Table 1

Demographic and global cognitive data of our subgroups (* indicates

p<0.05)

N age

gender

(m/f)

education

(years) MMSE

CDR sum

of boxes

MCI visuospatial 36 73.4 (9.0) 25/11 15.1 (3.6)* 26.4 (1.7) 1.65 (0.8)

MCI amnestic 104 74.3 (7.2) 73/31 16.3 (2.6)* 27.0 (1.8) 1.84 (0.9)

AD visuospatial 28 72.7 (9.0) 17/11 15.4 (3.1) 22.8 (2.0) 4.4 (1.9)

AD amnestic 68 73.3 (6.9) 35/33 15.2 (2.8) 23.6 (2.1) 4.2 (1.4)

Oral Sessions: O3-04: Diagnosis and Prognosis: Novel Neuropsychological Studies of Dementia P525

room. Patients with Alzheimer’s disease (AD) typically have difficulty with

tasks requiring ASA and anatomical regions implicated in ASA in the

healthy brain are vulnerable in AD, suggesting that ASAmay provide a win-

dow on AD pathophysiology. Methods: Here we studied the brain mecha-

nism of the ’cocktail party effect’ using 3T fMRI in a cohort of patients

fulfilling consensus criteria for typical AD in relation to age-matched

healthy subjects.We designed a ’sparse’ image acquisition, passive listening

paradigm to minimise extraneous cognitive or task-related attentional de-

mands, control low-level auditory perceptual features and optimise signal

detection. We reasoned that the cocktail party effect would be captured by

the differential ASA demands during processing of sound conditions where

the auditory target was a learned template (one’s own name) versus a com-

parably acoustically complex but unfamiliar sound object (one’s own name

spectrally rotated). Subjects heard four stimulus conditions: i) their own

name interleaved with babble, ii) own name superimposed on babble, iii)

own name spectrally rotated (rendered unrecognisable) and interleaved

with babble, or iv) own name spectrally rotated and superimposed on bab-

ble. Results: Compared with healthy older controls, AD patients showed

heightened activation in posterior hippocampus during ’cocktail party’ pro-

cessing. Conclusions: Our findings suggest that ASA is a model of generic

cortical information processing that can be used to probe obligatory patho-

physological mechanisms of AD, including abnormally heightened or com-

pensatory processes. This work goes beyond the traditional emphasis on

higher cognitive and mnestic functions in AD: besides illuminating an im-

portant but poorly understood class of perceptual symptoms, such work

promises novel insights into neural network dysfunction underpinning AD.

O3-04-04 GENETIC AND BRAIN ATROPHY MARKERS

ASSOCIATEDWITH DIFFERENT

PSYCHOLOGICAL PHENOTYPES WITHIN ADNI

Felix Woodward1, Kelvin Leung1, Sebastian Crutch2, 1University College

London Institute of Neurology, London, United Kingdom; 2Dementia

Research Centre, London, United Kingdom. Contact e-mail: felix.

woodward@ucl.ac.uk

Background: The study of phenotypic heterogeneity in Alzheimer’s dis-

ease (AD) may reveal important factors driving the spatiotemporal dynam-

ics of disease progression. Previous evidence suggests that individuals with

the visual syndrome posterior cortical atrophy (PCA) differ from typical AD

not only in atrophy distribution but also apolipoprotein E (APOE) genotype

(fewer ε4 allele carriers). This study evaluated whether more subtle varia-

tions in the relative extent of memory and visual dysfunction in typical

MCI and AD patients in ADNI are related to similar atrophy and genetic

profiles.Methods: For all ADNI MCI and AD patients, standardised scores

(relative to controls) were generated were for memory function (Rey Audi-

tory Verbal Learning Test) and visuospatial function (composite of MMSE

pentagon copy, ADAD-COG constructional praxis and clock copying sub-

tests). Patients with a discrepancy of >2 SDs between these scores were in-

cluded in the analysis.Results:A>2 SD discrepancy was identified in 35%

of MCI and 50% of AD ADNI participants (memory<vision: 104 MCI, 68

AD and vision<memory: 36 MCI, 28 AD) study groups. In MCI, the mem-

ory and visuospatial groups had equivalent demographics and measures of

global impairment (see table,). There were more e4 allele carriers in the am-

nestic (57.7 %) than visuospatial group (41.6%; p¼0.097). There were no

group differences in whole brain or ventricular atrophy. However, right hip-

pocampal atrophy was significantly greater in the amnestic group at 6

months (p<0.001), 12 months (p¼0.03) and 24months (p¼0.003). Left hip-

pocampal atrophy was significantly greater in the amnestic group at 24

months (p¼0.048). See figure. In AD there were no significant differences

between the groups in terms of global cognition or demographics. The

same pattern was seen with respect to APOE-ε4, although less emphatically

(57.1% in the visuospatial and 66.1% amnestic group). No significant differ-

ences in atrophy were observed. Conclusions: Considerable phenotypic

heterogeneity exists within the ADNI MCI and AD cohorts. In individuals

with MCI, relatively greater visuospatial than memory dysfunction is asso-

ciated with lower hippocampal atrophy and lower incidence of the ε4 allele.

