Patterns of neuropsychological impairment in Alzheimer's disease and mixed dementia. 2013

YanHong Dong, and Daniel Zheng Qiang Gan, and Stephen Ziyang Tay, and Way Inn Koay, and Simon Lowes Collinson, and Saima Hilal, and Narayanaswamy Venketasubramanian, and Christopher Chen
Memory Aging and Cognition Centre, Department of Pharmacology, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, The University of New South Wales, Australia.

BACKGROUND Mixed dementia (MD), i.e., the coexistence of Alzheimer's disease (AD) and cerebrovascular disease (CVD), is a common dementia subtype. Few studies have attempted to establish the cognitive profiles of mild-moderate MD and compare it to the profiles of AD using a comprehensive neuropsychological test battery. We aimed to establish the neuropsychological profile of mild-moderate MD in relation to mild-moderate AD. METHODS Patients with consensus diagnoses of MD and AD of mild-moderate severity (Clinical Dementia Rating score of 1-2) were recruited from a memory clinic. Cognitive performance was measured by a formal neuropsychological battery covering domains of attention, language, verbal and visual memory, visuoconstruction, visuomotor speed and executive function. Cognitive domain scores are z-scores calculated using the mean and SDs of the AD group. ANCOVAs with age and education as covariates were employed to examine differences in mean score difference of cognitive domains and subtests between patients with MD and AD. RESULTS 151 patients were recruited with the majority of AD (n=96, 63.6%) and a minority of MD (n=55, 36.4%). There were no significant differences in the demographic characteristics of patients with MD and AD. However, patients with MD were significantly more impaired than AD patients in global cognitive composite, attention and visuoconstruction (global cognitive composite: -0.32±0.98 vs 0±1, p=0.011; attention: -0.32±0.90 vs 0±1, p=0.013; visuoconstruction: -0.27±0.99 vs 0±1, p=0.024, respectively). CONCLUSIONS The neuropsychological profile of patients with MD of mild-moderate severity is characterized by a poorer global performance, as well as attention and visuoconstruction than those with AD of mild-moderate severity.

