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The Diagnostic and Predictive Accuracy of the Wechsler Memory Scale in Psychiatric Patients Over 65

Winwick Hospital, Warrington

ABSTRACT

A two-year follow-up study of 50 senile psychotics was carried out to establish more reliably the diagnosis of each case and to compare possible changes in diagnosis with Wechsler Memory Scale scores and changes in these following four repetitions of the test. In this way the validity of the Memory Scale with regard to the diagnosis of senile dementia could be more accurately evaluated.

The results showed that the presence of depression, or the adverse effect of long periods of hospitalization often resulted in an apparent memory disorder reflected both in a spuriously low first Memory Scale performance and a false diagnosis of dementia. After the fourth administration of the Scale, the final score and the extent to which the patient had been able to improve his performance were compared with the final diagnosis and outcome. There was a close relationship between significant improvement in test performance and a final diagnosis of a functional disorder, compared with the more limited improvement of the organic.

Additional analysis of the results on the Memory Scale sub-tests suggested that those patients subsequently diagnosed as brain-damaged showed most difficulty in learning new material, in contrast to those "functional" patients who showed this disability to a much less degree.

The results strongly suggested that a valid test of dementia should consist of a relatively pure measure of present learning ability, and that this could best be provided by successive repetitions of the test.