Journal of the International Neuropsychological Society



Semantic interference deficits and the detection of mild Alzheimer's disease and mild cognitive impairment without dementia


DAVID A.  LOEWENSTEIN  a1 a2 c1 , AMARILIS  ACEVEDO  a1 a2 , CHERYL  LUIS  a1 a2 , THOMAS  CRUM  a1 a2 , WARREN W.  BARKER  a1 and RANJAN  DUARA  a1 a2
a1 Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, Florida
a2 Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, Florida

Article author query
loewenstein da   [PubMed][Google Scholar] 
acevedo a   [PubMed][Google Scholar] 
luis c   [PubMed][Google Scholar] 
crum t   [PubMed][Google Scholar] 
barker ww   [PubMed][Google Scholar] 
duara r   [PubMed][Google Scholar] 

Abstract

Impairment in delayed recall has traditionally been considered a hallmark feature of Alzheimer's disease (AD). However, vulnerability to semantic interference may reflect early manifestations of the disorder. In this study, 26 mildly demented AD patients (mild AD), 53 patients with mild cognitive impairment without dementia (MCI), and 53 normal community-dwelling elders were first presented 10 common objects that were recalled over 3 learning trials. Subjects were then presented 10 new semantically related objects followed by recall for the original targets. After controlling for the degree of overall memory impairment, mild AD patients demonstrated greater proactive but equivalent retroactive interference relative to MCI patients. Normal elderly subjects exhibited the least amount of proactive and retroactive interference effects. Recall for targets susceptible to proactive interference correctly classified 81.3% of MCI patients and 81.3% of normal elderly subjects, outperforming measures of delayed recall and rate of forgetting. Adding recognition memory scores to the model enhanced both sensitivity (84.6%) and specificity (88.5%). A combination of proactive and retroactive interference measures yielded sensitivity of 84.6% and specificity of 96.2% in differentiating mild AD patients from normal older adults. Susceptibility to proactive semantic interference may be an early cognitive feature of MCI and AD patients presenting for clinical evaluation. (JINS, 2004, 10, 91–100.)

(Received September 27 2002)
(Revised April 22 2003)
(Accepted May 5 2003)


Key Words: Alzheimer's disease; Memory; Proactive interference.

Correspondence:
c1 Reprint requests to: David Loewenstein, Ph.D., UM Department of Psychiatry, Second Floor MRI Building, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140. E-mail: dloewenstein@worldnet.att.net


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