Predictors of cognitive decline in the early stage of probable Alzheimer'sdisease

Several papers have attempted to find neurological and neuropsychological p redictors of progression in Alzheimer's disease (AD) till now. Despite this quite large amount of works, different and not univocal conclusions have b een reported in this field. Different study samples, different end-points a nd differences in statistical methods can explain much of the inconsistency in the results obtained. In our study, AD patients were examined in a very early stage of the disease to avoid any possible risk to examine subjects at different times of evolution. All the patients underwent an extensive ne uropsychological test battery twice (baseline and follow-up) spaced out ove r about 1 year and were divided into two groups of fast decliners (FD) and slow decliners (SD) on the basis of their rate of decay at the MMSE score. Verbal memory tests, mental control abilities and attention-demanding tasks seem to play a pivotal role in distinguishing the two groups of subjects i n the early stage of the disease. Moreover, FD patients show a worse perfor mance than SD at the baseline in most of the cognitive domains explored. In conclusion, different subtypes of AD do exist and an important predictor o f progression is represented by the severity of the cognitive impairment at the onset. Copyright (C) 2000 S. Karger AG, Basel.