NEUROPSYCHOLOGICAL PATTERNS AND LANGUAGE DEFICITS IN 20 CONSECUTIVE CASES OF AUTOPSY-CONFIRMED ALZHEIMERS-DISEASE

A retrospective chart review of clinical symptoms was done for 20 cons ecutive patients in whom postmortem examination had revealed senile pl aques and neurofibrillary tangles in a distribution consistent with Al zheimer's disease. All patients had met clinical diagnostic criteria f or probable Alzheimer's disease. On initial examination, 1 to 14 years beyond putative onset of the dementia, all patients displayed at leas t some memory impairment. In 16 patients, disturbances of attention or recent memory were among the most salient features. In two patients, language disturbances, and in two others, visuospatial deficits, were more prominent than difficulties with memory and attention. On initial examination, 17 of the 20 patients displayed word-finding difficultie s, characteristically in the context of a fluent, anomic aphasia. All of the 12 reexamined patients demonstrated progressive, although varia ble, deterioration. In general, the initial salient deficit remained s alient during much of the disease course. Language comprehension was s pared in the earlier stages but eventually deteriorated. Severe defici ts emerged in all major cognitive domains as the disease reached the t erminal stages. Nonfluent aphasias (eg, Broca's aphasia) were not obse rved even in the advanced stages of the disease.