Patterns of Memory Performance in the Neurologically Impaired Aged

Abstract

SUMMARY:The specific behavioral manifestation associated with the different disorders producing the syndrome of dementia have remained poorly investigated. We examined the memory performance of three distinct groups of patients with dementia secondary to Alzheimer's disease (AD) multiple-infarctions (MID) and vertebrobasilar insufficiency (VBI) on the ten subtests of the Wechsler Memory Scale (WMS). Statistical methods of analysis were used to maximize the differences between the groups. Univariate statistical procedures revealed that the AD group performed significantly and consistently lower than the two cerebrovascular groups. There were no significant differences between the two cerebrovascular disease groups, even though the MID group tended to perform consistently more poorly than the VBI group. For heuristic and conceptual purposes as well as to determine which combination of the ten WMS variables produced the “best” statistical model differentiating the groups the data was analyzed by multivariate techniques. A discriminate function analysis obtained a 100% valid positive hit rate in discriminating among the three groups. One hundred percent diagnostic accuracy was also obtained in discriminating between MID and AD as well as AD and VBI. The two cerebrovascular groups tended to overlap in their probability distributions with an 81% hit rate. Different predicitive statistical models were identified to differentiate the various diagnostic groups. It was possible to discriminate the three diagnostic groups by different patterns of memory performance.

Memory failure in binswanger's disease and alzheimer's disease

“…Despite equivalent dementia severity, AD patients were more impaired than BD patients on two of three measures of episodic memory. In two studies (Gainotti et al, 1980;Perez et al, 1975), episodic memory was more impaired in AD than in vascular dementia, but the groups were not equated for age or dementia seventy. In another study (Loring et al, 1986), AD and vascular dementia patients did not differ in selective reminding performance, but dementia was not adequately documented in either group.…”

“…Second, methodological problems have plagued much of the previous neuropsychological research contrasting vascular dementia with other dementia syndromes. The primary problems have been a failure to match samples on key variables like dementia severity (Gainotti, Caltagirone, Masullo, & Miceli, 1980;Gandolfo, Vecchia, Moretti, Brusa, & Scotto, 1986;Perez, Gay, Taylor, & Rivera, 1975;Perez, Mathew, Stump, & Meyer, 1977;Schultz, Schmitt, Logue, & Rubin, 1986;Taylor & McGuire, 1985) and the use of outcome measures whose relevance to dementia is uncertain (Erkinjuntti, Laaksonen, Sulkava, Syrjalainen, & Palo, 1986;Muramoto, 1984). Loring, Meador, Mahurin, and Largen (1986) matched AD and vascular dementia groups on age, education, and the Dementia Rating Scale of Blessed, Tomlinson, and Roth (1968), but the group means on the latter scale were in the normal range, and the groups differed markedly in IQ.…”

Episodic Memory Functioning in Population-Based Samples of Very Old Adults with Alzheimer's Disease and Vascular Dementia

“…In two early studies, it was found that persons with AD performed worse than those with multi-infarct dementia (MID) on several episodic memory tasks [15,16]. However, in these studies the groups differed in global level of cognitive functioning.…”

Comparative Performance of Mildly Impaired Patients With Alzheimer's Disease and Multiple Cerebral Infarctions on Tests of Memory and Functional Capacity

“…Attempts to separate early AD from MICD (multi-infarct cognitive disorder) patients on the basis of neuropsychological measures generally have been unsuccessful, except for observed differences in semantic memory (La Rue, 1992;Loewenstein et al, 1989bLoewenstein et al, , 1991. Although there have been reported differences between AD and MICD patients on the Wechsler Adult Intelligence Scale (Fuld, 1984;Perez et al, 1975aPerez et al, , 1975b, language function (Powell et al, 1988), and visuospatial abilities (Gainotti et al, 1980), groups have not been equated for overall level of cognitive impairment or dementia severity (La Rue, 1992;Loewenstein & Rubert, 1992). When level of global mental status has been equated, Loewenstein andassociates (1989b, 1991) have consistently found that mildly impaired AD and MICD patients with equivalent Folstein Mini-Mental (MMSE) scores of 21 or above (Folstein et al, 1975) can be distinguished with regard to semantic intrusion errors and semantic memory deficits, even when no differences on neuropsychological measures of language, visuospatial abilities, and higherorder cognitive processes are observed.…”