Agraphia in Alzheimer’s Disease

Abstract

Writing disorders are an early manifestation of Alzheimer’s disease (AD), often more severe than language difficulties. AD patients produce shorter and less informative written descriptions of a complex picture than controls. These abbreviated texts also include many intrusions, semantic substitutions, and misspellings. Syntactic difficulties are characterized by a reduction of subordinate clauses rather than by the occurrence of grammatical errors. Lexical spelling is systematically more impaired and affected earlier than phonological spelling. With disease progression, the deficits of central writing processes extend to graphic difficulties and alteration of handwriting spatial organization. In the context of a semiotic hierarchy, an inverse relationship is suggested between writing acquisition during childhood and subsequent writing degradation in AD. The writing disturbance in AD is evidently related to a disruption in the anatomicofunctional cerebral network designed for writing processes, mainly in the parietal regions.

Agraphia in Korean patients with early onset Alzheimer's disease

“…Our patients showed visuoconstructional errors even in the early stages of disease, which is inconsistent with the findings of a previous study (Croisile, 1999). In that study, Croisile suggested that visuospatially disorganized handwriting appears later than linguistic abnormalities in the progression of the disease.…”

Age-related psychomotor slowing as an important component of verbal fluency

“…These results agree with previous research in which slower reading speed than in healthy controls has been reported in mild AD patients [11,22]. The corresponding reduction in handwriting speed was of 59%, which agrees with data from an earlier study [14]. Since no errors were observed in performance of reading and handwriting tasks, differences between groups were interpreted as the consequence of the progressive psychomotor decline related to aging.…”

Imaging correlates of posterior cortical atrophy

“…While parietal lobe atrophy was also present in the patients with typical AD, it was much less severe than that observed in the PCA patients, and in contrast it seemed to affect the left parietal lobe greater than the right. Features such as agraphia, acalculia and apraxia typically result from left parietal lobe damage, and are relatively common findings in patients with typical AD [12,39,51].…”