Assessment & Research

Changes in explicit memory associated with early dementia in adults with Down's syndrome.

Krinsky-McHale et al. (2002) · Journal of intellectual disability research : JIDR 2002
★ The Verdict

A quick word-list test can reveal early dementia in adults with Down syndrome up to three years before obvious symptoms appear.

✓ Read this if BCBAs serving adults with Down syndrome in residential or day programs.
✗ Skip if Clinicians who work only with young children or typically developing clients.

01Research in Context

01

What this study did

Mansell et al. (2002) gave adults with Down syndrome a simple word-list test called the Selective Reminding Test. They compared two groups: adults with early dementia and adults without dementia.

The test checks how many words a person can store for the long haul and how well they pull those words back out later.

02

What they found

The group with early dementia forgot words faster and could not get them back after delays. Their long-term storage and retrieval scores dropped steeply compared to peers without dementia.

These memory slips showed up as early as three years before doctors saw clear dementia signs.

03

How this fits with other research

Allen et al. (2001) saw a similar early warning, but with language instead of memory. They found that messy, off-topic talk came before global cognitive loss in the same population.

Faso et al. (2016) later widened the age range and added a psychopathology group. They showed that daily-life skills drop only when dementia is present, backing up the 2002 memory marker.

H-Fournier et al. (2004) and Hawley et al. (2004) looked at memory too, but in kids and teens without dementia. Their work helps us see that the steep drop seen in Mansell et al. (2002) is not just everyday Down syndrome forgetfulness—it is a new, illness-linked change.

04

Why it matters

You can spot trouble sooner by giving the short, low-cost Selective Reminding Test during annual reviews. A sudden slide in long-term word recall tells the team to start dementia work-ups, plan caregiver training, and adjust goals before behavior or safety issues bloom.

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Add the Selective Reminding Test to your yearly assessment battery and graph each client’s long-term storage score to watch for sudden drops.

02At a glance

Intervention
not applicable
Design
other
Population
down syndrome, dementia
Finding
negative

03Original abstract

BACKGROUND: A modified version of the Selective Reminding Test (SRT) (Buschke 1973) was used to examine the changes in memory that occur with early-stage dementia of the Alzheimer's type (DAT) in adults with intellectual disability (ID) and Down's syndrome (DS), and to compare these changes to those occurring with 'normal' ageing. METHOD: Hierarchical linear modelling analyses showed steep declines in the performance of participants who had met the criteria for the onset of DAT. Non-demented participants also showed declines in performance which were related to their age. However, the absolute magnitude of these declines was consistent with a 'normal' ageing pattern and not with undetected dementia. RESULTS: In analysing the specific memory components that are compromised, the present authors found that participants with early-stage DAT showed severely diminished long-term storage and retrieval processing abilities compared to their non-demented peers. Notably, these declines preceded other symptoms of dementia, in most cases by more than a full year and sometimes by as much as 3 years. CONCLUSIONS: Thus, the present results clearly confirm that memory processes are affected during early dementia in adults with DS, and that the SRT has promise as a clinical tool.

Journal of intellectual disability research : JIDR, 2002 · doi:10.1046/j.1365-2788.2002.00365.x