- Email: [email protected]
Cross-modal matching in patients with Alzheimer's disease
THIRD INTERNATIONAL
CONFERENCE
ON ALZHEIMER’S
DISEASE
Piccinin and M. Piccirilli. Dept. of Neurology, University of Perugia, 06100 Perugia, Italy. constitute one of the earliest and mOst Memory deficits of dementlng diseases. The identification Of prominent signs several forms of mnestic processes suggests that memory tasks can be used to correctly diagnose patients suffering from different dementia syndromes. This work was designed to check if it is mssible to highlight selective patterns of memory performances in vascular (VD) and Alzheimer-typ (DAT) dementias, which would be useful for discriminating between the two forms of mental who fulfilled the criteria of the deterioration. 30 patients DSM-III-R for DAT and VD, rispectively, partecipated to the st_Ldy. Moreover, patients diagnosed as DAT (mean age 63.9 yrs) met the criteria for probable DAT of NINCDS-ADRDA work group, and pdtients diagnosed as VD (mean age 63.6 yrs) had ischemic score modified by Loeb of more than 4. We include only patients who in the cause of extensive neuropsychological examination displayed a rmld to moderate cognitive impairment and no presented deficits of instrumental functions. 15 healthy subjects (mean age 61 .6 yrs) matched for educational level, were selected as a control group. The memory performances were investigated by using the following tasks: WAIS diglt forward repetition test and Rey Auditory-Verb& Learning test for verbal memory; Corsi’s cubes, Rey-Osterrieth complex figure design and Barbizet-Canv’s 7/24 test For vlsuospdtial memory. This battery includes d Serles of Items concerned with working memory and secondary memory in Its declarative form. The results indicate that neuropsychological memory testing iS d reliable rre!dsLLrefor the early detection of dementia. The value of mnesic skills in the differentla diagnosis of specific patterns of mental impairment is rr0i”e Intriguing. However, VD wdS associated especiallv with a disorder in recognition mzory, for the knowledge of suggesting that this defect can be helpful memorv functioning in the dementing illness.
36 Test-retest reliability of patient and caregiver related measures in dementia. SRJA de Rooij, S Teunisse, GJM Walstra Dept. of Neurology, Academisch Medisch Centrum, 1105 AZ Amsterdam, The Netherlands. In order to get a complete picture of the overall severity of dementia one has to take into account not only cognitive impairment but also disability in daily life and behavioral disturbance of the patient, and burden experienced by the caregiver. One of our ongoing research projects concerns the effect of therapeutic intervention in dementia. Within this scope we developed a study concerning the test-retest reliability of measures related to the disability in daily life and behavioral disturbances of the patient, and burden experienced by the caregiver. Subjects were primary caregivers (N=30) of dementia patients, visiting our Memory Clinic. Most patients were living at home. Test-retest period was two weeks. Measures were completed by the caregivers. Preliminary results concerning the repeatability of these measures look satisfactory. The frequency of contact between caregiver and patient is taken into account. This study was lingsgeneeskunde
supported by OG90-027.
the
fund
Ontwikke-
The aim
of this
impaired
on cross-modal
study
was
to investigate
matching
whether
Alzherner
patlents
would
be
tasks
METHOD: The performance of 2 groups were exammed a control group (n=6) and a patlent group with probable dementia of the Alzhelmer’s type as outllned Mean CAflCOG score (the by NINCDS-ADRDA criterra (n-10). neuropsychological component of the CAMDEX of Roth et ~1.1986) was 57 4 The 4 condltlons of testmg included two (SD-14 0. range 38 0 to 74 0) (Z)tactile-tactlle & Intra-modal matching tasks Ivisual-visual
(I
two-cross-modal
matching
tasks
(3)tactlle-visual
(4klsual-tactlIe
Visual stirnull consisted of random abstract designs drawn I” Ink on white Tactual stIrnull consisted of (a) 5 raised dot patterns constructed from I
card
tacked
onto board
were
sanded
and panted
RESULTS for the
(b) 6 copper black
wre
to create
patterns
glued onto boards
a consistent
tactile
severely U-4.5, unpared
ImpaIred on p
modahties (touch and vismn) time perwds of only a few
the Alzhelmer tactlIe memory
group on tactile-tactale impairment rather
are
delayed
tactile-tactile
planned
REFERENCES Butters N & Brady
to
investigate
performance B A (1968)
tactile-tactlle Alzheimer
than this will
The role
and that tactlle memory for objects seconds IS affected The deficits I”
matching, we feel, tend to Indicate a Future a sensory speclflc deflclt problem
where
both
immediate
early detection We acknowledge
of the left
F et al(1986) CAMDEX d,sorder I” the elderly
of dementia assistance
Brat from
and
parwtal
lobe III the mediation
be assessed
of the intraand cross-modal assoclatlons, Cortex,4.328-343 Butters N. Barton M & Brody B A (1970) Role of right parletal medlallon of cross-modal assoclatlons and reversible OperalIonS Cortex.6.174-190 Roth M. Tym E. Mountjoy the d,agons,s of mental
defwt patients
tactlle-wwal cross-modal matching results suggest that Alzheimer patients to integrate sensory Information from
different sense over very brief
studies
nails
texture
AND CONCLUSIONS: Results Indicate a slgmflcant Alzhemw group (Mann-Whitney U-9 5, p
were also (Mann-Whitney we severely
The boards
lobe In
I” the space,
A standardised Instrument for with special reference to the
J Psychlatry,149.698-709 The Wellcome Trust.
