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Open Access Research article

The Chinese version of story recall: a useful screening tool for mild cognitive impairment and Alzheimer’s disease in the elderly

Jing Shi1, Mingqing Wei1, Jinzhou Tian1*, Julie Snowden2, Xuekai Zhang1, Jingnian Ni1, Ting Li1, Wenjia Jian1, Congcong Ma1, Yanping Tong1, Jianping Liu3, Tonghua Liu4, Pengwen Wang5 and Yongyan Wang6

Author Affiliations

1 The 3rd Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China

2 Cerebral Function Unit, Greater Manchester Neuroscience Centre Salford Royal NHS Foundation Trust, Salford M6 8HD, UK

3 Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China

4 Beijing University of Chinese Medicine, Beijing 100029, China

5 Key Laboratory of Chinese Internal Medicine, Ministry of Education, Beijing University of Chinese Medicine, Beijing, China

6 Institute of Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China

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BMC Psychiatry 2014, 14:71  doi:10.1186/1471-244X-14-71

Published: 10 March 2014

Abstract

Background

Decline in verbal episodic memory is a core feature of amnestic mild cognitive impairment (aMCI). The delayed story recall (DSR) test from the Adult Memory and Information Processing Battery (AMIPB) discriminates MCI from normal aging and predicts its conversion to Alzheimer’s dementia. However, there is no study that validates the Chinese version of the DSR and reports cut-off scores in the Chinese population.

Methods

A total of 631 subjects were screened in the memory clinics of Dongzhimen Hospital, Beijing University of Chinese Medicine, China. 249 were considered to have normal cognition (NC), 134 met diagnostic criteria for MCI according to the MCI Working Group of the European Consortium on Alzheimer's Disease, and 97 met criteria for probable Alzheimer’s disease (AD) according to the NINCDS/ADRDA criteria, 14 exhibited vascular dementia (VaD), and 50 had a diagnosis of another type of dementia. Receiver operating characteristic (ROC) curve analyses were used to calculate the story recall cutoff score for detecting MCI and AD. Normative data in the NC group were obtained as a function of age and education.

Results

In this Chinese sample, the normative mean DSR score was 28.10 ± 8.54 in the 50–64 year-old group, 26.22 ± 8.38 in the 65–74 year-old group, and 24.42 ± 8.38 in the 75–85 year-old group. DSR performance was influenced by age and education. The DSR test had high sensitivity (0.899) and specificity (0.799) in the detection of MCI from NC using a cut-off score of 15.5. When the cutoff score was 10.5, the DSR test obtained optimal sensitivity (0.980) and specificity (0.938) in the discrimination of AD from NC. Cutoff scores and diagnostic values were calculated stratified by age and education.

Conclusions

The Chinese version of the DSR can be used as a screening tool to detect MCI and AD with high sensitivity and specificity, and it could be used to identify people at high risk of cognitive impairment.

Keywords:
Alzheimer’s disease, Mild cognitive impairment, Delayed story recall, Sensitivity; Specificity