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Study of phonemic and semantic verbal fluencies in patients with Alzheimer's disease
Poster Presentations P1 assess the diagnostic accuracy of the Korean version ACE (K-ACE) in a Korean Population. Methods: A total of 168 subjects (70 Alzheimer dementia, 37 Mild cognitive impairment, 61 control) who visited the neurology outpatient clinic of Seoul Medical Center were included. ACE was translated and modified to K-ACE. Sensitivity, specificity, area under curve, reliability, and Verbal-Language/Orientation-Memory (VLOM) ratio were evaluated. The receiver operating characteristic (ROC) curve was used to determine optimal cut-off score in screening dementia. Results: The ROC curves showed the superiority of the K-ACE over Korean Mini-mental Status Examination (K-MMSE) in diagnosis of Alzheimer dementia and Mild cognitive impairment. The optimal cut-off of the K-ACE for the identification of AD was 68/69, which had a sensitivity of 90% and a specificity of 87%. Conclusions: The K-ACE is a short, reliable, and valid neuropsychological test battery to screen dementia in the Korean elderly.
P1-420
CONTRIBUTION OF EXECUTIVE FUNCTIONING AND MEMORY TO RULE INDUCTION IN HEALTHY OLDER PEOPLE AND PATIENTS WITH MCI OR EARLY DEMENTIA
Sophie Heringa1, Joukje Oosterman2, Esther van den Berg3, Roy Kessels2, L. Kappelle1, H. Koek1, Geert-Jan Biessels1, 1University Medical Center, Utrecht, The Netherlands; 2Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands; 3 Utrecht University, Utrecht, Netherlands. Background: Inductive reasoning in healthy individuals is known to depend on executive functioning and, to a lesser extent, memory. We explored individual contributions of executive functioning and memory to rule induction in normal and pathological ageing, through administration of a newly developed task to healthy controls and patients with mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Methods: 20 healthy older volunteers (mean age 66613 years) and 27 patients (mean age 7769 years) participated. Patients were recruited from a memory clinic, diagnosed with amnesic MCI or AD, according to established diagnostic criteria. Patients with an MMSE < 20 or Clinical Dementia Rating Scale score >1 were excluded. Memory (composite of immediate and delayed recall RAVLT) and executive functioning (composite of Stroop card 3/2 and TMT B/A) were assessed and standardized into z-scores. For the experimental task participants were instructed to sort stimuli based on feedback. Numbers of trials needed to produce eight consecutive correct answers were recorded. The task included three rule induction conditions of increasing complexity. The second and third had an equally high memory load, the first a lower load. The third condition additionally had a high executive load, which was equally low in condition 1 and 2. For people with intact cognition, the difference score between condition 3 and 2 was hypothesized to reflect the executive component in rule induction. Results: Patients had significant lower z-scores than controls for the memory and executive functioning composite scores. Moreover, patients needed more trials on condition 2 and 3 of the inductive reasoning task (see Table). In controls, both memory (ß¼0.43, p<0.05) and executive functioning (ß¼0.62, p<0.05) independently predicted performance on condition 3 in stepwise regression. With regard to the difference score 3-2, only executive functioning continued to predict performance (ß¼0.48, p<0.05). In patients, both executive functioning (r¼0.36, p<0.05) and, marginally, memory (r¼0.31, p¼0.057) were associated with performance on condition 3, but only memory (r¼0.31, p¼0.057) was borderline significantly associated with the difference score. Conclusions: In healthy older participants, both executive functioning and memory contribute to inductive reasoning. In patients with MCI or AD however, memory deficits become a key determinant of complex rule induction.
