THIRD INTERNATIONAL CONFERENCE ON ALZHEIMER’S DISEASE

Piccinin and M. Piccirilli. Dept. of Neurology, University of Perugia, 06100 Perugia, Italy.

Memory deficits constitute one of the earliest and mOst prominent signs of dementlng diseases. The identification Of several forms of mnestic processes suggests that memory tasks can be used to correctly diagnose patients suffering from different dementia syndromes. This work was designed to check if it is mssible to highlight selective patterns of memory performances in vascular (VD) and Alzheimer-typ (DAT) dementias, which would be useful for discriminating between the two forms of mental deterioration. 30 patients who fulfilled the criteria of the DSM-III-R for DAT and VD, rispectively, partecipated to the st_Ldy. Moreover, patients diagnosed as DAT (mean age 63.9 yrs) met the criteria for probable DAT of NINCDS-ADRDA work group, and pdtients diagnosed as VD (mean age 63.6 yrs) had ischemic score modified by Loeb of more than 4. We include only patients who in the cause of extensive neuropsychological examination displayed a rmld to moderate cognitive impairment and no presented deficits of instrumental functions. 15 healthy subjects (mean age 61 .6 yrs) matched for educational level, were selected as a control group. The memory performances were investigated by using the following tasks: WAIS diglt forward repetition test and Rey Auditory-Verb& Learning test for verbal memory; Corsi’s cubes, Rey-Osterrieth complex figure design and Barbizet-Canv’s 7/24 test For vlsuospdtial memory. This battery includes d Serles of Items concerned with working memory and secondary memory in Its declarative form.

The results indicate that neuropsychological memory testing iS d reliable rre!dsLLre for the early detection of dementia. The value of mnesic skills in the differentla diagnosis of specific patterns of mental impairment is rr0i”e Intriguing. However, VD wdS associated especiallv with a disorder in recognition mzory, suggesting that this defect can be helpful for the knowledge of memorv functioning in the dementing illness.

36 Test-retest reliability of patient and caregiver related measures in dementia. SRJA de Rooij, S Teunisse, GJM Walstra Dept. of Neurology, Academisch Medisch Centrum, 1105 AZ Amsterdam, The Netherlands.

In order to get a complete picture of the overall severity of dementia one has to take into account not only cognitive impairment but also disability in daily life and behavioral disturbance of the patient, and burden experienced by the caregiver. One of our ongoing research projects concerns the effect of therapeutic intervention in dementia. Within this scope we developed a study concerning the test-retest reliability of measures related to the disability in daily life and behavioral disturbances of the patient, and burden experien- ced by the caregiver. Subjects were primary care- givers (N=30) of dementia patients, visiting our Memory Clinic. Most patients were living at home. Test-retest period was two weeks. Measures were completed by the caregivers. Preliminary results concerning the repeatability of these measures look satisfactory. The frequen- cy of contact between caregiver and patient is taken into account.

This study was supported by the fund Ontwikke- lingsgeneeskunde OG90-027.

37 CROSS-tlODAL MATCHING IN PATIENTS WITH ALZHEIMER’S DISEASE. L Bach. R Hunter. D N Brooks and J McCulloch. Wellcame Neuroscience Group, University of Glasgow. Scotland

INTRODUCTION: The parietal lobes are thought to be involved in the perception of somatosensory events and the integration of sensory input In humans, the parietal lobes have been implicated in cross-modal matching(Butters et al,l968,1970). Patients with left parietal damage were impalred on three cross-modal matching tasks (tactile-visual, visual-tactlle. auditory-visual),

The aim of this study was to investigate whether Alzherner patlents would be impaired on cross-modal matching tasks METHOD: The performance of 2 groups were exammed a control group (n=6) and a patlent group with probable dementia of the Alzhelmer’s type as outllned by NINCDS-ADRDA criterra (n-10). Mean CAflCOG score (the neuropsychological component of the CAMDEX of Roth et ~1.1986) was 57 4 (SD-14 0. range 38 0 to 74 0) The 4 condltlons of testmg included two Intra-modal matching tasks (I Ivisual-visual (Z)tactile-tactlle &

