Visuoconstructional problems in dementia: Contribution of executive systems functions.

Abstract

Visuoconstructional ability was assessed by asking patients diagnosed with Alzheimer's disease (AD), ischaemic vascular dementia (IVD), and Parkinson's disease (PD) and a normal control group (NC) to copy a modification of the Rey-Osterrieth Complex Figure (M-ROCF). The drawings of the NC group were superior to all dementia participants. AD patients generally outperformed IVD and PD patients; however, there were few differences between IVD and PD groups. Nonetheless, the drawings of IVD and PD patients were very fragmented and contained numerous perseverations and omissions. Despite these errors, patients with IVD and PD obtained higher delayed recognition memory scores than AD patients. Correlational analyses among dementia patients between neuropsychological tests and the copy of the M-ROCF found that accurate figure copy was most consistently correlated with tests of working memory, that is, tests requiring patients to monitor their behavior and sustain a complex mental set while performing mental manipulations. By contrast, no relationship between executive function tests related to measures of response selection/inhibition or other domains of neuropsychological functioning was found.

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

“…Traykov and co-workers (2002) found that AD patients had inferior performance on free and delayed recall and recognition as opposed to VaD patients, while the VaD group made more perseverative errors on the modified card sorting test, a test of executive functioning (EF). In accordance, Freeman et al (2000) observed a decrement in delayed recognition memory performance of a modification of the Rey-Osterrieth Complex Figure in AD patients compared to the VaD group, whereas the VaD group showed inferior performance on the copy condition, a condition strongly dependent upon working memory. However, differentiating these two clinical pictures based on neuropsychological tests remains indefinite (Almkvist, Fratiglioni, Aguero-Torres, Viitanen & Backman, 1999;Fahlander, Wahlin, Almkvist & Backman, 2002).…”

“…Tests such as the Block Design and Object Assembly test are often referred to as measuring constructional abilities (Lezak, 1995;Looi & Sachdev, 1999). However, EF such as strategy (Johanson, Gustafson & Risberg, 1986) or working memory (Freeman et al, 2000) can play an important role in constructional functions. Furthermore, a speed of processing component is present in several tasks as well, which might partly depend on EF (Desmond, 2004;Grigsby, Kaye & Robbins, 1995).…”

“…Both subtypes of dementia present profiles with distinguishable cognitive deficits, like executive dysfunctioning in VaD compared to a pronounced memory deficit in AD (Freeman et al, 2000;Graham, Emery & Hodges, 2004;Looi & Sachdev, 1999;Traykov et al, 2002). Traykov and co-workers (2002) found that AD patients had inferior performance on free and delayed recall and recognition as opposed to VaD patients, while the VaD group made more perseverative errors on the modified card sorting test, a test of executive functioning (EF).…”

Diagnóstico de doença de Alzheimer no Brasil: avaliação cognitiva e funcional. Recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

“…A figura complexa de Rey pode ajudar a discriminar pacientes com DA de controles [51][52][53] , mas não foram encontrados estudos brasileiros sobre este teste no diagnóstico de DA.…”

Normal Aging and Executive Functions in “Old-Old” Community Dwellers: Poor Performance Is Not an Inevitable Outcome

“…Nevertheless, a pattern emerges with consistent reports of impairments in verbal fluency, response inhibition, and mental set shifting, all characteristic of frontal systems abnormalities. Executive aspects of memory (organization and strategic encoding of information and retrieval efficiency), as well as constructional problem solving, have also been reported to be abnormal (Freeman et al, 2000).…”