P1-421
S247 STUDY OF PHONEMIC AND SEMANTIC VERBAL FLUENCIES IN PATIENTS WITH ALZHEIMER’S DISEASE
Emılio Herrera, Jr,1, Gustavo A. Herrera2, Ricardo Caramanti1, 1Faculty of Medicine of Catanduva, Catanduva, Brazil; 2Instituto Dr. Emilio Herrera Jr., Catanduva, Brazil. Background: In the literature the studies about patients with cortical and focal lesions conclude that the semantic verbal fluency are more specific for detect lesions in temporal lobe while the phonemic verbal fluency can detect better the frontal lesions. The objective of this study is evaluate the phonemic verbal fluency and the semantic verbal fluency for animals in patients with mild and moderate Alzheimer’s disease and compare it. Methods: The study was conducted in the Clinic of Cognitive Neurology at Medicine School of Catanduva, S~ao Paulo, Brazil, where patients were evaluated claiming loss of memory . These individuals underwent a full neuropsychological and complementary evaluation for the Alzheimer’s disease diagnostic. This evaluation included semantic and phonemic verbal fluencies tests. Results: We found 72 patients with diagnosis of Alzheimer’s disease after our neurophysiological and complementary evaluation. In this group the phonemic verbal production was smaller than semantic verbal fluency with 4.3 for 7.1 in the mild intensity, and 3.1 for 4 in the moderate intensity. Conclusions: The study shows that the phonemic verbal fluency is more affected than semantic verbal fluency in the mild disease phase in Alzheimer’s disease. This indicates more involvement of frontal lobe in these patients. With the disease’s progression the involvement of the temporal lobe increases and the two lobes are affected similarly. P1-422
EVALUATION OF THREE HAND POSITION TEST OF LURIA IN ALZHEIMER’S DISEASE AND YOUR RELATIONSHIP WITH AGE
Emılio Herrera, Jr,1, Gustavo A. Herrera2, Ricardo Caramanti3, 1Faculty of Medicine of Catanduva, Catanduva, Brazil; 2Instituto Dr. Emilio Herrera Jr., Catanduva, Brazil. Background: The Luria’s test consists in one sequence of three movements in the correct order and in the imitation of the examiner. Five chances are given to the patient to make the right movement sequence, naming 0 when there is no repetition of movements through 5, for the correct sequence. This test can evaluate the praxis in patients with Alzheimer, more affected in the moderate and advanced stages. The objective of this study is evaluate the Luria’s test performance in patients with Alzheimer’s disease and your relationship with age. Methods: The study was conducted in the Clinic of Cognitive Neurology at Medicine School of Catanduva, S~ao Paulo, Brazil, where patients were evaluated claiming loss of memory. These individuals underwent a full neuropsychological and complementary evaluation for the Alzheimer’s disease diagnosis. This evaluation included the Luria’s test. Results: : We found 216 patients with diagnosis of Alzheimer’s disease after our neurophysiological and complementary evaluate, 172 of them were in mild intensity and 44 were classified with moderated disease. In the mild intensity, 69 (40%) patients did not score any point and 60% scores. However in the moderated Alzheimer’s disease 37 (84%) of patients did not perform the sequence after five attempts and 16% agreed it. hen analyzing the scores of Luria in relation to age, we found that did not hit any of the five attempts 4 of 13 (30%) patients with age < 65 years, 24 of 66 (36%) among 65 to 74, 66 of 115 (57%) among 75 to 84 and 15 of 22 (68%) for more than 84 years old. Conclusions: The Luria’s test is important to the praxis evaluate in dementia. In the literature, the studies show increases on test with the progress of the Alzheimer’s disease, but in this study 40% of patients with mild and 84% with moderated intensities were not able to perform the test. Regarding age, we found that the test of Luria worsens with its increase.
P1-420
CONTRIBUTION OF EXECUTIVE FUNCTIONING AND MEMORY TO RULE INDUCTION IN HEALTHY OLDER PEOPLE AND PATIENTS WITH MCI OR EARLY DEMENTIA
Sophie Heringa1, Joukje Oosterman2, Esther van den Berg3, Roy Kessels2, L. Kappelle1, H. Koek1, Geert-Jan Biessels1, 1University Medical Center, Utrecht, The Netherlands; 2Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands; 3 Utrecht University, Utrecht, Netherlands. Background: Inductive reasoning in healthy individuals is known to depend on executive functioning and, to a lesser extent, memory. We explored individual contributions of executive functioning and memory to rule induction in normal and pathological ageing, through administration of a newly developed task to healthy controls and patients with mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Methods: 20 healthy older volunteers (mean age 66613 years) and 27 patients (mean age 7769 years) participated. Patients were recruited from a memory clinic, diagnosed with amnesic MCI or AD, according to established diagnostic criteria. Patients with an MMSE < 20 or Clinical Dementia Rating Scale score >1 were excluded. Memory (composite of immediate and delayed recall RAVLT) and executive functioning (composite of Stroop card 3/2 and TMT B/A) were assessed and standardized into z-scores. For the experimental task participants were instructed to sort stimuli based on feedback. Numbers of trials needed to produce eight consecutive correct answers were recorded. The task included three rule induction conditions of increasing complexity. The second and third had an equally high memory load, the first a lower load. The third condition additionally had a high executive load, which was equally low in condition 1 and 2. For people with intact cognition, the difference score between condition 3 and 2 was hypothesized to reflect the executive component in rule induction. Results: Patients had significant lower z-scores than controls for the memory and executive functioning composite scores. Moreover, patients needed more trials on condition 2 and 3 of the inductive reasoning task (see Table). In controls, both memory (ß¼0.43, p<0.05) and executive functioning (ß¼0.62, p<0.05) independently predicted performance on condition 3 in stepwise regression. With regard to the difference score 3-2, only executive functioning continued to predict performance (ß¼0.48, p<0.05). In patients, both executive functioning (r¼0.36, p<0.05) and, marginally, memory (r¼0.31, p¼0.057) were associated with performance on condition 3, but only memory (r¼0.31, p¼0.057) was borderline significantly associated with the difference score. Conclusions: In healthy older participants, both executive functioning and memory contribute to inductive reasoning. In patients with MCI or AD however, memory deficits become a key determinant of complex rule induction.
