Measuring the Course of Alzheimer's Disease

On two occasions one year apart, the cognitive performance of 12 patients with presenile dementia Alzheimer type (ATD) and 14 with alcoholic Korsakoff syndrome (KS) was assessed both psychologically using the Christensen version of Luria's neuropsychological investigation and physiologically by measuring P300 (P3) and other long-latency auditory event-related potentials. All patients with ATD showed evidence of psychological deterioration and most also showed changes in auditory P3, whereas on all measures the KS group remained essentially unchanged. The extent of the changes in the ATD group varied, but in general those patients with most psychological deterioration also displayed the biggest changes in P3 wave form. There were two patterns of decline: a majority followed the traditional progressive course associated with Alzheimer disease; and in a minority, decline was slower. Methods for determining the rate of decline in individual patients with ATD, together with the prognostic implications, are discussed.

[1]  J. Rohrbaugh,et al.  Endogenous potentials generated in the human hippocampal formation and amygdala by infrequent events. , 1980, Science.

[2]  M. Kopelman,et al.  Multiple memory deficits in Alzheimer-type dementia: implications for pharmacotherapy , 1985, Psychological Medicine.

[3]  F E Bloom,et al.  P300 latency reflects the degree of cognitive decline in dementing illness. , 1986, Electroencephalography and clinical neurophysiology.

[4]  M. Sim,et al.  ALZHEIMER'S DISEASE: ITS NATURAL HISTORY AND DIFFERENTIAL DIAGNOSIS , 1962, The Journal of nervous and mental disease.

[5]  D. Clair,et al.  PREMATURE SENILITY IN DOWN'S SYNDROME , 1985, The Lancet.

[6]  D. Ingvar,et al.  Cognitive Reduction in Presenile Dementia Related to Regional Abnormalities of the Cerebral Blood Flow , 1976, British Journal of Psychiatry.

[7]  G K Wilcock,et al.  Anatomical correlates of the distribution of the pathological changes in the neocortex in Alzheimer disease. , 1985, Proceedings of the National Academy of Sciences of the United States of America.

[8]  G. V. Van Hoesen,et al.  Alzheimer's disease: cell-specific pathology isolates the hippocampal formation. , 1984, Science.

[9]  C. P. Hughes,et al.  Mild senile dementia of Alzheimer type: research diagnostic criteria, recruitment, and description of a study population. , 1982, Journal of neurology, neurosurgery, and psychiatry.

[10]  F H Duffy,et al.  Brain electrical activity in patients with presenile and senile dementia of the Alzheimer type , 1984, Annals of neurology.

[11]  H. Wiśniewski,et al.  Presenile Dementia: Clinical Aspects and Evaluation of Cerebrospinal Fluid Dynamics , 1973 .

[12]  A. Kaszniak,et al.  Predictors of mortality in presenile and senile dementia , 1978, Annals of neurology.

[13]  J E Christie,et al.  Changes in Auditory P3 Event-related Potential in Schizophrenia and Depression , 1987, British Journal of Psychiatry.

[14]  K. Squires,et al.  Long latency event-related components of the auditory evoked potential in dementia. , 1978, Brain : a journal of neurology.

[15]  On the value of P300 Event-Related Potentials in the Differential Diagnosis of Dementia , 1984, British Journal of Psychiatry.

[16]  D. Clair,et al.  P3 and other Long Latency Auditory Evoked Potentials in Presenile Dementia Alzheimer Type and Alcoholic Korsakoff Syndrome , 1985, British Journal of Psychiatry.

[17]  R. Sulkava,et al.  Alzheimer's disease and senile dementia of Alzheimer type , 1982 .