These findings are in line with previous studies highlighting genetic differ-

ences between PCA and amnestic phenotypes of AD.

O3-04-05 COMPARING NEUROPSYCHIATRIC SYMPTOMS

IN PATIENTS WITH ALZHEIMER’S DISEASE AND

VASCULAR DEMENTIA

Amardeep Saund1, Cassandra Anor2, David Tang-Wai3, Ron Keren3,

Maria Carmela Tartaglia3, 1York University, Toronto, Ontario, Canada;2University of Toronto, Toronto, Ontario, Canada; 3TorontoWesternHospital,

Toronto, Ontario, Canada. Contact e-mail: c_anor84@hotmail.com

Background:Neuropsychiatric symptoms (NPS) are common in patients

with dementia including Alzheimer’s disease (AD) and vascular demen-

tia (VaD). The most common NPS encountered in dementia are apathy,

irritability, agitation, depression, delusions, hallucinations, anxiety, dis-

inhibition, aberrant motor behavior, sleep disturbances, euphoria, and

eating abnormalities1. These symptoms are a major source of caregiver

burden and a major contributor to institutionalization. Different neurode-

generative diseases may be associated with certain NPS and this may im-

pact treatment and care. Methods: This was a retrospective chart review

of 381 patients who presented to the Toronto Western Hospital Memory

Clinic with cognitive complaints. Forty-seven patients who met 2011 cri-

teria for Alzheimer’s disease2 and 18 patients with vascular disease un-

related to stroke3 who had a Neuropsychiatric Inventory (NPI)1 score or

data on NPS were included in the study. Chi-square tests and logistic re-

gression with diagnosis, age and gender were used to determine whether

diagnosis was associated with specific NPS. Results: There were no sig-

nificant differences in age, education or MMSE (AD 22.7; VaD 23.1) be-

tween patients with AD and VaD, but a significant difference in gender

(p¼0.0475, AD 66%F;VaD 39%F). NPS were common in AD and VaD.

VaD patients had significantly more sleep disturbances (p<0.05;AD25%,

VaD53%) and agitation (p<0.01;AD16%, VaD58%) than AD patients.

There was a trend for more aberrant motor behaviour in VaD

(p¼0.06,AD4%; VaD23%). Logistic regressions revealed diagnosis as

the main predictor of agitation controlling for age and gender, Odds

Oral Sessions: O3-05: Public Health and Psychosocial Focus: Interventions and Models of Care for People withMCI and Dementia

P526

Ratio of 10 (1.7- 66.9) for agitation if patient had VaD. Logistic regres-

sion for sleep disturbances revealed both age and diagnosis as predictors.

The frequency of the other NPS was not significantly different in AD and

VaD patients. Conclusions: Neuropsychiatric symptoms were frequently

present in AD and VaD. Agitation and sleep disturbances were more fre-

quently encountered in VaD than AD. These differences are likely re-

lated to underlying pathology and warrant further study as they have

implications for treatment. 1 Cummings, JL, Neurology,1997. 48(5

Sup6):pS10-6. 2McKhann, GM, et al., Alzheimers Dement,2011.

7(3):p263-9. 3Gorelick, PB, et al., Stroke,2011. 42(9):p2672-713.

O3-04-06 FASTER FORGETTING: DISTINGUISHING

ALZHEIMER’S DISEASE AND

FRONTOTEMPORAL DEMENTIAWITH DELAYED

RECALL MEASURES

Katija Khan1, Sarah Wakefield1, Daniel Blackburn2, Annalena Venneri1,1University of Sheffield, Sheffield, United Kingdom; 2Sheffield Institute for

Translational Neuroscience, University of Sheffield, Sheffield, United

Kingdom. Contact e-mail: kat.khan@sheffield.ac.uk

Background: Many neuropsychological features of Frontotemporal de-

mentia (FTD) overlap with AD (Alzheimer’s disease) making differen-

tial diagnosis a challenge. While some FTD patients show impairment

in executive functioning, others may also display relatively normal pro-

files. Deficits in visual and verbal memory have been noted in both de-

mentias but are less severe in FTD. Qualitative examination reveal

greater semantic memory impairment in AD than FTD, however, other

quantitative analyses of memory measures may also prove useful in dif-

ferentiating the two. Methods: Fifteen patients with AD, 15 patients

with FTD and 15 controls were administered the Mini Mental State Ex-

amination, a visuospatial memory measure: Rey Osterreith Complex

Figure and a verbal memory measure: Prose Memory. Copy, immediate,

delay (10 minutes) and percentage recall scores were compared using

ANOVA and post hoc analyses. Organisational strategy on the Rey Fig-

ure was assessed using the Hamby et al (1993) scoring system. Results:

Age and years of education were similar across all three groups. MMSE

scores were higher in the control group but similar across the FTD and

AD groups. The AD group performed significantly worse on all mea-

sures. Immediate prose memory recall, Rey copy and organizational

strategy scores distinguished AD from controls but not FTD. Delay mea-

sures on both the Rey figure and Prose memory distinguished both AD

and FTD from controls as well as AD from FTD. Percentage recall

scores on both measures differentiated AD from control as well as AD

from FTD. Conclusions: Immediate recall, copy and organizational strat-

egy scores were unable to distinguish AD from FTD. Delayed recall

showed a progressive decay in scores across controls, FTD and AD respec-

tively. This is consistent with reported findings which show retention prob-

lems in both dementias. Percentage recall scores for both visuospatial and

verbal memory measures were significantly lower in AD but not FTD pa-

tients. These scores are based on the patient’s initial reproduction and not

the original reproduction; therefore initial poor encoding is not penalized.

