Analysis of the episodic memory deficit in early Alzheimer's disease: evidence from the doors and people test.

Anterograde episodic memory was assessed in a cohort of 33 patients with early dementia of Alzheimer type (DAT) and 30 matched controls using immediate and delayed prose recall, the CERAD word learning test and the recently developed doors and people test of visual and verbal recall and recognition. DAT patients showed markedly impaired learning on all three measures, with little evidence of cumulation of information across trials. Patients showed more forgetting than controls on prose recall and the CERAD word list, but more detailed analysis suggested that this differential loss was attributable to the contribution of primary memory to immediate but not delayed recall. No differences in forgetting rate were observed on the doors and people test. Scaled scores were used to derive a recall-recognition index, together with a measure of material-specific memory based on the ratio of verbal to visual memory deficits. There was no evidence for differential sensitivity of recall over recognition, implying that the episodic memory deficit is one of learning, rather than of the retrieval of learned material. Although individuals varied in the relative degree of impairment of verbal and visual memory, there was no general tendency for material-specificity. It was concluded that the episodic memory deficit in DAT is general in nature and primarily reflects impaired learning rather than accelerated forgetting or disrupted retrieval.