NEUROPSYCHOLOGICAL, PSYCHIATRIC, AND CEREBRAL BLOOD-FLOW FINDINGS IN VASCULAR DEMENTIA AND ALZHEIMERS-DISEASE

Background and Purpose Psychiatric, neuropsychological, and cerebral b lood flow differences between patients with ischemic vascular dementia (IVD) or Alzheimer's disease (AD) were examined. Methods A consecutiv e series of patients who met either the criteria of the National Insti tute of Neurological Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association for probable AD or the State of Cali fornia AD Diagnostic and Treatment Centers criteria for probable IVD w ere included in the study. Twenty consecutive patients with IVD were m atched for age, sex, and Mini-Mental State Examination scores with 40 consecutive patients with probable AD. Patients underwent a psychiatri c interview, a neuropsychological assessment, and single-photon emissi on CT imaging with (99)mTc-hexamethylpropyleneamine oxime. Results Pat ients with IVD showed significantly more severe anosognosia (P<.05) an d emotional lability (P<.01) than AD patients, but no significant betw een-group differences were found in the frequency and severity of depr ession. IVD patients showed significantly more severe deficits in test s of planning, sequencing (P<.05), and verbal fluency (P<.05) as well as significantly more severe cerebral blood how deficits in the basal ganglia (P<.01) and the frontal lobes (P<.001) than AD patients. Concl usions Patients with IVD showed a relatively more severe dysfunction o f the frontal lobes as demonstrated by single-photon emission CT and e xpressed in specific psychiatric and neuropsychological changes than A D patients matched for age, sex, and severity of dementia.