Apraxia for differentiating Alzheimer’s disease from subcortical vascular dementia and mild cognitive impairment

Abstract

Although ideomotor limb apraxia is considered to be a typical sign of cortical pathologies such as Alzheimer’s disease (AD), it has been also reported in subcortical neurodegenerative diseases and vascular lesions. We aimed to investigate the difference between AD, subcortical vascular dementia (SVaD) and mild cognitive impairment (MCI) patients by means of ideomotor limb apraxia frequency and severity. Ninety-six AD, 72 SVaD, and 84 MCI patients were assessed with the mini-mental status examination (MMSe), clinical dementia rating (CDR) and the apraxia screening test of TULIA (AST). Apraxia was significantly more frequent in the AD patients (32.3%) than in both of the SVaD (16.7%) and MCI (4.8%) patients. The frequency of apraxia was also significantly higher in SVaD patients than in MCI patients. AD patients had significantly lower apraxia scores than both SVaD and MCI patients. In addition, a significant difference was found between SVaD and MCI patients in terms of apraxia scores. These results suggest that the widespread belief of the association between apraxia and cortical dementias is not exactly correct. The significant difference between both of the dementia groups and the MCI patients suggests that the absence of apraxia can be an indicator for MCI diagnosis.

A kinematic analysis of age-related changes in grasping to use and grasping to move common objects

“…In particular, changes in hand functionality may affect the way people communicate or respond to the environment, and interact with objects and tools presented in the surroundings. In neurological diseases associated with aging, such as dementia and Alzheimer's disease, patients may show deficits in performing gestures under verbal command, in imitation or in using common objects (Luchelli, Lopez, Faglioni, & Boller, 1993;Ozkan, Adapinar, Elmaci, & Arslantas, 2013;Rousseaux, Rénier, Anicet, Pasquier, & MackowiakCordoliani, 2012). The praxic performance in these studies is commonly assessed using qualitative measurements and accuracy scales (e.g., Rumiati, Papeo, & Corradi-Dell'Acqua, 2010).…”

Limb apraxia profiles in different clinical samples

“…Real tool-use impairment prevalence rates were reported with similar levels of 25-54% impaired patients (Del Ser, Hachinski, Merskey & Munoz, 2001;LeClerc, Wells, Sidani, Dawson & Fay, 2004;Wu & Lin, 2015). Moreover, studies indicated that Alzheimer's disease and vascular dementia patients have higher apraxia incidence rates than patients with mild cognitive impairment (Ahmed et al, 2016;Ozkan et al, 2013), frontotemporal dementia (Ahmed et al, 2016;Chandra, Isaac, & Abbas, 2015;Johnen, Frommeyer, et al, 2016;Johnen et al, 2015) or semantic dementia (Baumard et al, 2016).…”

“…Further, the incidence rates of apraxia in classic subtests of pantomime and imitation appeared to be on a similar level compared to other test instruments. Other research groups reported prevalence rates of around 28-57% in LHS patients (e.g., Donkervoort et al, 2000;Dovern et al, 2012;Kaya et al, 2006;Weiss et al, 2013) and of 32-69% in Alzheimer s disease patients (Ahmed et al, 2016;Ozkan et al, 2013), but these considered performance in imitation and pantomime tasks only. Had we similarly considered these tasks only (IML, IMF, and PTU), prevalence rates of apraxia for LHS patients would be at 52% for imitation and at 61% for pantomime tasks, which is comparable to previously reported results.…”

“…In this clinic patients with vascular dementia typically had suffered from multiple minor strokes, and their clinical progression including functional impairments usually occurred step by step. There is some evidence that suggests that Alzheimer's disease and vascular dementia groups do not differ in their praxis performance (Ahmed et al, 2016;Ozkan et al, 2013). Stroke onset in vascular dementia patients was at least two years ago (as opposed to a considerably shorter time since stroke onset in the stroke patient groups, LHS: M ¼ 89.5 days ago, RHS: M ¼ 60.31 days ago).…”

“…It is recognized as a diagnostic characteristic of Alzheimer's disease and as such it is included in the criteria of the National Institute of Neurological and Communicative Diseases and Stroke-Alzheimer s Disease and Related Disorders Association (NINCDS-ADRDA;McKhann et al, 1984;McKhann et al, 2011). Prevalence rates for difficulties in imitation and pantomime tasks range between 32 and 69% in Alzheimer's disease patients (Ahmed, Baker, Thompson, Husain & Butler, 2016;Ozkan, Adapinar, Elmaci & Arslantas, 2013), while difficulties seem to increase with ongoing disease decline (Edwards, Deuel, Baum & Morris, 1991;Parakh, Roy, Koo & Black, 2004;Wu & Lin, 2015), and go along with worse Mini Mental State Examination (MMSE) scores and deficient language comprehension abilities (Cotelli et al, 2014;Stamenova, Roy & Black, 2014;Wu & Lin, 2015). Real tool-use impairment prevalence rates were reported with similar levels of 25-54% impaired patients (Del Ser, Hachinski, Merskey & Munoz, 2001;LeClerc, Wells, Sidani, Dawson & Fay, 2004;Wu & Lin, 2015).…”