Cognitive-Behavioral Profiles of Neurodegenerative Dementias: Beyond Alzheimer's Disease

Abstract

The neurocognitive and behavioral profiles of vascular dementia and vascular cognitive impairment, dementia with Lewy bodies and Parkinson's disease with dementia, and dementia syndromes associated with frontotemporal lobar degenerations are compared and contrasted with Alzheimer's dementia (AD). Vascular dementia/vascular cognitive impairment is characterized by better verbal memory performance, worse quantitative executive functioning, and prominent depressed mood. Dementia with Lewy bodies and Parkinson's disease with dementia are equally contrasted with AD by defective processing of visual information, better performance on executively supported verbal learning tasks, greater attentional variability, poorer qualitative executive functioning, and the presence of mood-congruent visual hallucinations. The frontal variant of frontotemporal lobar degeneration (frontotemporal dementia) differs from AD by better multimodal retention on learning tasks, different patterns of generative word fluency, defective qualitative executive functioning, and by markedly impairment of comportment. For temporal variants of frontotemporal lobar degenerations, progressive aphasia and semantic dementia, worse language performance relative to AD is typically characteristic.

Dysfunction of the magnocellular stream in Alzheimer's disease evaluated by pattern electroretinograms and visual evoked potentials

“…Thus, despite the lack of significant difference between AD and depressed patients, some authors [39,46] were able to differentiate the two conditions.…”

“…However, visual impairment such as visuo-spatial, colour and motion perception deficits can be difficult to evaluate in patients with normal routine eye evaluation without the use of specific psychophysics and electrophysiologic exams [39,44,52,54,73,75,77,86]. Thus, it turns to be important the issue on how to evaluate subtle and specific deficits affecting different visual subsystems in AD patients.…”

“…Impairments in motion perception and target tracing are considered to be a relatively common, however not selective, symptoms after dementia onset in AD [13]. Specific involvement of the magno-cellular stream of visual processing is particularly important since cell loss, prevalent deposition of amyloid plaques and neurofibrillary tangles occur in the primary visual cortex of AD individuals with a prevalence in the M-pathway [38,39]. Our findings are consistent with the supposition that AD determines primary sensory disruption.…”

Evidence-Based Research and Practice in Clinical Neuropsychology

“…If the patient has been bedridden and in the hospital for 3 weeks for a hip fracture and is now being considered for discharge home in a wheelchair, the finding may not be considered abnormal or a contradiction to discharge. However, if the patient is referred to a dementia clinic for work-up and has a history of diabetes and hypertension, this finding in the context of other results might help distinguish vascular cognitive impairment versus Alzheimer's disease (Levy & Chelune, 2007).…”

Clinical, neuropathological and neuroimaging features of Alzheimer's disease and dementia with Lewy bodies

“…6 It has been shown that fluctuation in attention is significantly correlated with fluctuation in cognition, and therefore these two characteristics are often assessed together. 7 DLB patients commonly show increased variability in performance on cognitive tasks, both within and between subjects, and when compared with control subjects and subjects with AD. 6 A study by Ballard et al in 2001 8 evaluated attention and fluctuating attention in 85 patients with DLB and 80 with AD, and 35 age-matched controls.…”