THIRD INTERNATIONAL CONFERENCE ON ALZHEIMER’S DISEASE s3

Subjects with the CDR score 0.5 (indicating questionable dementia) or more were examined by a neurologist. The MMSE scores, GP:s assessment of cognitive capacity, relatives assessment of memory and functional capacity were analyzed of the subjects with the CDR score 0. A follow up was made after one year.

Results: CDR was completed in 656 cases. 93 subjects examined by a neurologist fulfilled the DSM-III-R criteria of dementia. 31 subjects with the CDR score 1 or more did not have dementia. After analyzing all available data of the subjects with the CDR score 0 we did not find any demented patents among them.

Conclusions: The modified CDR scale proved to be a good screening tool for dementia. With the cutpoint 1 (mild dementia) the sensitivity was 95 % and the specificity 94 %.

9 A LONG-TERM DEMENTIA STUDY. A 25 YEAR PERSPECnVEZ ON NEUROPSYCHOLOGICAL FINDINGS. A Johanson, L Gus&on, B Hagberg, J Risberg and A Brun. Depts of Psychogeriatrics, Psychia@y and Pathology and Gerontology Research Center, University of Lund, P.O. Box 638, S-220 09 Lund, Sweden. This paper focuses upon neuropsychological findings in the Lund longitud- inal dementia study. Patients with dementia of Alzheimer type (DAT), frontal lobe degeneration of non-Alzheimer type (FLD) and vascular dementia (VD) were included. The aim was to develop and evaluate neuropsychological tests for early identification of different types of dementia. An extensive neuro- psychological e xamination based on tests measuring verbal ability, memory functions, visuospatial functions and personality were performed repeatedly during the course of the disease. Certain patients were assessed at lo-15 occasions. The results from the neuropsychological testings were related to the clinical diagnosis, outcome of neurophysiological measurements such as regional cerebral blood flow (rCBF) and EEG and to the detailed neuropatho- logical evaluation of deceased cases. 5 1 patients (16 men and 35 women) with the clinical diagnosis of DAT were selected for this analysis. The onset of dementia was early (~65 years; mean=56, range 45-39) in 39 patients and late in 12 patients (mean=73, range 66-83). The duration of dementia at the first neuropsychological assessment was 4.3 in the early onset group and 2.1 years in the late onset group. RESULTS: Marked diffenmces in test profiles and behaviour characteristics were seen between patients with FLD and DAT. The FLD patients showed impaired results on verbal ability and better preserved capacity on memory and spatial functions. All DAT patients showed marked cognitive impairment in verbal as well as spatial memory and visuospatisl ability, while verbal function, as measured by vocabulary was better preserved. The testprofiles were influenced by the patients age and duration of the illness. CONCLUSION: The results have shown the possibility of early and correct diagnoses in patients with dementia using quantitative and qualitative neum- psychological methods.

10 Correlations between the “Severe Impairment Battery” and other scales for dementia

Parlato V (l-2), lavarone A (1). Galeone F (l), Boller F (2). Saxton J (3). Panisset M (2), Bonavita V (1). Carlomagno S (1)

lstituto di Scienze Neurologiche - Naples INSERM - lJ324, Paris (3) ADRC - Pittsburgh

To assess cognitive functions of patients with dementia’ in advanced stages of the disease, the Italian version of the “Severely Impaired Battery” (SIB) (Saxton et al. 1990) was given to 55 institutionalized patients with probable Alzheimer’s Disease. The SIB assesses nine behavioral and cognitive domains and consists of 57 simple questions composed of single one-step commands that can be presented in conjunction with gestual cues in order to facilitate comprehension. Its score ranges from 0 to 133 points. Credits are given to non-verbal and partially correct responses. All the patients also received the MMS examination, the Disability Rating Scale, Dementia Rating

Scale and the Blessed Dementia Scale. High positive correlations were found between the SIB scores and those of the other scales for the whole group of patients. However these correlations were no longer found when the 17 most severe patients, whose Dementia Rating Scale score was 3 or more, were considered. In these patients, while the MMS scores were less than 5, the SIB scores were widely distributed, ranging from 10 to 90. The highly significant inter-rater (p c.01) and test-retest (pc.01) reliability we found, confirms that the SIB is a reliable diagnostic tool for severely demented patients. It also offers the advantage of extending the range over which patients can be tested when they show a floor effect On tests like the MMS and the Blessed Scale.

11 TRAIL MAKING TEST IN THE SCREENING OF DEMENTIfi: AN INTRODUCTION OF A NEW VERSION n. Vanhanen. T. Hlnninen, E-L. Helkala, k. Kolvlsto. L. Mykklnen, M. Laakso. K. PySrB11, PJ. Riekkinen. Departments of neurology and Medicine, University of Kuopio, 70210 Kuoplo, Finland We have examined Trail Making test (TMT) for- screening of general population for dementia. A random population sample of 592 persons bar-n from 1912 to 1921 was draw" from Kuopio population. Resider the TMT A and B version. we used the TMT c. I” TMT C the alphabets ar-e replaced with the names of the months abbreviated into three first letters of the name of month. Verbal fluency test. Heaton visual reproduction test, Learning of the word list with Rucchke's selective reminding method and Mini Mental state examination were also administered to the subjects. The TMT C wae related to broader variety of cognitive abilities considered to deteriorate in dementia than the TMT 9. The re- test reliability of TMT C was as good as TMT 9. The TMT C differentiated the demented subjects from nondemented subjects yet after adJusting for age and education. However. to determine cutting point for predicting possible dementia. age and education should cone~der. TMT C dlf*erentlated better highly educated subjects than TNT B.

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SHORTENED STROOP COLOR-WORD TEST: ITS APPLICATION IN NORMAL AGING AND ALZHEIMER’S DISEASE Venneri A.‘**, Molinari MA.‘,Pentore RI, Cbtticelli B?,Nichelli P.‘, Clffarra P? ’ CJinicaNeurologica - UniversilPdegliStudi Via&i Po7zo;Il 411oOMCIENA ' Istilurodi kurologia Un iversiti degli Studi Via del Qartiere.4 43 IO PRMA (My)

Memory disorders are traditionally a primary diagnostic criteria and one of the most frequent manifestations of Alzheimer’s Disease (AD). Nevertheless selective attention and susceptibility to interference may also be affected in AD. One of the task used to assess these cognitive functions could be the Stroop Color-Word Test that consists of three subtests: reading color names, naming colors and identifying the color of ink a color-word is printed in rather than reading the word itself (interference effect). Since the Stroop Test in its original form take too longer to administer to demented people, we developed a shortened-version consisting of 30 items for each subtest. 25 early AD patients (mean age: 66.4) and 32 normal elderly controls matched for age and educational level were administered with this task as a part of a large battery. Performance was scored as execution time and number of errors. Results showed a statistical difference between AD patients and controls for execution time