The most common early deficit in patients with Alzheimer's disease (AD) is in recent memory. Distinguishing patients with AD from normal elderly individuals, using currently available memory tests, is limited by their lack of suitability for bedside use or for large-scale screening. We have devised a new memory test, a delayed word recall (DWR) test, that is both brief and efficient. It was designed specifically to maximize the likelihood of poor performance in patients with AD and minimize the likelihood of poor performance in normal elderly subjects. The DWR test uses required elaborative processing of to-be-remembered words and delayed free recall. Fifty-five normal elderly subjects and 28 patients with possible or probable AD were tested. The overall predictive accuracy of the DWR test was 95.2%. In addition, scores on the DWR test in normal subjects were not correlated with education or age. The inclusion of the DWR test in a previously studied cognitive detection battery for AD resulted in a considerable improvement in predictive accuracy.