IDEOMOTOR APRAXIA TEST - A NEW TEST OF IMITATION OF GESTURES FOR ELDERLY PEOPLE

Ideomotor apraxia is one of the earliest disturbances in Alzheimer's d isease (AD); no test of this disturbance has yet been validated for el derly people. We propose a test of meaningless gesture imitation and i ts relevance in elderly people is studied. The Ideomotor Apraxia Test (IAT) consists of showing 10 gestures. Each item is graded from 0 to 3 . IAT was carried out on 55 patients with AD (mean age: 86.8 +/- 6.8 ( 71-100); mean RIMS score: 14.6 +/- 6.3) and 26 elderly patients withou t cognitive impairment (mean age: 84.1 +/- 7.5 (70-100); mean MMS scor e: 27.5 +/- 1.9). The inter-rater reliability, a threshold, the appare nt sensitivity and specificity and the relationship between the MMS sc ore and the ideomotor apraxia score were determined. The mean apraxia score was 14.9 +/- 7.3 in the AD group and 28 +/- 1.6 in the normal gr oup (P < 0.0001). Inter-rater agreement is excellent (P = 0.995). The threshold is 27. The apparent sensitivity and specificity are very goo d (95% and 88%, respectively). The correlation between the MMS score a nd ideomotor apraxia score is excellent (r = 0.83 (95% CI; 0.72-0.91). Age and educational level do not influence ideomotor apraxia score. I AT is the first test that evaluates meaningless gesture imitating capa city in an elderly population. It is an easy and quick-to-perform test , useful routinely for diagnosis of AD. It could contribute to the ear ly diagnosis of AD and is correlated with the severity of cognitive im pairment, Eur J Neurol 5:571-578 (C) 1998 Lippincott Williams & Wilkin s.