More research is needed to identify measures that are sensitive to the early brain changes associated with Alzheimer's disease (AD). Studies suggest that associative memory is one of the first cognitive functions to decline in individuals at high risk to develop AD (Papp et al., 2015). We examined whether levels of brain pathology (e.g. tau and amyloid) relate to performance on an associative memory test, the Free and Cued Selective Reminding Test (FCSRT), in non-demented individuals with autosomal-dominant AD (ADAD), who are virtually destined to develop dementia in their forties. Twenty-four Presenilin-1 E280A carriers and twenty-nine non-carriers ages 27–55 years underwent neuropsychological testing, including the FCSRT, which uses controlled learning and cued recall. Amyloid burden was measured using PiB PET cerebral-to-cerebellar DVR, and tau was measured using Flortaucipir PET cerebral-to-cerebellar SUVR. PET images were analyzed using structural ROIs defined by Freesurfer. Linear regressions were used to examine the relationships between AD pathology burden, age and performance on the test (free immediate and delayed, and cued immediate and delayed recall). Carriers had lower FCSRT scores compared to non-carriers.In all carriers, greater age, cortical mean amyloid and regional tau pathology predicted lower FCSRT scores. In unimpaired carriers, greater amyloid burden predicted worse delayed free recall. Further, greater entorhinal tau predicted worse performance on all free recall scores, while greater inferior temporal tau predicted worse immediate free recall only. Performance on the FCSRT distinguished individuals at genetic risk for dementia from unimpaired non-carriers. Changes on free recall performance were seen earlier in the disease trajectory, followed by changes on cued recall performance. FCSRT may be a useful measure to identify individuals at increased risk for AD and track disease progression.