Assessment & Research

Modified cued recall test in the French population with Down syndrome: A retrospective medical records analysis.

Sacco et al. (2022) · Journal of intellectual disability research : JIDR 2022
★ The Verdict

Use a French mCRT score of 22 or below to flag possible Alzheimer’s in adults with Down syndrome.

✓ Read this if BCBAs working with French-speaking adults with Down syndrome in medical or day-program settings.
✗ Skip if Clinicians serving only English-speaking or pediatric populations.

01Research in Context

01

What this study did

Doctors looked back at medical charts of French adults with Down syndrome. They wanted to know if a short memory test could spot Alzheimer’s disease.

The test is called the modified cued recall test, or mCRT. They checked if a score of 22 or lower meant the person had Alzheimer’s.

02

What they found

The cut-off score worked. Adults with Down syndrome plus Alzheimer’s almost always scored 22 or below.

The same cut-off that works in English-speaking adults also works in French adults.

03

How this fits with other research

Prasher et al. (2004) already showed the 15-item ABDQ questionnaire can screen for dementia with 92 % accuracy. The new mCRT gives clinicians a second, memory-based option.

Gutman et al. (2016) found no change in NeuroTrax computer scores over 18 months. Their null result supports using simple paper tests like mCRT for quick screening instead of lengthy computer batteries.

Nieuwenhuis-Mark (2009) warned that wide ability ranges in Down syndrome make diagnosis hard. The mCRT cut-off tackles this by giving one clear number to watch.

04

Why it matters

You now have a fast, low-cost screen for Alzheimer’s in French-speaking adults with Down syndrome. Add the mCRT to annual check-ups starting at age 40. A score of 22 or lower signals the need for fuller assessment and care planning.

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Add the 5-minute mCRT to your intake packet and note any score ≤22 for physician follow-up.

02At a glance

Intervention
not applicable
Design
case series
Sample size
194
Population
down syndrome
Finding
positive
Magnitude
large

03Original abstract

BACKGROUND: Adults with Down syndrome (DS) are at increased risk of developing Alzheimer's disease (AD) due to genetic predisposition. Identification of patients with AD is difficult since intellectual disabilities (ID) may confound diagnosis. The objective of this study was to evaluate the ability of the French version of the modified cued recall test (mCRT) to distinguish between subjects with and without AD in the adult DS population. METHODS: This was a retrospective, single-centre, medical records study including data between March 2014 and July 2020. Adults aged ≥30 years with DS who had at least one mCRT record available were eligible. Age, sex and ID level were extracted, and subjects were attributed to three groups: patients with AD, patients with co-occurring conditions that may impact cognitive function and subjects without AD. mCRT scores, adjusted by sex, age and ID level, were compared between groups. The optimal cut-off value to distinguish between patients with and without AD was determined using the receiver operating characteristic curve. The impact of age and ID level on mCRT scores was assessed. RESULTS: Overall, 194 patients with DS were included: 12 patients with AD, 94 patients with co-occurring conditions and 88 healthy subjects. Total recall scores were significantly lower (P < 0.0001) in patients with AD compared with healthy subjects. The optimal cut-off value to discriminate between patients with AD and healthy subjects was 22, which compares well with the cut-off value of 23 originally reported for the English version of the mCRT. Patients aged 30-44 years had higher mCRT total recall scores compared with patients aged ≥45 years (P = 0.0221). Similarly, patients with mild ID had higher mCRT scores compared with patients with severe ID (P < 0.0001). INTERPRETATION: The mCRT is a sensitive tool that may help in the clinical diagnosis of AD in subjects with DS. Early recognition of AD is paramount to deliver appropriate interventions to this vulnerable population.

Journal of intellectual disability research : JIDR, 2022 · doi:10.1111/jir.12957