Evaluating the Validity of Story Retelling and Nonsense Phrase Repetition Tests for Diagnosing Mild Cognitive Impairment in Older Adults.

BACKGROUND

Emerging evidence suggests that impairments in language processing serve as early indicators of mild cognitive impairment (MCI) in older adults. This study examines the diagnostic utility of two easily administered language comprehension and retention tests in differentiating healthy older adults from those clinically diagnosed with MCI.

METHODS

A total of 32 individuals diagnosed with MCI and 43 cognitively healthy elderly participated in five assessments: story-retelling, nonsense phrase repetition, the Montreal Cognitive Assessment (MoCA), Instrumental Activities of Daily Living (IADLs), and the Geriatric Depression Scale (GDS). The first two assessments were designed to evaluate linguistic performance, whereas the remaining three were employed to assess overall cognitive function. Each test was administered individually, with sufficient time allocated for completion.

RESULTS

Statistical analyses revealed significant differences between the two groups, as indicated by the odds ratio, underscoring the ability of these assessments to distinguish individuals with MCI from healthy controls. Among the cognitive tests, the story-retelling task demonstrated the highest area under the ROC curve (AUC), affirming its strong diagnostic accuracy. With an optimal immediate story-retelling cut-off score of 12.5, the test yielded high sensitivity (92%) and specificity (76.7%), reinforcing its reliability in detecting MCI. These findings highlight the effectiveness of narrative recall tasks in identifying early cognitive decline and their potential clinical application in screening protocols.

CONCLUSION

Linguistic changes precede cognitive deterioration, making language-based assessments vital for early MCI detection. This study confirms that story-retelling tasks effectively differentiate individuals with MCI from healthy controls by evaluating verbal memory, organisational coherence, and recall. Given the subtle nature of these linguistic shifts, standardised language tests with normative benchmarks should be incorporated into screening protocols. Speech-language pathologists play a crucial role in detecting early cognitive decline, highlighting the importance of language-based assessments in MCI diagnosis.