Comparison between FCSRT and LASSI-L to Detect Early Stage Alzheimer's Disease

J Alzheimers Dis. 2018;61(1):103-111. doi: 10.3233/JAD-170604.


Background: The Free and Cued Selective Reminding Test (FCSRT) is the most accurate test for the diagnosis of prodromal Alzheimer's disease (AD). Recently, a novel cognitive test, the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L), has been developed in order to provide an early diagnosis.

Objective: To compare the diagnostic accuracy of the FCSRT and the LASSI-L for the diagnosis of AD in its preclinical and prodromal stages using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) as a reference.

Methods: Fifty patients consulting for subjective memory complaints without functional impairment and at risk for AD were enrolled and evaluated using FCSRT, LASSI-L, and FDG-PET. Participants were evaluated using a comprehensive neurological and neuropsychological protocol and were assessed with the FCSRT and LASSI-L. FDG-PET was acquired concomitantly and used for classification of patients as AD or non-AD according to brain metabolism using both visual and semi-quantitative methods.

Results: LASSI-L scores allowed a better classification of patients as AD/non-AD in comparison to FCSRT. Logistic regression analysis showed delayed recall and failure to recovery from proactive semantic interference from LASSI-L as independent statistically significant predictors, obtaining an area under the curve of 0.894. This area under the curve provided a better discrimination than the best FCSRT score (total delayed recall, area under the curve 0.708, p = 0.029).

Conclusions: The LASSI-L, a cognitive stress test, was superior to FCSRT in the prediction of AD features on FDG-PET. This emphasizes the possibility to advance toward an earlier diagnosis of AD from a clinical perspective.

Keywords: Alzheimer’s disease; early detection; memory; mild cognitive impairment; neuropsychological assessment; positron emission tomography.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications
  • Alzheimer Disease / diagnosis*
  • Cues*
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Memory Disorders / diagnosis*
  • Memory Disorders / etiology
  • Mental Recall / physiology*
  • Middle Aged
  • Neuropsychological Tests*
  • Positron-Emission Tomography
  • Psychiatric Status Rating Scales
  • ROC Curve
  • Semantics*


  • Fluorodeoxyglucose F18