Assessment for apraxia in Mild Cognitive Impairment and Alzheimer's disease

Abstract

ObjectiveTo evaluate apraxia in healthy elderly and in patients diagnosed with Alzheimer's disease (AD) and Mild cognitive impairment (MCI).MethodsWe evaluated 136 subjects with an average age of 75.74 years (minimum 60 years old, maximum 92 years old) and average schooling of 9 years (minimum of 7 and a maximum of 12 years), using the Mini-Mental State examination (MMSE), Cambridge Cognitive Examination (CAMCOG) and the Clock Drawing Test. For the analysis of the presence of apraxia, eight subitems from the CAMCOG were selected: the drawings of the pentagon, spiral, house, clock; and the tasks of putting a piece of paper in an envelope; the correct one hand waiving "Goodbye" movements; paper cutting using scissors; and brushing teeth.ResultsElder controls had an average score of 11.51, compared to MCI (11.13), and AD patients, whose average apraxia test scores were the lowest (10.23). Apraxia scores proved able to differentiate the three groups studied (p=0.001). In addition, a negative correlation was observed between apraxia and MMSE scores.ConclusionWe conclude that testing for the presence of apraxia is important in the evaluation of patients with cognitive impairments and may help to differentiate elderly controls, MCI and AD.

Accuracy of praxis test from Cambridge Cognitive Examination (CAMCOG) for Alzheimer’s disease: a cross-sectional study

“…This impairment is often inversely proportional to subcortical cerebral injury, thus allowing clinicians to provide a more accurate prognosis for cognitive decline and functional impairment. [8][9][10][11][12] In 1920, Lipeman studied 84 patients who suffered strokes and discovered that, in addition to aphasia, the patients also had impairments of motor skills such as debilitated copying and imitative gestures. 13 Moreover, regarding more precise aspects of the diagnosis, CAMCOG has contributed towards evaluation of total praxis and its subitems through showing the relevance of some studies that have indicated that impairment of praxis abilities confirms that there is a risk of rapid evolution to severe cases of dementia.…”

Avaliação da apraxia em nonagenários: dados de um ambulatório de geriatria

“…Estudos sobre a progressão e prognóstico na DA tem mostrado que os pacientes que desenvolvem precocemente apraxia declinam mais rapidamente que aqueles que não apresentam apraxia 25,26 . Esse fato deve-se a inúmeros fatores, sendo um dos mais importantes a degeneração dos lobos têmporo-parietais de forma mais intensa em alguns pacientes do que em outros.…”

Performance of the Pentagon Drawing test for the screening of older adults with Alzheimer's dementia

“…Praxis refers to a complex cognitive function, in which the motor system is used to execute complex learned actions and movements, such as the copying of drawings. 1 Praxis evaluation is an important stage in the cognitive evaluation of older adults because apraxia may suggest the presence of neurodegenerative disease, such as Alzheimer's disease (AD), 2 , 3 vascular dementia 4 , 5 or Parkinson's disease, 6 , 7 among others. Apraxia is included as one of the cognitive domains evaluated in the diagnostic criteria of major neurocognitive disorder according to the DSM-5.…”