Meyer Sascha R A, De Jonghe Jos F M, Schmand Ben, Ponds Rudolf W H M
a Department of Medical Psychology, School of Mental Health and Neuroscience (MHeNS) , Maastricht University Medical Center , Maastricht , the Netherlands.
b Department of Geriatric Medicine , Northwest Medical Center Location Alkmaar , Alkmaar , the Netherlands.
Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2019 May;26(3):447-462. doi: 10.1080/13825585.2018.1475002. Epub 2018 May 16.
Episodic memory tests need to determine the degree to which patients with moderate to severe memory deficits can still benefit from retrieval support. Especially in the case of Alzheimer's disease (AD), this may support health care to be more closely aligned with patients' memory capacities. We investigated whether the different measures of episodic memory of the Visual Association Test-Extended (VAT-E) can provide a more detailed and informative assessment on memory disturbances across a broad range of cognitive decline, from normal to severe impairment as seen in AD, by examining differences in floor effects. The VAT-E consists of 24 pairs of black-and-white line drawings. In a within-group design, we compared score distributions of VAT-E subtests in healthy elderly controls, mild cognitive impairment (MCI), and AD (n = 144), as well as in relation to global cognitive impairment. Paired associate recall showed a floor effect in 41% of MCI patients and 62% of AD patients. Free recall showed a floor effect in 73% of MCI patients and 84% of AD patients. Multiple-choice cued recognition did not show a floor effect in either of the patient groups. We conclude that the VAT-E covers a broad range of episodic memory decline in patients. As expected, paired associate recall was of intermediate difficulty, free recall was most difficult, and multiple-choice cued recognition was least difficult for patients. These varying levels of difficulty enable a more accurate determination of the level of retrieval support that can still benefit patients across a broad range of cognitive decline.
情景记忆测试需要确定中度至重度记忆缺陷患者仍能从检索支持中受益的程度。特别是在阿尔茨海默病（AD）的情况下，这可能有助于医疗保健与患者的记忆能力更紧密地匹配。我们通过检查地板效应的差异，研究了视觉联想测试扩展版（VAT-E）的不同情景记忆测量方法是否能对从正常到AD中所见的严重损伤等广泛认知衰退范围内的记忆障碍提供更详细和有用的评估。VAT-E由24对黑白线条图组成。在组内设计中，我们比较了健康老年对照组、轻度认知障碍（MCI）和AD患者（n = 144）中VAT-E子测试的分数分布，以及与整体认知障碍的关系。配对联想回忆在41%的MCI患者和62%的AD患者中出现地板效应。自由回忆在73%的MCI患者和84%的AD患者中出现地板效应。多项选择线索识别在两组患者中均未出现地板效应。我们得出结论，VAT-E涵盖了患者广泛的情景记忆衰退。正如预期的那样，配对联想回忆难度适中，自由回忆对患者来说最难，多项选择线索识别对患者来说最不难。这些不同的难度水平能够更准确地确定在广泛认知衰退范围内仍能使患者受益的检索支持水平。