P1-421
S247 STUDY OF PHONEMIC AND SEMANTIC VERBAL FLUENCIES IN PATIENTS WITH ALZHEIMER’S DISEASE
Emılio Herrera, Jr,1, Gustavo A. Herrera2, Ricardo Caramanti1, 1Faculty of Medicine of Catanduva, Catanduva, Brazil; 2Instituto Dr. Emilio Herrera Jr., Catanduva, Brazil. Background: In the literature the studies about patients with cortical and focal lesions conclude that the semantic verbal fluency are more specific for detect lesions in temporal lobe while the phonemic verbal fluency can detect better the frontal lesions. The objective of this study is evaluate the phonemic verbal fluency and the semantic verbal fluency for animals in patients with mild and moderate Alzheimer’s disease and compare it. Methods: The study was conducted in the Clinic of Cognitive Neurology at Medicine School of Catanduva, S~ao Paulo, Brazil, where patients were evaluated claiming loss of memory . These individuals underwent a full neuropsychological and complementary evaluation for the Alzheimer’s disease diagnostic. This evaluation included semantic and phonemic verbal fluencies tests. Results: We found 72 patients with diagnosis of Alzheimer’s disease after our neurophysiological and complementary evaluation. In this group the phonemic verbal production was smaller than semantic verbal fluency with 4.3 for 7.1 in the mild intensity, and 3.1 for 4 in the moderate intensity. Conclusions: The study shows that the phonemic verbal fluency is more affected than semantic verbal fluency in the mild disease phase in Alzheimer’s disease. This indicates more involvement of frontal lobe in these patients. With the disease’s progression the involvement of the temporal lobe increases and the two lobes are affected similarly. P1-422
EVALUATION OF THREE HAND POSITION TEST OF LURIA IN ALZHEIMER’S DISEASE AND YOUR RELATIONSHIP WITH AGE
Emılio Herrera, Jr,1, Gustavo A. Herrera2, Ricardo Caramanti3, 1Faculty of Medicine of Catanduva, Catanduva, Brazil; 2Instituto Dr. Emilio Herrera Jr., Catanduva, Brazil. Background: The Luria’s test consists in one sequence of three movements in the correct order and in the imitation of the examiner. Five chances are given to the patient to make the right movement sequence, naming 0 when there is no repetition of movements through 5, for the correct sequence. This test can evaluate the praxis in patients with Alzheimer, more affected in the moderate and advanced stages. The objective of this study is evaluate the Luria’s test performance in patients with Alzheimer’s disease and your relationship with age. Methods: The study was conducted in the Clinic of Cognitive Neurology at Medicine School of Catanduva, S~ao Paulo, Brazil, where patients were evaluated claiming loss of memory. These individuals underwent a full neuropsychological and complementary evaluation for the Alzheimer’s disease diagnosis. This evaluation included the Luria’s test. Results: : We found 216 patients with diagnosis of Alzheimer’s disease after our neurophysiological and complementary evaluate, 172 of them were in mild intensity and 44 were classified with moderated disease. In the mild intensity, 69 (40%) patients did not score any point and 60% scores. However in the moderated Alzheimer’s disease 37 (84%) of patients did not perform the sequence after five attempts and 16% agreed it. hen analyzing the scores of Luria in relation to age, we found that did not hit any of the five attempts 4 of 13 (30%) patients with age < 65 years, 24 of 66 (36%) among 65 to 74, 66 of 115 (57%) among 75 to 84 and 15 of 22 (68%) for more than 84 years old. Conclusions: The Luria’s test is important to the praxis evaluate in dementia. In the literature, the studies show increases on test with the progress of the Alzheimer’s disease, but in this study 40% of patients with mild and 84% with moderated intensities were not able to perform the test. Regarding age, we found that the test of Luria worsens with its increase.