Impaired imitation of gestures in mild dementia: comparison of dementia with Lewy bodies, Alzheimer's disease and vascular dementia

Nagahama, Yasuhiro; Okina, Tomoko; Suzuki, Norio

doi:10.1136/jnnp-2014-309436

Cited by 43 publications

(39 citation statements)

References 21 publications

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“…It has even been suggested that a reduced number of angles on the Mini Mental State Examination (MMSE) pentagon copy could be a marker of prodromal DLB, with a specificity of 91% in discrimination from AD [53]. However, DLB is also associated with visuoperceptual deficits (see [54] for a review) and praxic difficulties [55]. Hence, it has been suggested that copying impairments in patients with DLB might be linked to combined praxis and visuoperceptual disturbances [56] instead of reflecting pure visuoconstructive impairment.…”

Section: Discussionmentioning

confidence: 99%

Cognitive profile in prodromal dementia with Lewy bodies

et al. 2017

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BackgroundCortical and subcortical cognitive impairments have been found in dementia with Lewy bodies (DLB). Roughly, they comprise visuoconstructive and executive dysfunction, whereas memory would remain relatively spared. However, the cognitive profile of patients with prodromal DLB remains poorly illustrated to date.MethodsWe included 37 patients with prodromal DLB (age 67.2 ± 8.6 years, 18 men, Mini Mental State Examination [MMSE] score 27.4 ± 2) and 29 healthy control subjects (HCs; age 68.8 ± 7.9 years, 15 men, MMSE score 29.0 ± 0.9). They were presented with an extensive neuropsychological test battery to assess memory; speed of processing; executive function; visuoperceptual, visuospatial and visuoconstructive abilities; language; and social cognition.ResultsCompared with HCs, patients had lower scores on a visual recognition memory test (Delayed Matching to Sample-48 items; p ≤ 0.021) and lower free recall (all p ≤ 0.035), but not total recall, performance on a verbal episodic memory test (Free and Cued Selective Reminding Test). Short-term memory (p = 0.042) and working memory (p = 0.002) scores were also lower in patients. Assessment of executive function showed no slowing but overall lower performance in patients than in HCs (all p ≤ 0.049), whereas assessment of instrumental function yielded mixed results. Indeed, patients had lower scores on language tests (p ≤ 0.022), apraxia for pantomime of tool use (p = 0.002) and imitation of meaningless gesture (p = 0.005), as well as weakened visuospatial abilities (p = 0.047). Visuoconstruction was also impaired in patients. However, visuoperceptual abilities did not differ between groups. Finally, theory of mind abilities were lower in patients than in HCs (p < 0.05), but their emotion recognition abilities were similar.ConclusionsThis study presents the cognitive profile in patients with prodromal DLB. In line with the literature on DLB with dementia, our results show lower performance on tests of executive function and visuoconstruction. However, we found, from a prodromal stage of DLB, memory (free recall and visual recognition) and social cognition deficits, as well as weakened visuospatial and praxic abilities.

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Section: Discussionmentioning

confidence: 99%

Cognitive profile in prodromal dementia with Lewy bodies

et al. 2017

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“…This impairment is often inversely proportional to subcortical cerebral injury, thus allowing clinicians to provide a more accurate prognosis for cognitive decline and functional impairment. [8][9][10][11][12] In 1920, Lipeman studied 84 patients who suffered strokes and discovered that, in addition to aphasia, the patients also had impairments of motor skills such as debilitated copying and imitative gestures. 13 Moreover, regarding more precise aspects of the diagnosis, CAMCOG has contributed towards evaluation of total praxis and its subitems through showing the relevance of some studies that have indicated that impairment of praxis abilities confirms that there is a risk of rapid evolution to severe cases of dementia.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of praxis test from Cambridge Cognitive Examination (CAMCOG) for Alzheimer’s disease: a cross-sectional study