Women
of Lothian
38 DELUSIONS IN MULTI-INFARCT DEMENTIA AND IN ALZHEIMER’S DISEASE. G Binetti, 0 Zanetti,GB Frisoni, A Scuratti, D. DeLeo*,
A Bianchetti. M Trabucchi. Alzheimer's Dementia Care Unit, 1st S.CuoreFBF, Brescia, Italy. *Ist Psicogeriatria, Univ Padova, Italy. Memory loss is the hallmark of Alzheimer’s disease (AD) and multinfarct dementia (MID). However, psychotic symptoms have also been reported. Delusions have been found in 13% to 73% of patients with AD and in up to 40% of patients with MID. The present study was designed to investigate the frequency, the content and the prognostic significance of the presence of delusions during the disease in 61 subjects with AD and 31 subjects with MID. There was no difference in the frequency of delusions in the two diagnostic categories. Twenty-eight of 61 patients with AD and 12 of 31 patients with MID had experienced delusional beliefs at some point in the course of the illness. Eighteen patients with AD and 11 with MID had exhibited delusions during the first year of their diseases. The contents of the delusions were similars in the two groups and consisted of paranoid beliefs (AD: 42%; MID: 71%) and misidentifications delusions (AD: 58%; MID: 29%). A statistical significant difference was found in dementia severity as reflected by Mini Mental State Examination (MMSE), Activity of Daily Living(ADL) and Global Deterioration Scale (CDS) scores, between patients who exhibited or didn’t exhibite delusions during the disease. The patients who had experienced delusions during the illness, now show a higher MMSE score and a lower ADL and GDS score. The high frequency of delusions identified in this study (AD: 48% and MID: 38%) agrees with data shown in previous studies. Delusions have been reported frequently in the early phases of the illness, when the cognitive decline is relative mild and didn’t increase with increasing dementia severity. These data show a relative higher frequency of misidentification syndromes but no significant relationship was found between these delusions and MMSE, GDS, ADL scores. The presence of psychosis during the illness wasn’t associated with more rapid cognitive decline, but in contrast, it could be considered a good prognostic sign for the intellectual and functional decline.
37 CROSS-tlODAL MATCHING IN PATIENTS WITH ALZHEIMER’S L Bach. R Hunter. D N Brooks and J McCulloch. Wellcame University of Glasgow. Scotland INTRODUCTION:
The parietal
lobes
are
thought
to be involved
DISEASE. Neuroscience
perception of In humans, the
in the
somatosensory events and the integration of sensory input parietal lobes have been implicated in cross-modal matching(Butters al,l968,1970). cross-modal
Patients with left parietal matching tasks (tactile-visual,
damage were visual-tactlle.
Group,
et impalred on three auditory-visual),
39 CORRELATION BBTWEBN DEMENTIA AND VISUAL OR HEARING DEFICIT. n. c. Mizzoni, G. Neroni-Mercati, G. Tatangelo, B. Giannandrea and S. Bonaiuto. I.N.R.C.A.; 62010 Appignano (MC). Italy. The purpose of this study was to investigatethe possible correlationbetween dementia and visual or hearim deficit.
