This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Joseph J. Locascio, PhD; John H. Growdon, MD; Suzanne Corkin, PhD

Arch Neurol. 1995;52(11):1087-1099.

Abstract
Objectives
To identify the specific cognitive deficits that characterize Alzheimer's disease (AD) and determine which cognitive tests, or combination of tests, are best for detecting AD (ie, distinguishing patients with AD from normal control subjects), staging AD (ie, distinguishing different severities of dementia), and tracking disease progression.

Subjects
Patients with AD (n=123) and normal control subjects (n=60) of comparable age, education, and gender distribution.

Setting
Outpatient care.

Measures
Ten cognitive tests of memory, language, visuospatial abilities, and reasoning; the Information, Memory and Concentration subtest of the Blessed Dementia Scale, and the total score on an activities of daily living questionnaire.

Design
Patients with AD were tested every 6 to 24 months over a span of up to 5.5 years.

Results
Patients with AD were significantly inferior to normal control subjects on all cognitive tests. The scores of patients with AD worsened over time. Delayed recall of stories and figures showed sharp deterioration to an early floor, consistent with the finding that these tests discriminated patients with mild AD from normal control subjects well but were poor for staging. Confrontation naming, semantic fluency, and immediate recognition of geometric figures showed steady linear decline across time for patients with AD, consistent with these tests being found best for staging dementia severity.

Conclusions
We postulate that the pathologic bases of impairment in delayed recall are atrophy of cholinergic ventral forebrain neurons and partial deafferentation of the hippocampus, both of which occur early in the course of AD. Worsening language and visuospatial abilities likely reflect progressive loss of neocortical neurons and their connections.

Author Affiliations
From the Department of Brain and Cognitive Sciences and the Clinical Research Center, Massachusetts Institute of Technology, Cambridge (Drs Locascio, Growdon, and Corkin); and the Department of Neurology, Massachusetts General Hospital, Boston (Drs Locascio and Growdon).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Physical Activity Levels and Cognition in Women With Type 2 Diabetes
Devore et al.
Am J Epidemiol 2009;170:1040-1047.
ABSTRACT | FULL TEXT  

Delirium accelerates cognitive decline in Alzheimer disease
Fong et al.
Neurology 2009;72:1570-1575.
ABSTRACT | FULL TEXT  

Dietary Fat Intake and Cognitive Decline in Women With Type 2 Diabetes
Devore et al.
Diabetes Care 2009;32:635-640.
ABSTRACT | FULL TEXT  

CSF APPs{alpha} and Phosphorylated Tau Protein Levels in Mild Cognitive Impairment and Dementia of Alzheimer's Type
Fellgiebel et al.
J Geriatr Psychiatry Neurol 2009;22:3-9.
ABSTRACT  

Reaction Times and Performance Variability in Normal Aging, Mild Cognitive Impairment, and Alzheimer's Disease
Gorus et al.
J Geriatr Psychiatry Neurol 2008;21:204-218.
ABSTRACT  

Plasma Amyloid {beta}-Protein and C-reactive Protein in Relation to the Rate of Progression of Alzheimer Disease
Locascio et al.
Arch Neurol 2008;65:776-785.
ABSTRACT | FULL TEXT  

The Mini-Mental State Examination in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia
Osher et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2008;22:468-473.
ABSTRACT  

Word Reading and Posterior Temporal Dysfunction in Amnestic Mild Cognitive Impairment
Vandenbulcke et al.
Cereb Cortex 2007;17:542-551.
ABSTRACT | FULL TEXT  

Alzheimer's centennial legacy: origins, landmarks and the current status of knowledge concerning cognitive aspects.
Hodges
Brain 2006;129:2811-2822.
ABSTRACT | FULL TEXT  

Interaction between Testosterone and Apolipoprotein E {epsilon}4 Status on Cognition in Healthy Older Men
Burkhardt et al.
J. Clin. Endocrinol. Metab. 2006;91:1168-1172.
ABSTRACT | FULL TEXT  

Cognitive aging and Alzheimer's disease
Vandenberghe and Tournoy
Postgrad. Med. J. 2005;81:343-352.
ABSTRACT | FULL TEXT  

Early A{beta} accumulation and progressive synaptic loss, gliosis, and tangle formation in AD brain
Ingelsson et al.
Neurology 2004;62:925-931.
ABSTRACT | FULL TEXT  

Alzheimer's disease can be accurately diagnosed in very mildly impaired individuals
Salmon et al.
Neurology 2002;59:1022-1028.
ABSTRACT | FULL TEXT  

Rates of progression in mild cognitive impairment and early Alzheimer's disease
Storandt et al.
Neurology 2002;59:1034-1041.
ABSTRACT | FULL TEXT  

Apolipoprotein E Gender Effects on Cognitive Performance in Age-Associated Memory Impairment
Bartres-Faz et al.
J. Neuropsychiatry Clin. Neurosi. 2002;14:80-83.
ABSTRACT | FULL TEXT  

Cognitive and functional decline in African Americans with VaD, AD, and stroke without dementia
Nyenhuis et al.
Neurology 2002;58:56-61.
ABSTRACT | FULL TEXT  

Learning and Memory in Transgenic Mice Modeling Alzheimer's Disease
Ashe
Learn. Mem. 2001;8:301-308.
ABSTRACT | FULL TEXT  

Patterns of Cognitive Decline in Presymptomatic Alzheimer Disease: A Prospective Community Study
Chen et al.
Arch Gen Psychiatry 2001;58:853-858.
ABSTRACT | FULL TEXT  

Behavior and treatment in frontotemporal dementia
Perry and Miller
Neurology 2001;56:S46-51.
ABSTRACT | FULL TEXT  

Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented
Chen et al.
Neurology 2000;55:1847-1853.
ABSTRACT | FULL TEXT  

Case 11-2000- A 74-Year-Old Man with Memory Loss, Language Impairment, and Personality Changes
Growdin and Primavera
NEJM 2000;342:1110-1117.
FULL TEXT  

Longitudinal Course of Behavioral Problems During Alzheimer's Disease: Linear Versus Curvilinear Patterns of Decline
McCarty et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2000;55:200M-206.
ABSTRACT | FULL TEXT  

Atypical and typical presentations of Alzheimer's disease: a clinical, neuropsychological, neuroimaging and pathological study of 13 cases
Galton et al.
Brain 2000;123:484-498.
ABSTRACT | FULL TEXT  

Differences Between Pick Disease and Alzheimer Disease in Clinical Appearance and Rate of Cognitive Decline
Binetti et al.
Arch Neurol 2000;57:225-232.
ABSTRACT | FULL TEXT  

Clinicopathologic correlates in temporal cortex in dementia with Lewy bodies
Gomez-Isla et al.
Neurology 1999;53:2003-2003.
ABSTRACT | FULL TEXT  

Clinical and quantitative pathologic correlates of dementia with Lewy bodies
Gomez-Tortosa et al.
Neurology 1999;53:1284-1284.
ABSTRACT | FULL TEXT  

Classification and Staging of Dementia of the Alzheimer Type: A Comparison Between Neural Networks and Linear Discriminant Analysis
French et al.
Arch Neurol 1997;54:1001-1009.
ABSTRACT  

Pupil Dilation to Tropicamide Is Not Specific for Alzheimer Disease
Growdon et al.
Arch Neurol 1997;54:841-844.
ABSTRACT  

Profound Loss of Layer II Entorhinal Cortex Neurons Occurs in Very Mild Alzheimer''s Disease
Gomez-Isla et al.
J. Neurosci. 1996;16:4491-4500.
ABSTRACT | FULL TEXT