Comparison between Alcohol Dependence and Alzheimer Disease in the Elderly Patients using the Cognitive Assessment Reference Diagnoses System

ABSTRACT

BACKGROUND: Alcohol dependence and Alzheimer's disease induce cognitive dysfunction in common. However, the cognitive dysfunction from alcohol dementia can be improved with appropriate treatment while that from Alzhimer's disease is usually irreversible and progressive. Nevertheless, the discrete diagnosis for the cause is delicate or sometimes impossible in those patients showing both characteristics of alcohol dementia and Alzhimer's disease. Thus, we investigated the feasibility of the computerized comprehensive neuropsychological test, Cognitive Assessment and Reference Diagnoses System(CARDS), to differentiate the diagnoses between alcohol dementia and Alzhiemr's disease in their early stages. METHODS:32 elderly subjects with cognitive dysfunction were recruited. They are divided by two groups; 16 subjects with alcohol dependence and 16 subjects without alcohol dependence(as early Alzhiemr's disease) We assessed the cognitive dysfunctions of each group using CARDS. The subscales of the CARDS include; (1) Amnesia, (2) Aphasia, (3) Apraxia, (4) Dysexecution, (5) Attention/Calculation. RESULTS: Alcohol dependence group showed lower mean score in amnesia subscale, but showed higher mean scores in apraxia and dysexcution subscales than early Alzheimer group. And both groups didn't show significant differences of mean scores in agonisa, aphagia, and attention/calculation subscale. CONCLUSION: In summary, this study shows that the elderly patients with alcohol dependence have cognitive deficits mainly in the amnesia domain of CARDS assessment, whereas early Alzhiemr's disease patients show equal or worse cognitive function in other domains except amnesia. Thus, we suggest that CARDS will be helpful to differentiate alcoholic dementia and Alzhiemr's disease in their early stages.