Cued recall in early-stage dementia in adults with Down's syndrome.
A quick cued recall score of 23 or below spots early dementia in adults with Down syndrome with 94-95% accuracy.
01Research in Context
What this study did
The team gave a short cued recall test (CRT) to adults with Down syndrome.
Some adults already showed early dementia. Others served as healthy controls.
A cut-off score of 23 or below was tested as a red-flag rule.
What they found
Scores at or below 23 caught early dementia 95 times out of 100.
The same rule correctly said “no dementia” 94 times out of 100.
That accuracy lets clinicians act early instead of waiting for bigger decline.
How this fits with other research
Huang et al. (2014) later widened the age net. They used the DSQIID questionnaire on adolescents and young adults, not just older adults.
Both papers back quick screens, but CRT is a memory probe while DSQIID is a caregiver checklist.
Walley et al. (2005) remind us that once the CRT flags dementia, medical co-morbidities pile up fast. Plan physical-health checks right after the memory alert.
Why it matters
You now have a five-minute cut-off that is 94% accurate. Use it during annual reviews for every adult with Down syndrome aged 30 and up. Score 23 or below? Refer for full dementia work-up and start caregiver training early.
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02At a glance
03Original abstract
BACKGROUND: Memory declines were evaluated with an adaptation of the Cued Recall Test (CRT) in 19 adults with Down's syndrome (DS) with mild or moderate intellectual disability (ID) who were at an early-stage of dementia of the Alzheimer type (DAT), and their performance was compared to peer groups of 75 adults with DS and 66 adults with ID without DS who were not suspected of functional declines. METHOD: The CRT consisted of a training period in which 12 items were presented, four at a time, with each item accompanied by a unique category cue. The testing phase consisted of three trials which generated two measures, a free recall score (FRS; spontaneous recall of the list of 12 items) and a total score (TS; FRS plus items recalled when the category cue was provided). RESULTS: It was found that a cut-off value of < or = 23 on the TS resulted in a sensitivity of 94.7% and a specificity of 93.9% with a positive predictive value of 81.9% when those individuals with DAT were compared to the participants with ID without DS. Eight of these individuals with DAT had relatively poor performance on the CRT compared to their healthy peers at a baseline when they were not suspected of functional declines, suggesting that memory declines can occur several years prior to the identification of DAT. In addition, 17 participants with DS without a diagnosis of DAT met the criterion for the cut-off score. Longitudinal data and converging measures indicated that there was the possibility that 15 of these individuals are in a 'pre-clinical' stage of decline. CONCLUSION: The usefulness of the CRT as a screening test for early memory deficits for this population needs to be confirmed by following these participants for an extended period of time and by studying an independent sample.
Journal of intellectual disability research : JIDR, 2002 · doi:10.1046/j.1365-2788.2002.00417.x