PATTERNS OF NEUROPSYCHOLOGICAL IMPAIRMENT IN MILD DEMENTIA - A COMPARISON BETWEEN ALZHEIMERS-DISEASE AND MULTIINFARCT DEMENTIA

The objective was to investigate the clinical and psychometric differe nces between patients with dementia of Alzheimer type (DAT) and patien ts with multi-infarct dementia (MID), matched for age, sex, education, and severity. Sixteen patients with DAT, 16 patients with MID, and 30 healthy individuals, were drawn from a longitudinal study on aging an d dementia. Subjects with medical or previous mental disorders were ex cluded. DAT and controls with focal brain abnormalities on magnetic re sonance imaging (MRI) were excluded. Diagnosis of dementia was carried out according to DSM-III-R criteria. Dementia severity was staged usi ng the Clinical Dementia Rating (CDR) scale, and only patients with a score of 0.5-1 on CDR were studied. The main outcome measures were qua ntitative clinical scales of the assessment of global mental status, d epression and anxiety, as well as a wide battery of neuropsychological tests for the evaluation of executive/conceptual functions and memory , as well as attention verbal ability, and visuospatial skill function s. The performance of demented patients compared to normal controls wa s affected on all measurements except for depression and anxiety. DAT patients showed compared to MID patients a greater extent of impairmen t on tasks assessing verbal comprehension and memory while MID patient s were more significantly impaired on measures of frontal lobe functio ning. Clinically matched DAT and MID patients show a differential patt ern of neuropsychological impairment when studied in an early stage of dementia and with a mild degree of severity. Such patterns might be o f value for the development of clinical diagnostic criteria.