Six-year changes in immediate visual memory performance assessed by the Benton Visual Retention (BVR) test predicted Alzheimer's disease (AD) prior to its onset. Subjects of this study were 371 community-dwelling adult participants in the Baltimore Longitudinal Study of Aging, seven of whom received probable or definite AD diagnoses using DSM-III-R and NINCDS-ADRDA criteria. Subjects with diagnoses of AD had larger changes in immediate memory performance over the 6-year interval prior to the estimated onset of their disease than subjects without AD. Six-year longitudinal change as well as level in immediate visual memory performance also predicted subsequent cognitive performance 6–15 and 16–22 years later, even after adjusting for the influences of age, general ability, and initial immediate memory. These results provide evidence that change and level in immediate visual memory performance has long-term prognostic significance over as many as 16–22 years. These results further suggest that change in recent memory performance, an important component in AD diagnoses, may be an important precursor of the development of the disease.

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