Memory Binding Test Predicts Incident Dementia: Results from the Einstein Aging Study

Background: The Memory Binding Test (MBT) demonstrated good cross-sectional discriminative validity and predicted incident aMCI. Objective: To assess whether the MBT predicts incident dementia better than a conventional list learning test in a longitudinal community-based study. Methods: As a sub-study in the Einstein Aging Study, 309 participants age >= 70 initially free of dementia were administered the MBT and followed annually for incident dementia for up to 13 years. Based on previous work, poor memory binding was defined using an optimal empirical cut-score of <= 17 on the binding measure of the MBT, Total Items in the Paired condition (TIP). Cox proportional hazards models were used to assess predictive validity adjusting for covariates. We compared the predictive validity of MBT TIP to that of the free and cued selective reminding test free recall score (FCSRT-FR; cut-score: <= 24) and the single list recall measure of the MBT, Cued Recalled from List 1 (CR-L1; cut-score: <= 12). Results: Thirty-five of 309 participants developed incident dementia. When assessing each test alone, the hazard ratio (HR)for dementia was significant for MBT TIP (HR = 8.58, 95% CI: (3.58, 20.58), p < 0.0001), FCSRT-FR (HR = 4.19, 95% CI: (1.94, 9.04), p = 0.0003) and MBT CR-L1 (HR = 2.91, 95% CI: (1.37, 6.18), p = 0.006). MBT TIP remained a significant predictor of dementia (p = 0.0002) when adjusting for FCSRT-FR or CR-L1. Conclusions: Older adults with poor memory binding as measured by the MBT TIP were at increased risk for incident dementia. This measure outperforms conventional episodic memory measures of free and cued recall, supporting the memory binding hypothesis.