Errors of ideomotor apraxia in Alzheimer's disease

ABSTRACT

BACKGROUND & PURPOSE: Ideomotor apraxia is a gestural deficit which is not due to primary sensory or motor deficit, poor auditory comprehension or incooperation. Previous studies on apraxia in AD patients include advanced AD patients who exhibited marked impairment in auditory comprehension, This might have confounded the results of the studies. The purpose of this study is to observe the frequencies and patterns of gestural errors in the early stage of AD. METHOD: Eighteen patients with AD (M F = 4 14, age 62.6 + 7.2) and eighteen age- and sex- matched controls participated in this research. Patients who scored below 80 % of Western Aphasia Battery comprehension subtest and showed marked cognitive impairments were excluded (MMSE; 19.9 + 4.4, CDR 1.1+/- 0.5). Gestures. In response to commands were videotaped and analyzed by 2 neurologists and 1 speech-language pathologist. Test items included 3 types of movements ; 10 limb intrasitive, 15 transitive, and 10 buccofacial. RESULTS: Limb transitive movements were the most affected while buccofacial was the least. The error patterns most frequently observed were body-part-as-objects (BPO, 20%), external configuration orientation (ECO, 16%), and movement error(M, 9%). In comparision, BPO, ECO, M errors in normal control were 2%, 3%, and 4% respectively. In addition, apraxia item, which are to detecting AD were identified. CONCLUSION: It is suggested that the apraxia is commonly associated with AD even in the early stage of the disease and an accurate anaIysis of errors may contribute to establishing an early diagnosis of AD.