Intellectual faculties in patients with Alzheimer's disease regress to the level of a 4–5‐year‐old child

Abstract

Background: The present study investigated when children acquire the cognitive abilities and daily living skills that are lost in Alzheimer's disease. Methods: Among a total of 1046 students in kindergarten and elementary schools affiliated with Gunma University, Japan, five female and five male students in each grade were selected at random and examined by the mini‐mental state examination (MMSE) and physical self‐maintenance scale (PSMS). For comparison, a total of 135 outpatients with Alzheimer's disease were examined. The results of MMSE and PSMS from the first visit to Gunma University Hospital after the onset of Alzheimer's disease were used. Results: The MMSE score gradually increased from 10 points in the 1st year of kindergarten (age 3 in Japan) to 29 points in the 6th grade of elementary school (age 11 in Japan). The PSMS score increased similarly from 3 points in the 1st year of kindergarten to 6 points in the 6th grade of elementary school. The mean scores of MMSE and PSMS were 17.3 and 3.7 in the Alzheimer patients’ group. These findings suggested that cognitive and daily performance abilities examined by MMSE and PSMS are acquired in childhood during kindergarten and the early grades of elementary school. Conclusion: These cognitive and daily performance abilities of Alzheimer's disease outpatients regress to a level of a child between 4 and 5 years old. This simple understanding of Alzheimer's disease patients may contribute to further appropriate care by non‐specialists and caregivers.

Comparing the Latent Structure of the Children’s Category Test-Level 1 among Young Children and Older Adults: A Preliminary Study

“…It should be also noted that the disorganization of these higher order thinking abilities, which are related to fluid intelligence, was found to be present before the appearance of clinically detectable dementia in the participants in the sample of old-old adults. This result seems to be in line with findings indicating that a large proportion of healthy old-old adults shows memory decline which may represent the early stages of a potentially more severe cognitive impairment (Goldman et al, 2001;Shoji et al, 2002;Schmitt et al, 2000).…”

“…Moreover, researchers have observed the general relationship between aging and development as findings in gerontological research have indicated that the collapse of intelligence in dementia patients causes retrogression to childhood and/or appears to reverse Piaget's developmental stages (de Ajuriaguerra & Tissot, 1968;Rubial-Álvarez, de Sola, Machado, Sintas, Böhm, Sánchez-Benavides, Langohr, Muñiz, & Peña-Casanova, 2013;Shoji, Fukushima, Wakayana, Shizuka-Ikeda, Ikeda, Kawakami, Sakazume, Ikeda, Harigaya, Matsubara Kawarabayashi Murakami, Nagano, Manabe, & Abe, 2002). As stated by the retrogenic models, there is an inverse and progressive pattern of functional and cognitive decline observed in Alzheimer's Disease (AD) patients compared to the developmental acquisition of the corresponding capacities in children.…”

“…Since there is a loss of cognitive abilities acquired during childhood before the appearance of clinically detectable dementia (Shoji et al, 2002), comparisons of cognitive ability should also be made between the aforementioned groups of population, namely the developing children and the cognitively normal older adults or preclinical AD patients.…”

“…More sensitive tests to detect early or preclinical stages of AD are desired, such as the MMSE, Wechler Adult Intelligence Scale-Revised (WAIS-R) and the Wechler Memory Scale-Revised (WMS-R), which are evidencebased test batteries for memory decline and intelligence. However, these scales can be administered (have been developed and standardized) only to persons between 16 and 74 years of age (Shoji et al, 2002).…”

“…In order for an approximate comparison between children's and older adults' cognitive ability to be correctly conducted, the administration of the same screening instruments to the two groups should be available (Papantoniou, Moraitou, Dinou, Katsadima, Savvidou, & Foutsitzi, 2015;Rubial-Alvarez, Machado, Sintas, de Sola, Böhm, & Peña-Casanova, 2007;Shoji et al, 2002). In addition, throughout the many attempts that have been made to develop test batteries for the early detection of dementia, it is also possible that the detection of preclinical AD could be more accurate through neuropsychological tests focused on the detection of developmental disturbances both in young children and older adults.…”