Word list memory test Different test stimuli

AVLT IR AVLT Recog CERAD Trail 1 CERAD Trail 2 CERAD Trail 3 ISLT words ISLT adapted words

ARM SHOES BUTTER TICKET QUEEN FUDGE TEA

CAT MONKEY ARM BOOK GRASS BROWNIE POTATOES
AXE BOWL CORNER BUTTER ARM CANDY APPLES
BED COW LETTER CORNER BOOK BAGEL CHOCOLATE
PLANE FINGER QUEEN STONE STICK PRETZEL PASTRIE
DOG DRESS BOOK ARM CORNER KETCHUP EGG
EAR SPIDER STICK QUEEN BUTTER PEPPERONI CAKE
HAMMER CUP TICKET LETTER STONE PICKLE MAYONESE
CHAIR BEE GRASS STICK TICKET OATMEAL SPAGHETTI
CAR FOOT STONE GRASS LETTER SODA PICKLE
EYE HAT CORN BREAD SUGAR
HORSE BUTTERFLY SYRUP STEAK
KNIFE KETTLE
CLOCK MOUSE
BIKE HAND

Brief overlook over the strength and limitations of the study

Test/ AVLT CERAD ISLT Remarks

Area

Specific function Rote memorization, Verbal episodic Verbal recognition/

assessed proactive and memory/ Verbal Verbal memory
retroactive inference working memory

Stimuli description Consists animal names, Similar to AVLT but low Mainly comprises ISLT has
artifacts commonly familiarity and food items, groceries, functional high
used, furnitures, which imagibility. and items which can frequent stimuli
overall comprises of Less functional words. be bought from store and provides
day to day activity context. AVLT
utilities. can be equally
good but for
illiterates who are
not exposed to
testing situations
can face little
difficulty.
CERAD stimuli
need
modifications
Administration time 15 mins + 30 mins 10 minutes + 10 mins 5 - 10 mins + 20 ISLT is quick in
interval interval mins interval assessing.
CERAD interval
 Test/ AVLT CERAD ISLT Remarks
Area

time is less which

can be
advantageous in
the placement of
task in battery.
No of items and trails 15 items / 5+1 trails 10 items/ 3+1 trails 12 items / 3 +1 trails CERAD has order
rotation which
can fatigue
participant. AVLT
has relatively
more trails which
can be time
consuming.
Sensitivity Robust predictor of 84% accuracy in Sensitivity accounts ISLT does not
dementia in large detecting MCI for 90% have much
sample research back up
though its
sensitivity is
showin high in
published articles
Used in longitudinal YES YES Very limited(adapted AVLT has been
studies versions like good indicator for
groceries list) changes in Verbal
memory.
Advantages Vernacular translations Well established, Culutral specific, ISLT has to be
available, Widely used Clinically used, Vast ecological validity, developed from
in longitudinal studies literature Familiarity of words scratch, CERAD
easily associable need specific
changes in
stimuli, AVLT is
readily available
Limitations Relatively lengthy than Limited data in Non-AD Limited literature
other word list tasks. population available, not well
used in Longitudinal
studies, Relatively
new scale
 Test/ AVLT CERAD ISLT Remarks
Area

References Binder LM, Villanueva Morris JC, Heyman A, Lim, Y. Y., Prang, K.
MR, Howieson D, Mohs RC, et al. The H., Cysique, L.,
Moore RT. The Rey Consortium to Pietrzak, R. H.,
AVLT recognition Establish a Registry for Snyder, P. J., &
memory task measures Alzheimer's Disease Maruff, P. (2009). A
motivational (CERAD). Part I. method for cross-
impairment after mild Clinical and cultural adaptation of
head trauma. Arch Clin neuropsychological a verbal memory
Neuropsychol assessment of assessment.
1993;8:137-147. Alzheimer's Behavior Research
disease. Neurology Methods,41 , 1190
1989;39:1159-1165. 1200.
Tierney MC,
Moineddin R, Sensitivity and test-
McDowell I. Prediction Welsh KA, Butters N, retest reliability of
of all-cause Mohs RC, et al. The the international
dementia using Consortium to shopping list test in
neuropsychological Establish a Registry for assessing verbal
tests within 10 and 5 Alzheimer's Disease learning and memory
years (CERAD). Part V. A in mild Alzheimer's
of diagnosis in a normative study of the disease.
community-based neuropsychological Thompson TA1,
sample. J Alzheimers battery. Neurology Wilson PH, Snyder
Dis, 2010;22,1231- 1994;44:609-614. PJ, Pietrzak RH,
1240 Darby D, Maruff P,
Buschke H

AVLT vs CERAD

CERAD is more popular in clincal setups than research settings (healthy population) where as AVLT is
used more in research settings. It is widely used in longitudinal studies than CERAD. AVLT is available
in Kannada and Telugu versions which make the usability of test easy and there is no need to alter the
stimuli. With over all analysis of both the tests, AVLT will stand on top.

AVLT vs ISLT

As mentioned above, AVLT has vast literature backup where as ISLT is relatively new and not widely
tested. One study( three year longitudinal study) has used ISLT for verbal learning function(1) yet it
needs more testing. Nevetheless it is more culture specific and the translation is not direct unlike AVLT.
The stimuli is selected from community and linguistic comparision is not prominent. The stimuli is
highly functional, personally associative(food items) and SLT paradigm provides hypothetical
situtation unlike AVLT where one has to just remember words with no episodic touch. Having stated
this, few questions have been listed below to understand the selection of task.

Why SLT is preferred ?

SLT paradigm uses hypothetical situation to test verbal memory. For illiterate population who are not
exposed to testing situations or rote learning situations, SLT paradigm can be relatively less strainful.

Are AVLT and SLT similar?

In both the cases participant has to listen words carefully and has to recall later. The difference lies in
the instructions, No of items and No of trials.

But SLT do not have strong research backup?

There is a limited literature about the usage of SLT as a tool that can differentiate healthy and
cognitively impaired population. The available literature shows strong positive correlation between
different types of Word list recall tasks(HAVL, CAVLT) and SLT(2). In longitudinal studies, it is not
yet been an established tool.

Then why to take a chance ?

The available (limited though) literature suggests it has more ecological validity than other types of
word list learning tasks. By adapting SLT paradigm in the study it serves few advantages
1. If SLT can be good predictor, it saves time and will be culturally sound task
2. In India it will become the first systematically studied SLT and can be furtther used in different
studies and may be in clinical settings in future
3. This will be a first longitudinal study to test the specificity of the SLT.

How can it be done ?

1. We have to formulate list of day to day shopping items and take a poll on items which are easily
available by survey method.
2. We have to administer AVLT and newly developed SLT on healthy and MCI population
3. Check whether the AVLT and ISLT have positive correlation to establish concurrent validity.
4. Adapt the norms of AVLT to decide cutoff in SLT scores.