AD patients exhibited faster forgetting while the performance of FTD pa-

tients was similar to controls. Thus in patients showing overlap of symp-

toms, faster forgetting in AD patients can be used to aid differential

diagnosis.

ORAL SESSIONS: O3-05:

PUBLIC HEALTH AND PSYCHOSOCIAL FOCUS:

INTERVENTIONS AND MODELS OF CARE FOR PEOPLE WITH

MCI AND DEMENTIA

O3-05-01 PHYSICAL ACTIVITY, INDEPENDENT

FUNCTIONING AND EMOTIONALWELL-BEING

IN EARLY-ONSET DEMENTIA

Astrid Hooghiemstra1, Laura Eggermont2, Wiesje Van der Flier3,

Philip Scheltens3, Erik Scherder2, 1VU University and VU University

Medical Center, Alzheimer Center, Amsterdam, Netherlands; 2VU

University, Amsterdam, Netherlands; 3VU University Medical Center,

Amsterdam, Netherlands. Contact e-mail: a.m.hooghiemstra@vu.nl

Background: It is known that physical activity benefits emotional well-

being. A positive relationship between physical activity levels and

executive functioning, crucial for independent functioning, has been

demonstrated in older persons with and without cognitive impairment.

In view of the better physical shape of middle-aged adults compared

to older persons, it is surprising that no studies regarding physical activ-

ity focus on patients suffering from early-onset dementia (EOD). The

aims of the present study were twofold: 1) to assess the difference in

the amount of daily physical activity between EOD patients and cogni-

tively healthy middle-aged adults, and 2) to study whether higher levels

of physical activity are related to better independent functioning and

emotional well-being in EOD patients. Methods: EOD patients (n¼62)

and cognitively healthy adults of middle age (n¼130) participated.

EOD patients were recruited in order to participate in a physical activity

program. Outcome measures were physical activity (pedometer and

questionnaire: Physical Activity Scale for the Elderly (PASE)), executive

functioning, (instrumental) activities of daily living, mood, and quality

of life. Results: No differences existed between EOD patients and

healthy adults in age and level of education (for mean and standard de-

viations see Table 1). The EOD group included relatively more males

than the control group. 77% of EOD patients had probable Alzheimer’s

disease. Preliminary results show that EOD patients reported less en-

gagement in physical activities on the PASE compared to healthy adults

(m¼144.8665.3 and m¼187.0676.0, p<.001). However, EOD patients

and healthy adults take the same amount of steps every day

(687163715 vs. 704862797), reflecting a less active lifestyle than rec-

ommended by the World Health Organization. In EOD patients, we ob-

served a modest correlation (r¼.33; p¼.02) between the number of steps

taken each day and the initiative to undertake (instrumental) activities of

daily living, after controlling for age and sex. No other correlations

reached significance. Conclusions: This is the first study to examine

physical activity in EOD patients. Preliminary results indicate that phys-

ical activity is related to the extent of (dis)ability.

Table 1

Demographics for EOD patients and healthy adults

EOD Healthy adults

(n ¼ 62)

(n ¼ 130) p-value

Age (M 6 SD)

61.8 6 4.9 61.2 6 4.4 .40

Sex (_/\)

41/21 62/68 .02

Level of education#

5.3 6 1.2 5.4 6 1.0 .80

MMSE (M 6 SD)

24.3 6 3.5 29.1 6 1.4 <.001

Diagnosis, n (%)

AD 47 (77%)

VaD

5 (8%)

DLB

7 (12%)

FTD

2 (3%)

Independent samples t-tests were conducted for age and MMSE, Mann-

Whitney U test for level of education and c2 -test for sex.

EOD ¼ early-onset dementia; M ¼ mean; SD ¼ standard deviation;

MMSE ¼ Mini-Mental State Examination; AD ¼ Alzheimer’s disease;

VaD ¼ vascular dementia; DLB ¼ dementia with lewy bodies; FTD ¼frontotemporal dementia

#Categorization of education (low versus high education) is based on

Verhage’s education classification (Verhage, 1964)

O3-05-02 CARE MANAGEMENT FOR VA PATIENTS WITH

VASCULAR RISK FACTORS AND COGNITIVE

IMPAIRMENT: A RANDOMIZED TRIAL

Laura M. Bonner1, Gayle Robinson1, Suzanne Craft2, 1VA Puget Sound

Health Care System, Seattle, Washington, United States; 2Wake Forest