Parts are sometimes greater than the whole: Utilizing the WMS-IV LM Story A recognition score as an indicator of cognitive impairment.

Verbal memory measures have strong diagnostic utility in helping to identify cognitive impairment. Although the Wechsler Memory Scale-Fourth Edition (WMS-IV) is a commonly used memory measure, it has been less extensively studied than other verbal memory tests. The goal of the current study was to investigate whether examining recognition scores from individual stories within the WMS-IV Logical Memory (LM) subtest can help provide additional information above the total WMS-IV LM recognition score. Participants in the current study included 278 patients seen in a memory disorders clinic. Individuals underwent comprehensive neuropsychological evaluations and were diagnosed with either intact cognitive functioning (n = 69), mild neurocognitive disorder MiNCD (n = 160), or major neurocognitive disorder MaNCD (n = 49). Results showed that individuals with MaNCD performed worse than those with MiNCD on the WMS-IV LM Total Recognition score, WMS-IV LM Story A Recognition score and WMS-IV LM Story B Recognition score, as expected. However, the WMS-IV LM Story A Recognition score added incremental validity above and beyond the WMS-IV LM Story B Recognition score and the WMS-IV LM Total Recognition score in distinguishing between individuals with and without neurocognitive disorders. Specifically, a cutoff score of ≤ 6 provided maximum sensitivity and specificity in distinguishing between normal cognition and objective cognitive impairment. Findings suggest that the inclusion of the Recognition score from WMS-IV LM Story A can help improve diagnostic clarity when considered with other scores in a comprehensive neuropsychological battery.