M. Merello et al., EXTRAPYRAMIDALISM IN ALZHEIMERS-DISEASE - PREVALENCE, PSYCHIATRIC, AND NEUROPSYCHOLOGICAL CORRELATES, Journal of Neurology, Neurosurgery and Psychiatry, 57(12), 1994, pp. 1503-1509
The prevalence and clinical correlates of extrapyramidal signs in a co
nsecutive series of 78 patients with Alzheimer's disease attending a n
eurology clinic, and 20 age comparable normal controls, were examined.
Based on the unified Parkinson's disease rating scale (UPDRS) finding
s, 18 patients (23%) met criteria for parkinsonism, 44 (56%) had isola
ted extrapyramidal signs, and 16 (21%) had no extrapyramidal signs. Wh
ereas the control group showed a simliar prevalence of isolated- extra
pyramidal signs (57%), none of them showed parkinsonism. No significan
t differences were found for age, sex, duration of illness, and severi
ty of dementia among the three Alzheimer's disease groups. Patient's w
ith Alzheimer's disease-parkinsonism, however, showed a significantly
higher frequency of major depression and dysthymia and significantly h
igher Hamilton depression scores than patients with isolated or no ext
rapyramidal signs. Patients with Alzheimer's disease-parkinsonism also
show significantly more deficits on frontal lobe related tasks such a
s the Wisconsin card sorting test, trail making test, and verbal fluen
cy, as well as on tests of constructional praxis and abstract reasonin
g than patients with Alzheimer's disease but no extrapyramidal signs.
In conclusion, the study showed a specific association between Alzheim
er's disease and parkinson, as well as significant relationships betwe
en parkinsonism, deficits in executive functions, and depression among
patients with Alzheimer's disease.