et al. 2018

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BACKGROUND: Praxis impairment may be one of the first symptoms manifested in dementia, primarily in cortical dementia. The Cambridge Cognitive Examination (CAMCOG) evaluates praxis, but little is known about the accuracy of CAMCOG for diagnosing dementia. The aims here were to investigate the accuracy of praxis and its subitems in CAMCOG (constructive, ideomotor and ideational subitems) for diagnosing Alzheimer's disease (AD) among elderly patients. DESIGN AND SETTING: Cross-sectional study on community-dwelling elderly people. METHODS: 158 elderly patients were evaluated. CAMCOG, Mini-Mental State Examination and Pfeffer Functional Activities Questionnaire were used. ROC curve analysis was used to establish cutoff points. RESULTS: The total scores for praxis and the constructive subitem presented significant differences (P < 0.0001) between healthy elderly people and AD patients. Stage of dementia (clinical dementia rating, CDR = 0, 1 and 2) showed that total and constructive praxis can be used to classify the stages of dementia (mild and moderate cases), i.e. constructive praxis classified 88% of the patients with mild dementia (P < 0.0001) while total praxis classified 56% with moderate dementia. Comparison of normal controls (NC) and mild dementia cases showed specificity of 71% and sensitivity of 88% (AUC = 0.88; P < 0.0001). CONCLUSION: Some praxis subtests can have higher predictive diagnostic value for detecting Alzheimer's disease in mild stages (total praxis AUC = 0.858; P < 0.0001; constructive AUC = 0.972; P < 0.0001). Constructive praxis as measured using CAMCOG may contribute towards diagnosing dementia, because occurrence of impairment of praxis may help in recognizing an evolving dementia syndrome.

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“…Age-related decline specifically impacts timing processing and control of attentional load, which are viewed as primary factors in task performance of interlimb coordination in the upper extremity ( Krampe et al, 2010 ). In addition, cognitive impairment influences coordination, such that decreased imitation ability of bimanual gestures has been observed in older adults in the early stages of dementia ( Nagahama et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Age-Related Changes in Bimanual Instrument Playing with Rhythmic Cueing

Kim

Cho

Yoo³

2017

Front. Psychol.

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Deficits in bimanual coordination of older adults have been demonstrated to significantly limit their functioning in daily life. As a bimanual sensorimotor task, instrument playing has great potential for motor and cognitive training in advanced age. While the process of matching a person’s repetitive movements to auditory rhythmic cueing during instrument playing was documented to involve motor and attentional control, investigation into whether the level of cognitive functioning influences the ability to rhythmically coordinate movement to an external beat in older populations is relatively limited. Therefore, the current study aimed to examine how timing accuracy during bimanual instrument playing with rhythmic cueing differed depending on the degree of participants’ cognitive aging. Twenty one young adults, 20 healthy older adults, and 17 older adults with mild dementia participated in this study. Each participant tapped an electronic drum in time to the rhythmic cueing provided using both hands simultaneously and in alternation. During bimanual instrument playing with rhythmic cueing, mean and variability of synchronization errors were measured and compared across the groups and the tempo of cueing during each type of tapping task. Correlations of such timing parameters with cognitive measures were also analyzed. The results showed that the group factor resulted in significant differences in the synchronization errors-related parameters. During bimanual tapping tasks, cognitive decline resulted in differences in synchronization errors between younger adults and older adults with mild dimentia. Also, in terms of variability of synchronization errors, younger adults showed significant differences in maintaining timing performance from older adults with and without mild dementia, which may be attributed to decreased processing time for bimanual coordination due to aging. Significant correlations were observed between variability of synchronization errors and performance of cognitive tasks involving executive control and cognitive flexibility when asked for bimanual coordination in response to external timing cues at adjusted tempi. Also, significant correlations with cognitive measures were more prevalent in variability of synchronization errors during alternative tapping compared to simultaneous tapping. The current study supports that bimanual tapping may be predictive of cognitive processing of older adults. Also, tempo and type of movement required for instrument playing both involve cognitive and motor loads at different levels, and such variables could be important factors for determining the complexity of the task and the involved task requirements for interventions using instrument playing.

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Impaired imitation of gestures in mild dementia: comparison of dementia with Lewy bodies, Alzheimer's disease and vascular dementia

Cited by 43 publications

References 21 publications

Cognitive profile in prodromal dementia with Lewy bodies

Cognitive profile in prodromal dementia with Lewy bodies

Accuracy of praxis test from Cambridge Cognitive Examination (CAMCOG) for Alzheimer’s disease: a cross-sectional study

Age-Related Changes in Bimanual Instrument Playing with Rhythmic Cueing

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