When wrong answers lead us down the right path

While significant investments have been made in imaging acquisition and biomarker methods, progressing from brain MRI to PET scans and developing higher sensitivity imaging tracers and serum markers, the primary methods for documenting clinical manifestations of AD, using neuropsychological tests to detect a cognitive impairment, have gone largely unnoticed outside of the neuropsychological professional community. Over time, while different list learning and story memory tasks have been developed and used, remarkably, the AD research world continues to primarily rely on the delayed recall score from memory tasks. [...]while detecting pathological emergence of AD has evolved, the persistent reliance on the same behavioral measure for an early signal of memory impairment has meant not keeping up with the biomarker community in finding memory markers that are or might be better than those that are 75+ years old. The process score profile consistent with early AD has been characterized as having slowed learning across trials of a word-list memory task (i.e. a flattened learning slope), increased susceptibility to interference, and a greater frequency of nontarget word intrusion errors, particularly on cued recall trials that pull for intrusions that are semantically related to the target words (Delis et al., 1991; Loewenstein et al., 2004; Salmon and Bondi, 2009). Most of the older adult research that involves biomarkers has been conducted on predominately non-Hispanic white participants. [...]the fact that 53% of the sample in this study was Spanish-speaking is a relative strength.