenham apresentado os escores mais baixos. Recência mostrou-se reduzida entre os pacientes em relação aos grupos controles.

Conclusões:

O efeito de primazia foi observado nos pacientes com DA bem como nos dois grupos controles normais. O efeito de recência foi apresentado pelos grupos controles normais, mas de forma extremamente empobrecida pelos pacientes com Alzheimer. O primeiro item da lista foi universalmente melhor evocado.

Palavras-chave:
evocação imediata,testes neuropsicológicos,memória,doença de Alzheimer,idoso,envelhecimento.

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Full text available only in PDF format.

References

¹
Murdock Jr BB. Serial position effect of free recall. J ExpPsychol 1962;64:482-488.
²
Wright RE. Adult age similarities in free recall output orderand strategies. J Gerontol 1982;37:76-79.
³
Mitrushina M, Satz P, Chervinsky A, et al. Performance offour age groups of normal elderly on the rey auditory-verbal learning test. J Clin Psychol 1991;47:351-357.
⁴
Petersen RC, Smith G, Kokmen E, et al. Memory functioning in normal aging. Neurology 1992;42:396-401.
⁵
Carlesimo GA, Sabbadini M, Fadda L, et al. Different components in word-list forgetting of pure amnesics, degenerative demented, and healthy subjects. Cortex 1995;31:735745.
⁶
Bayley PJ, Salmon DP, Bondi MW, et al. Comparison of theserial position effect in very mild Alzheimer's disease, mild Alzheimer's disease and amnesia associated with electroconvulsive therapy. J Int Neuropsychol Soc 2000;6:290-298.
⁷
Lezak MD. Neuropsychological assessment. 3th ed. New York: Oxford University Press; 1995:366-368.
⁸
Ceitlin L, Santos B, Parisotto L, Zanatta M, Chaves ML.Elaboration of word lists in Portuguese with emotional content and their influence on memory function in normal subjects. Int J Methods Psychiatr Res 1995;5:195-203.
⁹
Chaves ML, Izquierdo I. Differential diagnosis betweendementia and depression: a study of efficiency increment. Acta Neurol Scand 1992;85:378-382.
¹⁰
Bertolucci PHF, Okamoto.IH, Brucki SM, Siviero MO,Toniolo Neto J, Ramos LR. Applicability of the CERAD neuropsycological battery to brazilian elderly. Arq Neuropsiquiatr 2001;59:532-536.
¹¹
Foldi NS, Brickman AM, Schaefer LA, Knutelska ME.Distinct serial position profiles and neuropsychological measures differentiate late life depression from normal aging and Alzheimer's disease. Psychiatry Res 2003;120:71-84.
¹²
Buschke H, Sliwinski MJ, Kuslansky G, Katz M, Verghese J,Lipton RB. Retention weighted recall improves discrimination of Alzheimer's disease. J Int Neuropsychol Soc 2006; 12:436-440.
¹³
American Psychiatric Association. Diagnostic and StatisticalManual of Mental Disorders DSM-IV, 4th ed. Washington DC: American Psychiatric Association; 1994.
¹⁴
McKhann G, Drachman D, Folstein M, Katzman R, Price D,Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDAWork Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984;34:939-944.
¹⁵
Morris JC. The clinical dementia rating (CDR): current version and scoring. Neurology 1993;43:2412-2414.
¹⁶
Maia AL, Godinho C, Ferreira ED, et al. Application of theBrazilian version of the CDR scale in samples of dementia patients. Arq Neuropsiquiatr 2006;64:485-489.
¹⁷
McKeith IG, Fairbairn AF, Bothwell RA, et al. An evaluationof the predictive validity and inter-rater reliability of clinical diagnostic criteria for senile dementia of Lewy body type. Neurology 1994;44:872-877.
¹⁸
Brun A, Englund B, Gustafson L, et al. Clinical and neuropathological criteria for frontotemporal dementia. The Lund and Manchester Groups. J Neurol Neurosurg Psychiatry 1994;57:416-418.
¹⁹
Pirozzo S, Pa pinczak T, Glasziou P. Whispered voice test forscreening for hearing impairment in adults and children: systematic review. BMJ 2003;327:967-971.
²⁰
Smeeth L, Iliffe S. Community screening for visual impairment in older people. J Am Geriatric Soc 2001;49:673-675.
²¹
Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: apractical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
²²
Delis DC, Kaplan E, Kramer JH, et al. California VerbalLearning Test-II. 2nd ed. San Antonio, TX: The Psychological Corporation; 2000.
²³
Bigler ED, Rosa L, Schultz F, Hall S, Harris J. Rey-AuditoryVerbal Learning and Rey-Osterrieth Complex Figure Design performance in Alzheimer's disease and closed head injury. J Clin Psychol 1989;45:277-280.
²⁴
Delis DC, Massman PJ, Butters N, Salmon DP, Demadura TL.Profiles of demented and amnesic patients on the California Verbal Learning Test: implications for the assessment of memory disorders. J Consult Clin Psychol 1991;3:19-26.
²⁵
Gainotti G, Marra C. Some aspects of memory disordersclearly distinguish dementia of the Alzheimer's type from depressive pseudo-dementia. J Clin Exp Neuropsychol 1994; 16:65-78.
²⁶
Gainotti G, Marra C, Villa G, Parlato V, Chiarotti F. Sensitivity and specificity of some neuropsychological markers of Alzheimer's dementia. Alzheimer Dis Assoc Disord 1998;12:152-162.
²⁷
Bäckman L, Small BJ. Influences of cognitive support onepisodic remembering: tracing the process of loss from normal aging to Alzheimer's disease. Psychol Aging 1998;13: 267-276.
²⁸
Kopelman MD. Rates of forgetting in Alzheimer-typedementia and Korsakoff's syndrome. Neuropsychologia 1985;23:623-638.
²⁹
Atkinson RC, Shiffrin RM. Human memory: a proposedsystem and its control processes. In: Spence KW, Spence JI, editors. The psychology of learning and motivation: advances in research and theories. New York: Academic Press; 1968:89-195.
³⁰
Hill CD, Stoudemire A, Morris R, Martino-Saltzman D,Markwalter HR. Similarities and differences in memory in patients with primary dementia and depression-related cognitive dysfunction. J Neuropsychiatry Clin Neurosci 1993; 5:277-282.
³¹
Cherry BJ, J. Buckwalter JG, Henderson VW. Better preservation of memory span relative to supraspan immediate recall in Alzheimer's disease. Neuropsychologia 2002;40: 846-852.
³²
Witte KL, Freund JS, Sebby RA. Adult differences in freerecall and subjective organization. Psychol Aging 1990;15: 307-309.
³³
Baddeley AD, Hitch G. The recency effect: Implicit learningwith explicit retrieval. Mem Cognit 1993;21:146-155.
³⁴
Glenberg AM. Temporal context and recency. In: GorfeinDS, Hoffman RR, editors, Memory and learning: The Ebbinghaus Centennial Conference. Hillsdale, NJ: Erlbaum; 1987:173-190.
³⁵
Neath I. Distinctiveness and serial position effects in recognition. Mem Cognit 1993;21:689-698.
³⁶
Korsnes MS, Magnussen S, Reinvang I. Serial positioneffects in visual short-term memory for words and abstract spatial designs. Scand J Psychol 1996;37:62-73.
³⁷
Korsnes SM, Gilinsky AS. Aging and serial-list picture memory. Percept Mot Skills 1993;76:1011-1014.
³⁸
Wright AA, Santiago HC, Sands SF, Kendrick DF, Cook RG.Memory processing of serial-lists by pigeons, monkeys and people. Science 1985;229:287-289.

