Patterns of Neuropsychological Functioning Among Patients With Multi-Infarct and Alzheimer's Dementia: A Comparative Analysis

Abstract

Cognitive and neuropsychological tests are often employed to help describe the functioning of patients with multi-infarct dementia (MID) or patients with dementia of the Alzheimer's type (DAT). In this study, the Halstead-Reitan Neuropsychological Battery (HRNB), Wechsler Adult Intelligence Scale-Revised (WAIS-R), and Wechsler Memory Scale (WMS) were completed by 20 MID patients and 62 patients with DAT. Total scores on these measures did not differentiate DAT and MID patients. Contrary to clinical observations, cognitive tasks assessing social judgment did not differentiate between the groups. However, MID patients demonstrated greater variability in test scores. Compared with DAT patients, the MID patients demonstrated better preserved memory as shown on the WMS in comparison to the WAIS-R IQ.

Differential Verbal Fluency Deficits in the Preclinical Stages of Alzheimer's Disease and Vascular Dementia

“…Given this overlap and given the robust evidence for preclinical cognitive deficits in AD, such deficits may be expected in VaD as well. Third, as described in a previous section, there are strikingly similar patterns of cognitive deficits in the early clinical stages of AD and VaD (Almkvist et al, 1993;Erker et al, 1995;Erkinjuntti et al, 1986). Hence, in Study II and III, we investigated preclinical cognitive deficits in VaD three years before diagnosis.…”

“…However, several other studies have failed to differentiate between these two dementia disorders on the basis of cognitive test scores (Almkvist et al, 1993;Almkvist, Fratiglioni, Agüero-Torres, Viitanen, & Bäckman, 1999;Erker, Searight, & Petersen, 1995;Erkinjuntti et al, 1986); for a review see (Almkvist, 1994). Note that in all studies referenced above the dementia groups were matched on severity of cognitive impairment, hence this should not be a reason for the discrepancies in the findings.…”

Distinguishing between Vascular Dementia and Alzheimer's Disease by Means of the WAIS: A Meta-analysis

“…The MMSE scores from the demented elderly ranged between 16.1 (+/−4.02) and 25.3 (+/ −3.8), which represents the mild and moderate dementia stages, with little attention dedicated to the severely demented group. Equally, the other instruments that were applied revealed mild and moderate dementia in the majority of the cases (e.g., stages 5 and 6 from the Global Deterioration Scale in the study of Erker, Searight & Peterson, 1995). Therefore, these results are probably best applicable in the mild and moderate demented patients, but not the severely demented.…”

Similar patterns of cognitive deficits in the preclinical phases of vascular dementia and Alzheimer's disease

“…A third reason is that there are many similarities between AD and VaD with regard to patterns of cognitive impairment in the early clinical phases. Although some research suggests a more pronounced impairment of episodic memory in AD and special difficulties in executive tasks in VaD (Looi & Sachdev, 1999), the bulk of evidence indicates strikingly similar patterns of cognitive deficits in the two diseases (Almkvist et al, 1993(Almkvist et al, , 1999Erker et al, 1995;Erkinjuntti et al, 1986;Fahlander et al, 2002;Hassing & Bäckman, 1997). Given that early clinical AD and VaD have a similar effect on many cognitive functions, similarities in preclinical manifestations might be expected as well.…”