CONFERENCE
ON ALZHEIMER’S
DISEASE
Piccinin and M. Piccirilli. Dept. of Neurology, University of Perugia, 06100 Perugia, Italy. constitute one of the earliest and mOst Memory deficits of dementlng diseases. The identification Of prominent signs several forms of mnestic processes suggests that memory tasks can be used to correctly diagnose patients suffering from different dementia syndromes. This work was designed to check if it is mssible to highlight selective patterns of memory performances in vascular (VD) and Alzheimer-typ (DAT) dementias, which would be useful for discriminating between the two forms of mental who fulfilled the criteria of the deterioration. 30 patients DSM-III-R for DAT and VD, rispectively, partecipated to the st_Ldy. Moreover, patients diagnosed as DAT (mean age 63.9 yrs) met the criteria for probable DAT of NINCDS-ADRDA work group, and pdtients diagnosed as VD (mean age 63.6 yrs) had ischemic score modified by Loeb of more than 4. We include only patients who in the cause of extensive neuropsychological examination displayed a rmld to moderate cognitive impairment and no presented deficits of instrumental functions. 15 healthy subjects (mean age 61 .6 yrs) matched for educational level, were selected as a control group. The memory performances were investigated by using the following tasks: WAIS diglt forward repetition test and Rey Auditory-Verb& Learning test for verbal memory; Corsi’s cubes, Rey-Osterrieth complex figure design and Barbizet-Canv’s 7/24 test For vlsuospdtial memory. This battery includes d Serles of Items concerned with working memory and secondary memory in Its declarative form. The results indicate that neuropsychological memory testing iS d reliable rre!dsLLrefor the early detection of dementia. The value of mnesic skills in the differentla diagnosis of specific patterns of mental impairment is rr0i”e Intriguing. However, VD wdS associated especiallv with a disorder in recognition mzory, for the knowledge of suggesting that this defect can be helpful memorv functioning in the dementing illness.
36 Test-retest reliability of patient and caregiver related measures in dementia. SRJA de Rooij, S Teunisse, GJM Walstra Dept. of Neurology, Academisch Medisch Centrum, 1105 AZ Amsterdam, The Netherlands. In order to get a complete picture of the overall severity of dementia one has to take into account not only cognitive impairment but also disability in daily life and behavioral disturbance of the patient, and burden experienced by the caregiver. One of our ongoing research projects concerns the effect of therapeutic intervention in dementia. Within this scope we developed a study concerning the test-retest reliability of measures related to the disability in daily life and behavioral disturbances of the patient, and burden experienced by the caregiver. Subjects were primary caregivers (N=30) of dementia patients, visiting our Memory Clinic. Most patients were living at home. Test-retest period was two weeks. Measures were completed by the caregivers. Preliminary results concerning the repeatability of these measures look satisfactory. The frequency of contact between caregiver and patient is taken into account. This study was lingsgeneeskunde
supported by OG90-027.
the
fund
Ontwikke-
The aim
of this
impaired
on cross-modal
study
was
to investigate
matching
whether
Alzherner
patlents
would
be
tasks
METHOD: The performance of 2 groups were exammed a control group (n=6) and a patlent group with probable dementia of the Alzhelmer’s type as outllned Mean CAflCOG score (the by NINCDS-ADRDA criterra (n-10). neuropsychological component of the CAMDEX of Roth et ~1.1986) was 57 4 The 4 condltlons of testmg included two (SD-14 0. range 38 0 to 74 0) (Z)tactile-tactlle & Intra-modal matching tasks Ivisual-visual
(I
two-cross-modal
matching
tasks
(3)tactlle-visual
(4klsual-tactlIe
Visual stirnull consisted of random abstract designs drawn I” Ink on white Tactual stIrnull consisted of (a) 5 raised dot patterns constructed from I
card
tacked
onto board
were
sanded
and panted
RESULTS for the
(b) 6 copper black
wre
to create
patterns
glued onto boards
a consistent
tactile
severely U-4.5, unpared
ImpaIred on p
modahties (touch and vismn) time perwds of only a few
the Alzhelmer tactlIe memory
group on tactile-tactale impairment rather
are
delayed
tactile-tactile
planned
REFERENCES Butters N & Brady
to
investigate
performance B A (1968)
tactile-tactlle Alzheimer
than this will
The role
and that tactlle memory for objects seconds IS affected The deficits I”
matching, we feel, tend to Indicate a Future a sensory speclflc deflclt problem
where
both
immediate
early detection We acknowledge
of the left
F et al(1986) CAMDEX d,sorder I” the elderly
of dementia assistance
Brat from
and
parwtal
lobe III the mediation
be assessed
of the intraand cross-modal assoclatlons, Cortex,4.328-343 Butters N. Barton M & Brody B A (1970) Role of right parletal medlallon of cross-modal assoclatlons and reversible OperalIonS Cortex.6.174-190 Roth M. Tym E. Mountjoy the d,agons,s of mental
defwt patients
tactlle-wwal cross-modal matching results suggest that Alzheimer patients to integrate sensory Information from
different sense over very brief
studies
nails
texture
AND CONCLUSIONS: Results Indicate a slgmflcant Alzhemw group (Mann-Whitney U-9 5, p
were also (Mann-Whitney we severely
The boards
lobe In
I” the space,
A standardised Instrument for with special reference to the
J Psychlatry,149.698-709 The Wellcome Trust.
