ABSTRACT
AIMS: To establish the discriminatory validity of the mini-mental test (MMSE) and the memory alteration test (M@T) for the diagnosis of amnestic mild cognitive impairment (aMCI) and probable Alzheimer's disease (AD), and also to study the association between the results obtained in screening tests, a neuropsychological battery and a functional questionnaire in healthy persons and in patients with aMCI and AD. SUBJECTS AND METHODS: We evaluated 27 normal controls, 27 patients with aMCI and 35 patients with AD using the MMSE and a memory screening test, the M@T, a neuropsychological battery and a questionnaire on functional activities of daily living. Pearson correlation coefficients were used to evaluate the relations between the scores on the M@T and the MMSE and the neuropsychological tests. The area below the curve, the sensitivity and the specificity were calculated for the screening tests. RESULTS: In patients with aMCI, the scores on the M@T and the MMSE were strongly associated with the performance in the episodic memory tests in frontal tests and with the scores on the functional questionnaire, but not with tests that evaluated praxias and perceptive functions. In patients with AD, the scores on the M@T and the MMSE were associated with results in semantic memory, language, executive functions and praxias, but not with perceptive tests and functional questionnaires. CONCLUSIONS: In patients with aMCI and AD, the association between MMSE and M@T only correlate with some cognitive functions, without there being any association with other cognitive functions. Therefore, screening tests cannot be used as the only instrument for evaluating the cognitive status in patients with suspected dementia.
Subject(s)
Alzheimer Disease , Cognition Disorders , Neuropsychological Tests , Psychiatric Status Rating Scales , Aged , Alzheimer Disease/physiopathology , Alzheimer Disease/psychology , Cognition Disorders/physiopathology , Cognition Disorders/psychology , Humans , Memory/physiology , Middle Aged , Neuropsychological Tests/standards , Neuropsychological Tests/statistics & numerical data , Psychiatric Status Rating Scales/standards , Psychiatric Status Rating Scales/statistics & numerical data , Reproducibility of Results , Sensitivity and Specificity , Surveys and QuestionnairesABSTRACT
INTRODUCTION: The term 'posterior cortical atrophy' (PCA) refers to a neurodegenerative syndrome that is characterised by progressive alteration of the higher visual-perceptual and/or visual-spatial functions, which often presents Alzheimer's disease (AD). AIM: To describe the value of neuropsychological tests in the differential diagnosis of patients with PCA versus patients with typical AD. SUBJECTS AND METHODS: The sample was made up of four patients with PCA, four patients with initial typical AD with no significant differences in the degree of cognitive impairment according to the Minimental State Examination and seven cognitively healthy controls. Subjects were administered a full neuropsychological battery of tests for memory, language, praxias, executive functions, and visual-perceptual and visual-spatial capacities. The statistical analysis was performed using the Mann-Whitney U test for non-parametric tests and independent samples. RESULTS: In the neuropsychological study, scores were significantly lower in the group with PCA compared to the control group in verbal comprehension, praxias and visual gnosias (p < 0.05), and significantly higher with respect to the group with typical AD in episodic memory tests (p < 0.05). In contrast, patients with PCA had a significantly lower score in comparison to typical AD in visual-perceptive and visual-spatial tests (p < 0.05), and in constructive praxias (p < 0.05). CONCLUSIONS: Results in the neuropsychological tests show subjects with PCA and typical AD have different cognitive profiles, and are useful in the differential diagnosis of the two clinical variants.
Subject(s)
Alzheimer Disease , Atrophy , Cerebral Cortex , Aged , Alzheimer Disease/diagnosis , Alzheimer Disease/pathology , Alzheimer Disease/physiopathology , Atrophy/pathology , Atrophy/physiopathology , Cerebral Cortex/pathology , Cerebral Cortex/physiopathology , Cognition Disorders/physiopathology , Female , Humans , Middle Aged , Neuropsychological TestsABSTRACT
Introducción. El término 'atrofia cortical posterior' (ACP) hace referencia a un síndrome neurodegenerativo caracterizado or una alteración progresiva de las funciones visuoperceptivas y/o visuoespaciales superiores, que frecuentemente presenta patología de enfermedad de Alzheimer (EA). Objetivo. Describir la utilidad de las pruebas neuropsicológicas en el diagnóstico diferencial de los pacientes con ACP frente a pacientes con EA típica. Sujetos y métodos. La muestra estaba formada por cuatro pacientes con ACP, cuatro pacientes con EA típica inicial sin diferencias significativas en el grado de deterioro cognitivo según el Minimental State Examination y siete controles cognitivamente sanos. Se administró una batería neuropsicológica completa que incluía test de memoria, lenguaje, praxias, función ejecutiva y las capacidades visuoperceptivas y visuoespaciales. En el análisis estadístico se utilizó la U de Mann-Whitney para pruebas no paramétricas y muestras independientes. Resultados. El estudio neuropsicológico mostró puntuaciones significativamente inferiores del grupo con ACP frente al grupo control en comprensión verbal, praxias y gnosias visuales (p < 0,05), y significativamente superiores respecto al grupo de EA típica en pruebas de memoria episódica (p < 0,05). Por el contrario, los pacientes con ACP tuvieron una puntuación significativamente inferior frente a la EA típica en pruebas visuoperceptivas y visuoespaciales (p < 0,05) y en las praxias constructivas (p < 0,05). Conclusión. Los resultados en las pruebas neuropsicológicas muestran diferentes perfiles cognitivos entre los sujetos con ACP y EA típica, y son útiles en el diagnóstico diferencial entre ambas variantes clínicas (AU)
Introduction. The term 'posterior cortical atrophy' (PCA) refers to a neurodegenerative syndrome that is characterised by progressive alteration of the higher visual-perceptual and/or visual-spatial functions, which often presents Alzheimers disease (AD). Aim. To describe the value of neuropsychological tests in the differential diagnosis of patients with PCA versus patients with typical AD. Subjects and methods. The sample was made up of four patients with PCA, four patients with initial typical AD with no significant differences in the degree of cognitive impairment according to the Minimental State Examination and seven cognitively healthy controls. Subjects were administered a full neuropsychological battery of tests for memory, language, praxias, executive functions, and visual-perceptual and visual-spatial capacities. The statistical analysis was performed using the Mann-Whitney U test for non-parametric tests and independent samples. Results. In the neuropsychological study, scores were significantly lower in the group with PCA compared to the control group in verbal comprehension, praxias and visual gnosias (p < 0.05), and significantly higher with respect to the group with typical AD in episodic memory tests (p < 0.05). In contrast, patients with PCA had a significantly lower score in comparison to typical AD in visual-perceptive and visual-spatial tests (p < 0.05), and in constructive praxias (p < 0.05). Conclusions. Results in the neuropsychological tests show subjects with PCA and typical AD have different cognitive profiles, and are useful in the differential diagnosis of the two clinical variants (AU)
