Doctor of Philosophy (PhD)



Document Type



Serial position effects (SPEs) have shown to be sensitive predictors of future cognitive decline (Bruno et al., 2013) and conversion from mild cognitive impairment (MCI) to Alzheimer’s disease (AD; Egli et al., 2014), even when accounting for total learning and memory scores. However, conflicting results have been found in the literature, which may be at least partially related to the many ways in which SPEs have been calculated. The current study aimed to address the discrepancies in the literature by examining SPEs in participants with and without MCI.

86 participants (57 healthy comparison, 29 MCI) completed the California Verbal Learning Test, Third Edition (CVLT3) and the Rey Auditory Verbal Learning Test (RAVLT), along with measures assessing multiple cognitive domains and self-reported emotional and functional status questionnaires. Each participant completed two visits, between 3 and 9 days apart, with a different memory measure administered on each day. To calculate serial position effects, the standard scoring approach (Delis et al., 2000) and the regional scoring approach (Foldi et al., 2003) were used.

Results showed that, when significant differences were found, SPEs were always reduced in the MCI group compared to the healthy comparison group when using regional scoring; however, results were not as consistent when using standard scoring. ROC analyses showed that only regional scoring of SPEs from delayed recall of the RAVLT and the CVLT3 accurately discriminated between those with and without MCI. Executive functioning was broadly related to words recalled from the middle region of the CVLT3 and the RAVLT. Although significant associations for executive functioning and trial 1 were only found on the CVLT3 and not the RAVLT, the correlations between these measures were not significantly different. SPEs from the RAVLT and the CVLT3 were broadly associated with a subjective measure of functional status, but demonstrated fewer associations with other measures of subjective cognitive complaints.

Overall, results suggest that regional scoring of SPEs may be more sensitive at identifying subtle cognitive decline compared to standard scoring. However, the specific measure that is used to analyze SPEs can impact the interpretation of findings.



Committee Chair

Calamia, Matthew



Available for download on Saturday, March 08, 2025