Publication Dates

Publication in this collection
Jan-Mar 2007

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Murdock Jr BB. Serial position effect of free recall. J ExpPsychol 1962;64:482-488.

[2] ²
Wright RE. Adult age similarities in free recall output orderand strategies. J Gerontol 1982;37:76-79.

[3] ³
Mitrushina M, Satz P, Chervinsky A, et al. Performance offour age groups of normal elderly on the rey auditory-verbal learning test. J Clin Psychol 1991;47:351-357.

[4] ⁴
Petersen RC, Smith G, Kokmen E, et al. Memory functioning in normal aging. Neurology 1992;42:396-401.

[5] ⁵
Carlesimo GA, Sabbadini M, Fadda L, et al. Different components in word-list forgetting of pure amnesics, degenerative demented, and healthy subjects. Cortex 1995;31:735745.

[6] ⁶
Bayley PJ, Salmon DP, Bondi MW, et al. Comparison of theserial position effect in very mild Alzheimer's disease, mild Alzheimer's disease and amnesia associated with electroconvulsive therapy. J Int Neuropsychol Soc 2000;6:290-298.

[7] ⁷
Lezak MD. Neuropsychological assessment. 3th ed. New York: Oxford University Press; 1995:366-368.

[8] ⁸
Ceitlin L, Santos B, Parisotto L, Zanatta M, Chaves ML.Elaboration of word lists in Portuguese with emotional content and their influence on memory function in normal subjects. Int J Methods Psychiatr Res 1995;5:195-203.

[9] ⁹
Chaves ML, Izquierdo I. Differential diagnosis betweendementia and depression: a study of efficiency increment. Acta Neurol Scand 1992;85:378-382.

[10] ¹⁰
Bertolucci PHF, Okamoto.IH, Brucki SM, Siviero MO,Toniolo Neto J, Ramos LR. Applicability of the CERAD neuropsycological battery to brazilian elderly. Arq Neuropsiquiatr 2001;59:532-536.

[11] ¹¹
Foldi NS, Brickman AM, Schaefer LA, Knutelska ME.Distinct serial position profiles and neuropsychological measures differentiate late life depression from normal aging and Alzheimer's disease. Psychiatry Res 2003;120:71-84.

[12] ¹²
Buschke H, Sliwinski MJ, Kuslansky G, Katz M, Verghese J,Lipton RB. Retention weighted recall improves discrimination of Alzheimer's disease. J Int Neuropsychol Soc 2006; 12:436-440.

