Schrijnemaekers A M C, de Jager Celeste A, Hogervorst E, Budge M M
Department of Geriatrics, RIAGG, Roermond, The Netherlands.
J Clin Exp Neuropsychol. 2006 Apr;28(3):438-55. doi: 10.1080/13803390590935462.
Memory tests may be predictive for cognitive decline. We investigated the sensitivity and change in performance over time of the Hopkins Verbal Learning Test (HVLT) and the Mini-Mental Status Examination (MMSE) for Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD) when compared to cognitively healthy controls. Participants included elderly controls (n = 54), MCI (n = 19) and AD cases (n = 28) from OPTIMA. The MMSE and the HVLT (version 1) were administered twice to all subjects with an interval of 2-3 years.MCI and AD cases had poorer performance than controls on the HVLT and MMSE at both testing episodes (p < 0.05). The HVLT profile over time showed a learning effect in the control group (P < 0.0001), a trend to decline in the AD group (p = 0.09) and no change in the MCI group (P = 0.8). A subgroup of MCI subjects had lower HVLT scores at follow-up. The MMSE profile showed no significant change over time for all three groups (P > 0.05). The HVLT had better sensitivity and specificity compared to the MMSE for detecting MCI and AD. The HVLT is not only valuable for cross-sectional designs but has also proved to be valuable in a longitudinal design. Cognitively healthy controls showed evidence of learning strategies on the HVLT after a 2-3 year interval, with improved scores at the second testing episode. By contrast, an MCI group showed no benefits of previous exposure to this test. Lack of use of learning strategies on the HVLT may be an important marker of the likelihood of cognitive decline to MCI or dementia.
记忆测试可能对认知衰退具有预测作用。我们调查了霍普金斯言语学习测试（HVLT）和简易精神状态检查表（MMSE）在用于轻度认知障碍（MCI）和阿尔茨海默病（AD）时相较于认知健康对照组的敏感性以及随时间推移的表现变化。参与者包括来自OPTIMA的老年对照组（n = 54）、MCI组（n = 19）和AD病例组（n = 28）。MMSE和HVLT（版本1）对所有受试者进行了两次测试，间隔时间为2至3年。在两次测试中，MCI和AD病例组在HVLT和MMSE上的表现均比对照组差（p < 0.05）。随时间推移，HVLT结果显示对照组有学习效应（P < 0.0001），AD组有下降趋势（p = 0.09），MCI组无变化（P = 0.8）。MCI受试者的一个亚组在随访时HVLT得分较低。MMSE结果显示，所有三组随时间均无显著变化（P > 0.05）。与MMSE相比，HVLT在检测MCI和AD时具有更好的敏感性和特异性。HVLT不仅在横断面设计中有价值，而且在纵向设计中也被证明是有价值的。认知健康对照组在间隔2至3年后在HVLT上显示出学习策略的证据，第二次测试时得分有所提高。相比之下，MCI组并未从之前进行该测试中获益。在HVLT上未使用学习策略可能是认知衰退至MCI或痴呆可能性的一个重要标志。