Women
of Lothian
38 DELUSIONS IN MULTI-INFARCT DEMENTIA AND IN ALZHEIMER’S DISEASE. G Binetti, 0 Zanetti,GB Frisoni, A Scuratti, D. DeLeo*,
A Bianchetti. M Trabucchi. Alzheimer's Dementia Care Unit, 1st S.CuoreFBF, Brescia, Italy. *Ist Psicogeriatria, Univ Padova, Italy. Memory loss is the hallmark of Alzheimer’s disease (AD) and multinfarct dementia (MID). However, psychotic symptoms have also been reported. Delusions have been found in 13% to 73% of patients with AD and in up to 40% of patients with MID. The present study was designed to investigate the frequency, the content and the prognostic significance of the presence of delusions during the disease in 61 subjects with AD and 31 subjects with MID. There was no difference in the frequency of delusions in the two diagnostic categories. Twenty-eight of 61 patients with AD and 12 of 31 patients with MID had experienced delusional beliefs at some point in the course of the illness. Eighteen patients with AD and 11 with MID had exhibited delusions during the first year of their diseases. The contents of the delusions were similars in the two groups and consisted of paranoid beliefs (AD: 42%; MID: 71%) and misidentifications delusions (AD: 58%; MID: 29%). A statistical significant difference was found in dementia severity as reflected by Mini Mental State Examination (MMSE), Activity of Daily Living(ADL) and Global Deterioration Scale (CDS) scores, between patients who exhibited or didn’t exhibite delusions during the disease. The patients who had experienced delusions during the illness, now show a higher MMSE score and a lower ADL and GDS score. The high frequency of delusions identified in this study (AD: 48% and MID: 38%) agrees with data shown in previous studies. Delusions have been reported frequently in the early phases of the illness, when the cognitive decline is relative mild and didn’t increase with increasing dementia severity. These data show a relative higher frequency of misidentification syndromes but no significant relationship was found between these delusions and MMSE, GDS, ADL scores. The presence of psychosis during the illness wasn’t associated with more rapid cognitive decline, but in contrast, it could be considered a good prognostic sign for the intellectual and functional decline.
37 CROSS-tlODAL MATCHING IN PATIENTS WITH ALZHEIMER’S L Bach. R Hunter. D N Brooks and J McCulloch. Wellcame University of Glasgow. Scotland INTRODUCTION:
The parietal
lobes
are
thought
to be involved
DISEASE. Neuroscience
perception of In humans, the
in the
somatosensory events and the integration of sensory input parietal lobes have been implicated in cross-modal matching(Butters al,l968,1970). cross-modal
Patients with left parietal matching tasks (tactile-visual,
damage were visual-tactlle.
Group,
et impalred on three auditory-visual),
39 CORRELATION BBTWEBN DEMENTIA AND VISUAL OR HEARING DEFICIT. n. c. Mizzoni, G. Neroni-Mercati, G. Tatangelo, B. Giannandrea and S. Bonaiuto. I.N.R.C.A.; 62010 Appignano (MC). Italy. The purpose of this study was to investigatethe possible correlationbetween dementia and visual or hearim deficit.