Free and Cued Selective Reminding Test - accuracy for the differential diagnosis of Alzheimer's and neurodegenerative diseases: A large-scale biomarker-characterized monocenter cohort study (ClinAD)

Alzheimers Dement. 2017 Aug;13(8):913-923. doi: 10.1016/j.jalz.2016.12.014. Epub 2017 Feb 21.

Abstract

Introduction: The International Working Group recommended the Free and Cued Selective Reminding Test (FCSRT) as a sensitive detector of the amnesic syndrome of the hippocampal type in typical Alzheimer's disease (AD). But does it differentiate AD from other neurodegenerative diseases?

Methods: We assessed the FCSRT and cerebrospinal fluid (CSF) AD biomarkers in 992 cases. Experts, blinded to biomarker data, attributed in 650 cases a diagnosis of typical AD, frontotemporal dementia, posterior cortical atrophy, Lewy body disease, progressive supranuclear palsy, corticobasal syndrome, primary progressive aphasias, "subjective cognitive decline," or depression.

Results: The FCSRT distinguished typical AD from all other conditions with a sensitivity of 100% and a specificity of 75%. Non-AD neurodegenerative diseases with positive AD CSF biomarkers ("atypical AD") did not have lower FCSRT scores than those with negative biomarkers.

Discussion: The FCSRT is a reliable tool for diagnosing typical AD among various neurodegenerative diseases. At an individual level, however, its specificity is not absolute. Our findings also widen the spectrum of atypical AD to multiple neurodegenerative conditions.

Keywords: Alzheimer's disease; Assessment of memory disorders; Dementia; Neurodegenerative diseases.

MeSH terms

  • Aged
  • Biomarkers / cerebrospinal fluid
  • Cohort Studies
  • Cues
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Memory*
  • Mental Status and Dementia Tests*
  • Neurodegenerative Diseases / cerebrospinal fluid*
  • Neurodegenerative Diseases / diagnosis*
  • Neurodegenerative Diseases / psychology
  • Neuropsychological Tests*
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Biomarkers