The “dementia profile” is used to reduce false positives on the Word Memory Test (WMT). Provided that this profile reflects genuine memory impairment, corresponding cognitive deficits should be found in neuropsychological testing. We examined whether a WMT dementia profile is a significant indicator of cognitive impairment and/or decline. In addition, we evaluated the classification accuracy for the clinical diagnosis of dementia. Elderly patients (n = 167) with cognitive complaints were given an extensive neuropsychological test battery, including the WMT. This was repeated 2 years later. The results demonstrate that patients with the dementia profile have a higher chance of showing real cognitive impairment at baseline, and even more so 2 years later. They showed a faster cognitive decline than patients who passed the WMT effort subtasks. Sensitivity of the profile was a moderate 60%. However, the positive predictive value was high, viz. 81% at baseline and 93% at follow-up.