[13] ¹³
American Psychiatric Association. Diagnostic and StatisticalManual of Mental Disorders DSM-IV, 4th ed. Washington DC: American Psychiatric Association; 1994.

[14] ¹⁴
McKhann G, Drachman D, Folstein M, Katzman R, Price D,Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDAWork Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984;34:939-944.

[15] ¹⁵
Morris JC. The clinical dementia rating (CDR): current version and scoring. Neurology 1993;43:2412-2414.

[16] ¹⁶
Maia AL, Godinho C, Ferreira ED, et al. Application of theBrazilian version of the CDR scale in samples of dementia patients. Arq Neuropsiquiatr 2006;64:485-489.

[17] ¹⁷
McKeith IG, Fairbairn AF, Bothwell RA, et al. An evaluationof the predictive validity and inter-rater reliability of clinical diagnostic criteria for senile dementia of Lewy body type. Neurology 1994;44:872-877.

[18] ¹⁸
Brun A, Englund B, Gustafson L, et al. Clinical and neuropathological criteria for frontotemporal dementia. The Lund and Manchester Groups. J Neurol Neurosurg Psychiatry 1994;57:416-418.

[19] ¹⁹
Pirozzo S, Pa pinczak T, Glasziou P. Whispered voice test forscreening for hearing impairment in adults and children: systematic review. BMJ 2003;327:967-971.

[20] ²⁰
Smeeth L, Iliffe S. Community screening for visual impairment in older people. J Am Geriatric Soc 2001;49:673-675.

[21] ²¹
Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: apractical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.

[22] ²²
Delis DC, Kaplan E, Kramer JH, et al. California VerbalLearning Test-II. 2nd ed. San Antonio, TX: The Psychological Corporation; 2000.

[23] ²³
Bigler ED, Rosa L, Schultz F, Hall S, Harris J. Rey-AuditoryVerbal Learning and Rey-Osterrieth Complex Figure Design performance in Alzheimer's disease and closed head injury. J Clin Psychol 1989;45:277-280.

[24] ²⁴
Delis DC, Massman PJ, Butters N, Salmon DP, Demadura TL.Profiles of demented and amnesic patients on the California Verbal Learning Test: implications for the assessment of memory disorders. J Consult Clin Psychol 1991;3:19-26.

[25] ²⁵
Gainotti G, Marra C. Some aspects of memory disordersclearly distinguish dementia of the Alzheimer's type from depressive pseudo-dementia. J Clin Exp Neuropsychol 1994; 16:65-78.

[26] ²⁶
Gainotti G, Marra C, Villa G, Parlato V, Chiarotti F. Sensitivity and specificity of some neuropsychological markers of Alzheimer's dementia. Alzheimer Dis Assoc Disord 1998;12:152-162.

[27] ²⁷
Bäckman L, Small BJ. Influences of cognitive support onepisodic remembering: tracing the process of loss from normal aging to Alzheimer's disease. Psychol Aging 1998;13: 267-276.

[28] ²⁸
Kopelman MD. Rates of forgetting in Alzheimer-typedementia and Korsakoff's syndrome. Neuropsychologia 1985;23:623-638.

[29] ²⁹
Atkinson RC, Shiffrin RM. Human memory: a proposedsystem and its control processes. In: Spence KW, Spence JI, editors. The psychology of learning and motivation: advances in research and theories. New York: Academic Press; 1968:89-195.

[30] ³⁰
Hill CD, Stoudemire A, Morris R, Martino-Saltzman D,Markwalter HR. Similarities and differences in memory in patients with primary dementia and depression-related cognitive dysfunction. J Neuropsychiatry Clin Neurosci 1993; 5:277-282.

[31] ³¹
Cherry BJ, J. Buckwalter JG, Henderson VW. Better preservation of memory span relative to supraspan immediate recall in Alzheimer's disease. Neuropsychologia 2002;40: 846-852.

[32] ³²
Witte KL, Freund JS, Sebby RA. Adult differences in freerecall and subjective organization. Psychol Aging 1990;15: 307-309.

[33] ³³
Baddeley AD, Hitch G. The recency effect: Implicit learningwith explicit retrieval. Mem Cognit 1993;21:146-155.

[34] ³⁴
Glenberg AM. Temporal context and recency. In: GorfeinDS, Hoffman RR, editors, Memory and learning: The Ebbinghaus Centennial Conference. Hillsdale, NJ: Erlbaum; 1987:173-190.

[35] ³⁵
Neath I. Distinctiveness and serial position effects in recognition. Mem Cognit 1993;21:689-698.

[36] ³⁶
Korsnes MS, Magnussen S, Reinvang I. Serial positioneffects in visual short-term memory for words and abstract spatial designs. Scand J Psychol 1996;37:62-73.

[37] ³⁷
Korsnes SM, Gilinsky AS. Aging and serial-list picture memory. Percept Mot Skills 1993;76:1011-1014.

[38] ³⁸
Wright AA, Santiago HC, Sands SF, Kendrick DF, Cook RG.Memory processing of serial-lists by pigeons, monkeys and people. Science 1985;229:287-289.

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