With an increasing focus on biomarkers in dementia research, illustrating the role of neuropsychological assessment in detecting mild cognitive impairment (MCI) and Alzheimer’s dementia (AD) is important. This systematic review and meta-analysis, conducted in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) standards, summarizes the sensitivity and specificity of memory measures in individuals with MCI and AD. Both meta-analytic and qualitative examination of AD versus healthy control (HC) studies (n = 47) revealed generally high sensitivity and specificity (≥ 80% for AD comparisons) for measures of immediate (sensitivity = 87%, specificity = 88%) and delayed memory (sensitivity = 89%, specificity = 89%), especially those involving word-list recall. Examination of MCI versus HC studies (n = 38) revealed generally lower diagnostic accuracy for both immediate (sensitivity = 72%, specificity = 81%) and delayed memory (sensitivity = 75%, specificity = 81%). Measures that differentiated AD from other conditions (n = 10 studies) yielded mixed results, with generally high sensitivity in the context of low or variable specificity. Results confirm that memory measures have high diagnostic accuracy for identification of AD, are promising but require further refinement for identification of MCI, and provide support for ongoing investigation of neuropsychological assessment as a cognitive biomarker of preclinical AD. Emphasizing diagnostic test accuracy statistics over null hypothesis testing in future studies will promote the ongoing use of neuropsychological tests as Alzheimer’s disease research and clinical criteria increasingly rely upon cerebrospinal fluid (CSF) and neuroimaging biomarkers.

中文翻译：

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阿尔茨海默氏痴呆和轻度认知障碍记忆测量的诊断准确性：系统回顾和荟萃分析

随着痴呆症研究中生物标志物的日益受到关注，阐明神经心理学评估在检测轻度认知障碍 (MCI) 和阿尔茨海默氏痴呆 (AD) 中的作用非常重要。这项系统评价和荟萃分析是根据 PRISMA（系统评价和荟萃分析的首选报告项目）标准进行的，总结了 MCI 和 AD 患者记忆测量的敏感性和特异性。AD 与健康对照 (HC) 研究 ( n = 47)的荟萃分析和定性检查均 显示，对于立即测量，通常具有较高的敏感性和特异性（AD 比较≥ 80%）（敏感性 = 87%，特异性 = 88%）和延迟记忆（敏感性 = 89%，特异性 = 89%），尤其是涉及单词列表回忆的记忆。MCI 与 HC 研究 ( n  = 38) 的检查显示，即时记忆（敏感性 = 72%，特异性 = 81%）和延迟记忆（敏感性 = 75%，特异性 = 81%）的诊断准确性普遍较低。将 AD 与其他疾病区分开来的措施（n  = 10 项研究）产生了不同的结果，在特异性较低或可变的情况下，敏感性通常较高。结果证实，记忆测量对于 AD 的识别具有很高的诊断准确性，对于 MCI 的识别很有希望，但需要进一步完善，并为正在进行的神经心理学评估作为临床前 AD 认知生物标志物的研究提供支持。在未来的研究中强调诊断测试准确性统计而不是零假设测试将促进神经心理学测试的持续使用，因为阿尔茨海默病研究和临床标准越来越依赖于脑脊液（CSF）和神经影像生物标志物。