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Neuropsychological performance in Lewy body dementia and Alzheimer's disease

Published online by Cambridge University Press:  03 January 2018

Zuzana Walker*
Affiliation:
University College London Medical School and Whittington Hospital
Ruth L. Allen
Affiliation:
North London Rotational Training Scheme in Psychiatry
Sukhwinder Shergill
Affiliation:
Maudsley Hospital, London
Cornelius L. E. Katona
Affiliation:
University College London Medical School and Princess Alexandra Hospital, Harlow
*
Dr Zuzana Walker, Department of Psychiatry, University College London Medical School, Wolfson Building, Riding House Street, London WIN 8AA

Abstract

Background

Lewy body dementia (LBD) is emerging as a common cause of degenerative dementia. However, LBD cannot yet be diagnosed with certainty in life. There is some preliminary evidence that the pattern of cognitive impairment in LBD is different from that in Alzheimer's disease (AD). We set out to compare the performance on different subtests of the Cambridge Cognitive Examination (CAMCOG) of LBD patients and AD patients who were similar in overall degree of cognitive impairment.

Methods

All patients were recruited from a memory clinic LBD (n = 17) was diagnosed according to the McKeith clinical criteria. AD (n = 17) was diagnosed according to NINCDS-ADRDA criteria. The performances of LBD and AD patients on the neuropsychological subscales of the CAMCOG were compared by applying Hotelling's multivariate test of significance and subsequent univariate F tests.

Results

There were no statistically significant differences between the two groups on Mini-Mental State Examination and global CAMCOG rating. Hotelling's test with LBD and AD as the between-group factor and the neuropsychological subtests from CAMCOG as dependent variables revealed a statistically significant group effect (P < 0.05). Univariate F tests showed that recall (P < 0.02) and praxis (P < 0.003) significantly contributed to this effect.

Conclusions

These results suggest that there may be different neuropsychological profiles in the two conditions, with LBD subjects being better on recall but worse on praxis than those with AD.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Berl, L. (NM) Clinical Dementia Rating (CDR). Psychopharmacology Bulletin, 24, 637639.Google Scholar
Byrne, E. J. (1995) Cortical Lewy body disease: An alternative view. In Developments in Dementia and Functional Disorders in the Elderly (eds Levy, R. & Howard, R.), pp. 2130. Petersfield. UK: Wrightson Biomedical.Google Scholar
Coofer, J. A., Sagar, H. J., Jordan, N., et al (1991) Cognitive impairment in early, untreated Parkinsons disease and its relationship to motor disability. Brain, 114, 20952122.Google Scholar
Fotetoin, M. F., Folttoin, S. E. & McHugh, P. R. (1975) Mini Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Galloway, P. H., Sahgal, A., McKeith, L. G., et al (1993) Visual pattern recognition memory and learning deficits in senile dementias of Alzheimer and Lewy body types. Dementia. 3, 101107.Google Scholar
Hansen, L., Salmon, D., Galasko, D. et al (1990) The Lewy body variant of Alzheimer's disease: A clinical and pathologic entity Neurology, 40, 18.Google Scholar
Hodges, J. R. (1994) Standardised mental test schedules: Their uses and abuses. In Cognitive Assessment for Clinicians, pp. 183195. Oxford: Oxford University Press.Google Scholar
Huber, J., Shuttleworth, E. C. & Fraidanberg, D. L. (1989) Neuropsychological differences between the dementias of Alzheimer's and Parkinson's disease. Archives of Neurology, 46, 12871291.Google Scholar
McKeith, I. G., Perry, R. H., Fairbairn, A. F., et al (1992) Operational criteria for senile dementia of Lewy body type (SDLT). Pathological Medicine, 22, 911922.Google Scholar
McKeith, I. G., Perry, R. H., Fairbairn, A. F., Galasko, D., Wilcock, G. K., et al (1995) Lewy body dementia – diagnosis and treatment. British Journal of Psychiatry, 167, 709717.Google Scholar
McKhann, G., Drachman, D., Folstein, M. F., et al (1984) Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Pattie, A. H. & Gilleard, C. J. (1979) Manual of the Clifton Assessment Procedures for the Elderly (CAPE), Sevenoaks: Hodder and Stoughton.Google Scholar
Pillton, B., Dubois, B., Lhermitta, F. et al (1986) Heterogeneity of cognitive impairment in progressive supranuclear palsy Parkinsons disease, and Alzheimer's disease. Neurology, 36, 11791185.Google Scholar
Richards, M., McLoughlin, D. & Lavy, R. (1995) The relationship between extrapyramidal signs and cognitive function in patients with moderate to severe Alzheimer's disease. International Journal of Geriatric Psychiatry, 10, 395399.Google Scholar
Roth, M., Tym, E., Mountjoy, C. Q. et al (1906) CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698709.CrossRefGoogle Scholar
Sahgal, L. A., Galloway, R. H., McKaith, I. G., et al (1992) Matching-to-sample deficits in patients with senile dementias of the Alzheimer and Lewy body types. Arch Neurology, 49, 10431046.Google Scholar
Wechsler, D. (1981) WAIS-R Manual, New York: Psychological Corporation.Google Scholar
Yesavage, J. A. (1988) Geriatric Depression Scale. Psychopharmacology Bulletin, 24, 709711.Google Scholar
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