Proper Name Recall as an Early Indicator of Preclinical Alzheimer’s Disease Pathology

ABSTRACT Background Early detection of Alzheimer’s disease (AD) is crucial; however, standard neuropsychological tests often lack sensitivity. Process scores, such as proper name (PN) recall from Logical Memory (LM), may improve the detection of AD-related biomarker positivity. We examined whether baseline PN recall predicted future cerebrospinal fluid (CSF) amyloid (Aβ42/Aβ40) and tau (pTau 181 ) status, and whether biomarker status predicted PN recall trajectories. Methods We analyzed 271 cognitively unimpaired BIOCARD participants (mean age = 57.3, 60.3% female, mean follow-up = 15.5) using logistic regression and mixed-effects models to examine the associations between PN recall and CSF biomarkers. Results Higher baseline PN recall predicted lower amyloid positivity (odds ratio [OR] = 0.72, p = 0.015). Amyloid and tau positivity have been linked to a faster decline in PN. Biomarker-positive participants in the biomarker-negative group lacked practice effects. Conclusions PN recall predicts future AD biomarker positivity and may enhance early detection of AD-related cognitive decline.