Cognitive Test Performance in Detecting, Staging, and Tracking Alzheimer's Disease
Abstract
OBJECTIVES: To identify the specific cognitive deficits that characterize Alzheimer's disease (AD) and determine which cognitive tests, or combination of tests, are best for detecting AD (ie, distinguishing patients with AD from normal control subjects), staging AD (ie, distinguishing different severities of dementia), and tracking disease progression. SUBJECTS: Patients with AD (n = 123) and normal control subjects (n = 60) of comparable age, education, and gender distribution. SETTING: Outpatient care. MEASURES: Ten cognitive tests of memory, language, visuospatial abilities, and reasoning; the Information, Memory and Concentration subtest of the Blessed Dementia Scale, and the total score on an activities of daily living questionnaire. DESIGN: Patients with AD were tested every 6 to 24 months over a span of up to 5.5 years. RESULTS: Patients with AD were significantly inferior to normal control subjects on all cognitive tests. The scores of patients with AD worsened over time. Delayed recall of stories and figures showed sharp deterioration to an early floor, consistent with the finding that these tests discriminated patients with mild AD from normal control subjects well but were poor for staging. Confrontation naming, semantic fluency, and immediate recognition of geometric figures showed steady linear decline across time for patients with AD, consistent with these tests being found best for staging dementia severity. CONCLUSIONS: We postulate that the pathologic bases of impairment in delayed recall are atrophy of cholinergic ventral forebrain neurons and partial deafferentation of the hippocampus, both of which occur early in the course of AD. Worsening language and visuospatial abilities likely reflect progressive loss of neocortical neurons and their connections.
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The net result of multiple lesions in memory-related structures accounts for the impairment in explicit memory function that occurs as an early symptom in AD.
“and that the net result of these multiple lesions in memory-related structures accounts for the impairment in explicit memory function that occurs as an early symptom in AD (Locascio et al., 1995).”
From Profound Loss of Layer II Entorhinal Cortex Neurons Occurs in Very Mild Alzheimer’s Disease (1996) · cites this paper as Locascio et al., 1995
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Profound Loss of Layer II Entorhinal Cortex Neurons Occurs in Very Mild Alzheimer’s Disease
Gómez-Isla, T., Price, J. L., McKeel Jr., D. W., Morris, J. C., Growdon, J. H., & Hyman, B. T. (1996) · The Journal of Neuroscience · doi:10.1523/jneurosci.16-14-04491.1996 · Cited by 1,796 · see citing works
“It is likely that neuronal loss occurs in these areas as well, and that the net result of these multiple lesions in memory-related structures accounts for the impairment in explicit memory function that occurs as an early symptom in AD (Locascio et al., 1995).”
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Self-citationLong-term course and effectiveness of combination therapy in Alzheimer disease
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- Authors
- Locascio, J. J., Growdon, J. H., & Corkin, S.
- Affiliations
- Massachusetts Institute of Technology (US)
- ORCID
- Locascio, J. J.
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 1995-11-01
- Volume
- 52
- Issue
- 11
- Pages
- 1087-1099
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W2011315628
- Cited by
- 228
- References
- 5
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 6 · 2019: 6 · 2018: 2 · 2017: 9 · 2016: 7 · 2015: 5 · 2014: 11 · 2013: 13 · 2012: 17
- FWCI
- 3.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r37ag006605-08)
- National Institute on Aging (AG06605, P50AG005134, AG 05134, 5R37AG06605)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Keywords
- Alzheimer's disease, cognitive impairment, dementia staging, disease progression, delayed recall, confrontation naming, semantic fluency, visuospatial ability, language impairment, hippocampal atrophy, cholinergic neuron loss, activities of daily living
- MeSH terms
- Aged, Alzheimer Disease, Cognition, Female, Humans, Male, Memory, Neuropsychological Tests, Spatial Behavior, Visual Perception, Reproducibility of Results
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