Objective: We investigated how well a visual associative learning task discriminates Alzheimer’s disease (AD) dementia from other types of dementia and how it relates to AD pathology. Methods: 3,599 patients (63.9 ± 8.9 years old, 41% female) from the Amsterdam Dementia Cohort completed two sets of the Visual Association Test (VAT) in a single test session and underwent magnetic resonance imaging. We performed receiver operating curve analysis to investigate the VAT’s discriminatory ability between AD dementia and other diagnoses and compared it to that of other episodic memory tests. We tested associations between VAT performance and medial temporal lobe atrophy (MTA), and amyloid status (n = 2,769, 77%). Results: Patients with AD dementia performed worse on the VAT than all other patients. The VAT discriminated well between AD and other types of dementia (area under the curve range 0.70–0.86), better than other episodic memory tests. Six-hundred forty patients (17.8%) learned all associations on VAT-A, but not on VAT-B, and they were more likely to have higher MTA scores (odds ratios range 1.63 (MTA 0.5) through 5.13 for MTA ≥ 3, all p < .001) and to be amyloid positive (odds ratio = 3.38, 95%CI = [2.71, 4.22], p < .001) than patients who learned all associations on both sets. Conclusions: Performance on the VAT, especially on a second set administered immediately after the first, discriminates AD from other types of dementia and is associated with MTA and amyloid positivity. The VAT might be a useful, simple tool to assess early episodic memory deficits in the presence of AD pathology.

中文翻译：

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视觉联想学习可检测早期情景记忆缺陷并将阿尔茨海默病与其他类型的痴呆症区分开来

目的：我们研究了视觉联想学习任务如何区分阿尔茨海默病 (AD) 痴呆与其他类型的痴呆，以及它与 AD 病理学的关系。方法：来自阿姆斯特丹痴呆症队列的 3,599 名患者（63.9 ± 8.9 岁，41% 女性）在一次测试中完成了两组视觉关联测试 (VAT)，并接受了磁共振成像。我们进行了受试者工作曲线分析，以研究 VAT 对 AD 痴呆和其他诊断的区分能力，并将其与其他情景记忆测试进行比较。我们测试了增值税表现与内侧颞叶萎缩（MTA）和淀粉样蛋白状态之间的关联（n= 2,769, 77%）。结果：AD 痴呆患者的增值税表现比所有其他患者更差。VAT 可以很好地区分 AD 和其他类型的痴呆症（曲线下面积 0.70-0.86），优于其他情景记忆测试。640 名患者 (17.8%) 了解了 VAT-A 的所有关联，但没有了解 VAT-B 的所有关联，并且他们更有可能具有较高的 MTA 评分（对于 MTA ≥ 3，比值比范围为 1.63 (MTA 0.5) 至 5.13，全部p< .001）且淀粉样蛋白呈阳性（比值比 = 3.38，95%CI = [2.71, 4.22]，p< .001）比在两组上都了解所有关联的患者要好。结论：VAT 的表现，尤其是在第一组之后立即进行的第二组，可以将 AD 与其他类型的痴呆区分开来，并且与 MTA 和淀粉样蛋白阳性相关。VAT 可能是一种有用且简单的工具，可用于评估 AD 病理情况下的早期情景记忆缺陷。