UI MeSH Term Description Entries
D008297 Male Males
D009483 Neuropsychological Tests Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury. Aphasia Tests,Cognitive Test,Cognitive Testing,Cognitive Tests,Memory for Designs Test,Neuropsychological Testing,AX-CPT,Behavioral Assessment of Dysexecutive Syndrome,CANTAB,Cambridge Neuropsychological Test Automated Battery,Clock Test,Cognitive Function Scanner,Continuous Performance Task,Controlled Oral Word Association Test,Delis-Kaplan Executive Function System,Developmental Neuropsychological Assessment,Hooper Visual Organization Test,NEPSY,Neuropsychologic Tests,Neuropsychological Test,Paced Auditory Serial Addition Test,Repeatable Battery for the Assessment of Neuropsychological Status,Rey-Osterrieth Complex Figure,Symbol Digit Modalities Test,Test of Everyday Attention,Test, Neuropsychological,Tests, Neuropsychological,Tower of London Test,Neuropsychologic Test,Test, Cognitive,Testing, Cognitive,Testing, Neuropsychological,Tests, Cognitive
D003072 Cognition Disorders Disorders characterized by disturbances in mental processes related to learning, thinking, reasoning, and judgment. Overinclusion,Disorder, Cognition,Disorders, Cognition
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000544 Alzheimer Disease A degenerative disease of the BRAIN characterized by the insidious onset of DEMENTIA. Impairment of MEMORY, judgment, attention span, and problem solving skills are followed by severe APRAXIAS and a global loss of cognitive abilities. The condition primarily occurs after age 60, and is marked pathologically by severe cortical atrophy and the triad of SENILE PLAQUES; NEUROFIBRILLARY TANGLES; and NEUROPIL THREADS. (From Adams et al., Principles of Neurology, 6th ed, pp1049-57) Acute Confusional Senile Dementia,Alzheimer's Diseases,Dementia, Alzheimer Type,Dementia, Senile,Presenile Alzheimer Dementia,Senile Dementia, Alzheimer Type,Alzheimer Dementia,Alzheimer Disease, Early Onset,Alzheimer Disease, Late Onset,Alzheimer Sclerosis,Alzheimer Syndrome,Alzheimer Type Senile Dementia,Alzheimer's Disease,Alzheimer's Disease, Focal Onset,Alzheimer-Type Dementia (ATD),Dementia, Presenile,Dementia, Primary Senile Degenerative,Early Onset Alzheimer Disease,Familial Alzheimer Disease (FAD),Focal Onset Alzheimer's Disease,Late Onset Alzheimer Disease,Primary Senile Degenerative Dementia,Senile Dementia, Acute Confusional,Alzheimer Dementias,Alzheimer Disease, Familial (FAD),Alzheimer Diseases,Alzheimer Type Dementia,Alzheimer Type Dementia (ATD),Alzheimers Diseases,Dementia, Alzheimer,Dementia, Alzheimer-Type (ATD),Familial Alzheimer Diseases (FAD),Presenile Dementia,Sclerosis, Alzheimer,Senile Dementia
D015140 Dementia, Vascular An imprecise term referring to dementia associated with CEREBROVASCULAR DISORDERS, including CEREBRAL INFARCTION (single or multiple), and conditions associated with chronic BRAIN ISCHEMIA. Diffuse, cortical, and subcortical subtypes have been described. (From Gerontol Geriatr 1998 Feb;31(1):36-44) Arteriosclerotic Dementia,Binswanger Disease,Encephalopathy, Binswanger,Leukoencephalopathy, Subcortical,Subcortical Arteriosclerotic Encephalopathy,Vascular Dementia,Acute Onset Vascular Dementia,Arteriosclerotic Encephalopathy, Subcortical,Binswanger Encephalopathy,Binswanger's Disease,Chronic Progressive Subcortical Encephalopathy,Encephalopathy, Binswanger's,Encephalopathy, Chronic Progressive Subcortical,Encephalopathy, Subcortical Arteriosclerotic,Encephalopathy, Subcortical, Chronic Progressive,Subcortical Encephalopathy, Chronic Progressive,Subcortical Leukoencephalopathy,Subcortical Vascular Dementia,Vascular Dementia, Acute Onset,Arteriosclerotic Dementias,Arteriosclerotic Encephalopathies, Subcortical,Binswanger's Encephalopathy,Binswangers Disease,Dementia, Arteriosclerotic,Dementia, Subcortical Vascular,Dementias, Arteriosclerotic,Dementias, Subcortical Vascular,Dementias, Vascular,Disease, Binswanger,Disease, Binswanger's,Encephalopathies, Subcortical Arteriosclerotic,Encephalopathy, Binswangers,Leukoencephalopathies, Subcortical,Subcortical Arteriosclerotic Encephalopathies,Subcortical Leukoencephalopathies,Subcortical Vascular Dementias,Vascular Dementia, Subcortical,Vascular Dementias,Vascular Dementias, Subcortical
D016022 Case-Control Studies Comparisons that start with the identification of persons with the disease or outcome of interest and a control (comparison, referent) group without the disease or outcome of interest. The relationship of an attribute is examined by comparing both groups with regard to the frequency or levels of outcome over time. Case-Base Studies,Case-Comparison Studies,Case-Referent Studies,Matched Case-Control Studies,Nested Case-Control Studies,Case Control Studies,Case-Compeer Studies,Case-Referrent Studies,Case Base Studies,Case Comparison Studies,Case Control Study,Case Referent Studies,Case Referrent Studies,Case-Comparison Study,Case-Control Studies, Matched,Case-Control Studies, Nested,Case-Control Study,Case-Control Study, Matched,Case-Control Study, Nested,Case-Referent Study,Case-Referrent Study,Matched Case Control Studies,Matched Case-Control Study,Nested Case Control Studies,Nested Case-Control Study,Studies, Case Control,Studies, Case-Base,Studies, Case-Comparison,Studies, Case-Compeer,Studies, Case-Control,Studies, Case-Referent,Studies, Case-Referrent,Studies, Matched Case-Control,Studies, Nested Case-Control,Study, Case Control,Study, Case-Comparison,Study, Case-Control,Study, Case-Referent,Study, Case-Referrent,Study, Matched Case-Control,Study, Nested Case-Control
D063189 Symptom Assessment Evaluation of manifestations of disease. Symptom Evaluation,Assessment, Symptom,Assessments, Symptom,Evaluation, Symptom,Evaluations, Symptom,Symptom Assessments,Symptom Evaluations

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