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Learning and Generalization Tasks Predict Short-Term Cognitive Outcome in Nondemented Elderly

Department of Psychology, Rutgers University, myers{at}pavlov.rutgers.edu

Alan Kluger, PhD

Department of Psychology, Lehman College/CUNY, Department of Psychiatry, New York University Medical Center

James Golomb, MD

Department of Neurology, New York University Medical Center New York

Mark A. Gluck, PhD

Center for Molecular and Behavioral Neuroscience Rutgers University, Newark, New Jersey

Steven Ferris, PhD

Department of Psychiatry, New York University Medical Center

This study examines whether behavioral measures obtained in nondemented elderly can predict cognitive status at 2-year follow-up. Prior studies have established that delayed paragraph recall can help predict short-term risk for decline to mild cognitive impairment and Alzheimer disease. It was examined whether prediction accuracy can be improved by adding a discrimination-and-generalization task that has previously been shown to be disrupted in nondemented elderly with hippocampal atrophy, a risk factor for Alzheimer disease. Fifty nondemented, medically healthy elderly patients received baseline clinical diagnosis and cognitive testing; 2 years later, patients received a follow-up clinical diagnosis of normal, mild cognitive impairment, or probable Alzheimer disease. In all, 2 baseline variables, delayed paragraph recall and generalization performance, were predictive of follow-up outcome with sensitivity of 81% and specificity of 91%—better than the classification accuracy based on either of these measures alone. These preliminary results suggest that these behavioral tasks may be useful tools in predicting short-term cognitive outcome in nondemented elderly.

Key Words: aging • cognition • mild cognitive impairment • Alzheimer disease • hippocampus • memory

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