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Verbal learning in Alzheimer’s disease: Cumulative word knowledge gains across learning trials

Published online by Cambridge University Press:  01 September 2009

PAUL S. FOSTER ,
VALERIA DRAGO ,
GREGORY P. CRUCIAN ,
ROBERT D. RHODES ,
BRIAN V. SHENAL  and
KENNETH M. HEILMAN
PAUL S. FOSTER*
Affiliation:
Psychology Department, Middle Tennessee State University, Murfreesboro, Tennessee Department of Neurology, University of Florida, Gainesville, Florida
VALERIA DRAGO
Affiliation:
Department of Neurology, University of Florida, Gainesville, Florida Oasi Institute for Research on Brain Aging and Mental Retardation, Troina, Italy
GREGORY P. CRUCIAN
Affiliation:
Psychology Department, University of Canterbury, Christchurch, New Zealand Brain Injury Rehabilitation Service, Burwood Hospital, Christchurch, New Zealand
ROBERT D. RHODES
Affiliation:
Psychology Department, Concord University, Athens, West Virginia
BRIAN V. SHENAL
Affiliation:
Mental Health Service Line, Salem VA Medical Center, Salem, Virginia
KENNETH M. HEILMAN
Affiliation:
Department of Neurology, University of Florida, Gainesville, Florida Department of Neurology, Malcom Randall VAMC, Gainesville, Florida
*
*Correspondence and reprint requests: Paul S. Foster, Psychology Department, Middle Tennessee State University, 1500 Greenland Drive, Murfreesboro, Tennessee 37132. E-mail: paul.foster@neurology.ufl.edu
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Abstract

Research regarding learning in Alzheimer’s disease (AD) patients has been mixed. Learning capacity might be better indexed using a score that reflects the interaction between the learning slope and total recall, referred to as the Cumulative Word Learning (CWL) score. We compared a group of AD patients to normal participants using a traditional index of learning and the CWL score that were derived from the Hopkins Verbal Learning Test – Revised (HVLT-R). The HVLT-R is a supra-span, list-learning test containing 12 words from three semantic categories. The results indicated that the sample of AD patients performed within the average range, using the traditional learning z score. Although mild AD patients were not found to differ from controls in the traditional learning z score, a significant difference was noted for the CWL score. The moderate AD patients differed from the normal controls in both learning measures. Furthermore, unlike the traditional learning score, the CWL score was a significant predictor of overall cognitive functioning, as indexed using their Mini-Mental State Examination (MMSE) score. Thus, the CWL score might be a more sensitive indicator overall of total learning capacity and may be useful in staging Alzheimer’s disease because of increased resilience to floor effects. (JINS, 2009, 15, 730–739.)

Keywords

VerbalLearningMemoryAlzheimer’s diseaseLearning curve
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 5 , September 2009 , pp. 730 - 739
Copyright
Copyright © The International Neuropsychological Society 2009

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