two-cross-modal matching tasks (3)tactlle-visual (4klsual-tactlIe Visual stirnull consisted of random abstract designs drawn I” Ink on white card Tactual stIrnull consisted of (a) 5 raised dot patterns constructed from I nails tacked onto board (b) 6 copper wre patterns glued onto boards The boards were sanded and panted black to create a consistent tactile texture RESULTS AND CONCLUSIONS: Results Indicate a slgmflcant tactile-tactlle defwt for the Alzhemw group (Mann-Whitney U-9 5, p<O 05) Alzheimer patients were also severely ImpaIred on tactlle-wwal cross-modal matching (Mann-Whitney U-4.5, p<O.Ol) These results suggest that Alzheimer patients we severely unpared in the ability to integrate sensory Information from different sense modahties (touch and vismn) and that tactlle memory for objects over very brief time perwds of only a few seconds IS affected The deficits I” the Alzhelmer group on tactile-tactale matching, we feel, tend to Indicate a tactlIe memory impairment rather than a sensory speclflc deflclt Future studies are planned to investigate this problem where both immediate and delayed tactile-tactile performance will be assessed REFERENCES Butters N & Brady B A (1968) The role of the left parwtal lobe III the mediation of the intra- and cross-modal assoclatlons, Cortex,4.328-343 Butters N. Barton M & Brody B A (1970) Role of right parletal lobe I” the medlallon of cross-modal assoclatlons and reversible OperalIonS In space,

Cortex.6.174-190 Roth M. Tym E. Mountjoy F et al(1986) CAMDEX A standardised Instrument for the d,agons,s of mental d,sorder I” the elderly with special reference to the early detection of dementia Brat J Psychlatry,149.698-709 We acknowledge assistance from The Wellcome Trust. Women of Lothian

38 DELUSIONS IN MULTI-INFARCT DEMENTIA AND IN ALZHEI- MER’S DISEASE. G Binetti, 0 Zanetti,GB Frisoni, A Scuratti, D. DeLeo*, A Bianchetti. M Trabucchi. Alzheimer's Dementia Care Unit, 1st S.Cuore- FBF, Brescia, Italy. *Ist Psicogeriatria, Univ Padova, Italy.

Memory loss is the hallmark of Alzheimer’s disease (AD) and multinfarct dementia (MID). However, psychotic symptoms have also been reported. Delusions have been found in 13% to 73% of patients with AD and in up to 40% of patients with MID. The present study was designed to investigate the frequency, the content and the prognostic significance of the presence of delusions during the disease in 61 subjects with AD and 31 subjects with MID. There was no difference in the frequency of delusions in the two diagnostic categories. Twenty-eight of 61 patients with AD and 12 of 31 patients with MID had experienced delusional beliefs at some point in the course of the illness. Eighteen patients with AD and 11 with MID had exhibited delusions during the first year of their diseases. The contents of the delusions were similars in the two groups and consisted of paranoid beliefs (AD: 42%; MID: 71%) and misidentifications delusions (AD: 58%; MID: 29%). A statistical significant difference was found in dementia severity as reflected by Mini Mental State Examination (MMSE), Activity of Daily Living (ADL) and Global Deterioration Scale (CDS) scores, between patients who exhibited or didn’t exhibite delusions during the disease. The patients who had experienced delusions during the illness, now show a higher MMSE score and a lower ADL and GDS score. The high frequency of delusions identified in this study (AD: 48% and MID: 38%) agrees with data shown in previous studies. Delusions have been reported frequently in the early phases of the illness, when the cognitive decline is relative mild and didn’t increase with increasing dementia severity. These data show a relative higher frequency of misidentification syndromes but no significant relationship was found between these delusions and MMSE, GDS, ADL scores. The presence of psychosis during the illness wasn’t associated with more rapid cognitive decline, but in contrast, it could be considered a good prognostic sign for the intellectual and functional decline.

39 CORRELATION BBTWEBN DEMENTIA AND VISUAL OR HEARING DEFICIT. n. c. Mizzoni, G. Neroni-Mercati, G. Tatangelo, B. Giannandrea and S. Bonaiuto. I.N.R.C.A.; 62010 Appignano (MC). Italy.

The purpose of this study was to investigate the possible correlation between dementia and visual or hearim deficit.