Potential for misclassification of mild cognitive impairment: a study of memory scores on the Wechsler Memory Scale-III in healthy older adults

J Int Neuropsychol Soc. 2008 May;14(3):463-78. doi: 10.1017/S1355617708080521.

Abstract

The psychometric criterion of mild cognitive impairment (MCI) generally involves having an unusually low score on memory testing (i.e., -1.5 SDs). However, healthy older adults can obtain low scores, particularly when multiple memory measures are administered. In turn, there is a substantial risk of psychometrically misclassifying MCI in healthy older adults. This study examined the base rates of low memory scores in older adults (55-87 years; n = 550) from the Wechsler Memory Scale-Third Edition (WMS-III; Wechsler, 1997b) standardization sample. The WMS-III consists of four co-normed episodic memory tests (i.e., Logical Memory, Faces, Verbal Paired Associates, and Family Pictures) that yield eight age- and demographically-adjusted standard scores (Auditory Recognition and Working Memory tests not included). When the eight age-adjusted scores were examined simultaneously, 26% of older adults had one or more scores at or below the 5th percentile (i.e., -1.5 SDs). On the eight demographically- adjusted scores, 39% had at least one score at or below the 5th percentile. There was an inverse relationship between intellectual abilities and prevalence of low memory scores, particularly with the age-adjusted WMS-III scores. Understanding the base rates of low scores can reduce the overinterpretation of low memory scores and minimize false-positive misclassification.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cognition Disorders / diagnosis*
  • Female
  • Geriatric Assessment*
  • Humans
  • Male
  • Memory / physiology*
  • Middle Aged
  • Neuropsychological Tests*
  • Wechsler Scales*