Neuropsychological function in Alzheimer's disease. Pattern of impairment and rates of progression.

Although patients with Alzheimer's disease (AD) generally have impairments in multiple areas of cognitive function, there are those patients who appear to have neuropsychological deficits more prominent in one domain than in other domains. We examined the neuropsychological status of 86 patients with probable AD and 92 elderly control subjects and identified the patterns of impairments in the patients with AD. Independent deficits of visuoconstructional and lexical/semantic abilities were identified in a subset of patients by a principal components analysis. Individual patients were identified who were predominantly impaired in one, but not the other, neuropsychological domain. There were no striking relationships between the demographic characteristics of the patients and their pattern of deficits at the initial evaluation. There were no significant differences in age at onset or rate of progression of dementia among patients with different patterns of cognitive dysfunction. A review of the results of this and other studies suggests that the language impairment in AD may be associated with two distinct neuropsychological abnormalities: a lexical/semantic impairment that is unrelated to onset or progression of symptoms, and a syntactic impairment that may be associated with earlier onset and more rapid progression of dementia.

[1]  B. Seltzer,et al.  A comparison of clinical features in early- and late-onset primary degenerative dementia. One entity or two? , 1983, Archives of neurology.

[2]  A. Rey.  Lexamen psychologique : Dans les cas d'encephalopathie traumatique (Les problemes) , 1941 .

[3]  J. Becker,et al.  Normal Rates of Forgetting of Verbal and Non-Verbal Material in Alzheimer's Disease , 1987, Cortex.

[4]  H. Chui,et al.  Clinical subtypes of dementia of the Alzheimer type , 1985, Neurology.

[5]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[6]  A. Kertesz.  The Western Aphasia Battery , 1982 .

[7]  M. Roth,et al.  The Association Between Quantitative Measures of Dementia and of Senile Change in the Cerebral Grey Matter of Elderly Subjects , 1968, British Journal of Psychiatry.

[8]  P. Osterrieth.  Le test de copie d'une figure complexe , 1944 .

[9]  D. A. Kenny,et al.  Estimating the effects of social interventions , 1981 .

[10]  J. Becker,et al.  Cognitive deficits and clinical diagnosis of Alzheimer's disease , 1987, Neurology.

[11]  E. Kaplan,et al.  The Boston naming test , 2001 .

[12]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[13]  P. Osterrieth,et al.  Le test de copie d'une figure complexe; contribution à l'étude de la perception et de la mémoire. , 1944 .

[14]  S. Corkin,et al.  Equivalent forms of the Boston Naming Test. , 1986, Journal of Clinical and Experimental Neuropsychology.

[15]  C. McDonald.  Clinical Heterogeneity in Senile Dementia , 1969, British Journal of Psychiatry.

[16]  R. Heaton,et al.  Neuropsychologic features of early- and late-onset Alzheimer's disease. , 1986, Archives of neurology.

[17]  Suzanne Corkin,et al.  Semantic impairment and anomia in Alzheimer's disease , 1986, Brain and Language.

[18]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[19]  D. Wechsler.  A Standardized Memory Scale for Clinical Use , 1945 .

[20]  J Marshall,et al.  Cerebral blood flow in dementia. , 1975, Archives of neurology.

[21]  T. Shallice.  Specific impairments of planning. , 1982, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[22]  R. Katzman.,et al.  Biopsy‐proved Alzheimer disease presenting as a right parietal lobe syndrome , 1982, Annals of neurology.

[23]  M. Hamilton,et al.  Development of a rating scale for primary depressive illness. , 1967, The British journal of social and clinical psychology.

[24]  T J Rosen,et al.  Age at Onset and Rate of Progression of Alzheimer's Disease , 1987, Journal of the American Geriatrics Society.

[25]  W. Kapoor,et al.  A controlled study of survival with dementia. , 1987, Archives of neurology.