What methods are used to test short term memory?

Methods for Testing Short-Term Memory

The most effective approach to testing short-term memory involves using standardized word-list learning tests that assess both immediate and delayed recall, allowing clinicians to determine retention over time. 1

Standardized Clinical Tests

Word-List Learning Tests

• The Free and Cued Selective Reminding Test, Rey Auditory Verbal Learning Test, and California Verbal Learning Test are recommended word-list learning tests that reveal learning rate and maximum acquisition over multiple trials 1
• These tests demonstrate whether the patient is paying attention during immediate recall, establishing a baseline to assess relative material retention on delayed recall 1
• The Hopkins Verbal Learning Test-Revised (HVLT-R) is preferred for its multiple alternate forms, use in clinical trials, and relatively brief administration time 1
• The California Verbal Learning Test-Second Edition (CVLT-2) is an alternative that provides additional information through cued recall and interference lists 1

Paragraph and Visual Memory Tests

• Immediate and delayed recall of paragraphs such as the Logical Memory I and II of the Wechsler Memory Scale Revised can assess verbal memory 1
• Immediate and delayed recall of nonverbal materials, such as the Visual Reproduction subtests of the Wechsler Memory Scale-Revised I and II, evaluate visual memory 1

Brief Clinical Assessment Tools

Montreal Cognitive Assessment (MoCA)

• The MoCA includes a 5-word immediate and delayed memory test that can be administered in 10-15 minutes 1, 2
• It has higher sensitivity (90%) for detecting mild cognitive impairment compared to the MMSE 2
• The MoCA can be used without permission for clinical or educational non-commercial purposes 1

Mini-Cog

• Combines three-item word recall and clock drawing test, taking only 2-4 minutes to administer 2
• Has high sensitivity (76%) and specificity (89%) for detecting cognitive impairment 2
• Recommended by the Alzheimer's Association and American Academy of Family Physicians for cognitive screening 2

Informal Clinical Techniques

Simple Office-Based Methods

• Ask a patient to learn a street address and recall it after a delay of a few minutes (e.g., John Brown, 42 Market Street, Chicago) 1
• Ask the patient to name three objects (e.g., pen, paper clip, dollar bill), place them in different locations, and recall both objects and locations after a brief delay 1
• These approaches are easy to perform during an office visit but may be insensitive to subtle cognitive dysfunction in early stages of impairment 1

Computerized Assessment Options

Automated Testing Systems

• Computerized cognitive assessments provide standardized administration and automated scoring 1
• The Cognitive Drug Research Computerized Assessment System has been used in multiple clinical trials 1
• Computerized tests may be more sensitive in detecting cognitive fluctuations than traditional paper-and-pencil measures 1
• These tests can be administered remotely and may provide increased sensitivity to change compared to pen-and-paper tests 1

Clinical Implementation Considerations

Test Selection Factors

• Consider the patient's education level, language, and whether you need to detect mild cognitive impairment versus dementia 2
• Brief cognitive tests should reinforce—but never substitute—clinical judgment 3
• Combining an informant questionnaire with brief cognitive tests improves detection of cognitive impairment 3

Common Pitfalls

• Brief informal tests are often insensitive to subtle cognitive dysfunction during early stages of impairment 1
• The Mini-Mental State Examination's 3-word recall test may be insensitive to subtle memory impairment 1
• Test scores alone are not a diagnosis and must be interpreted in the context of a comprehensive evaluation 2
• Scores must be interpreted considering the patient's age and educational background 1

By using these standardized approaches to test short-term memory, clinicians can effectively identify memory impairments and contribute to early detection of cognitive disorders that impact morbidity, mortality, and quality of life.