Alzheimer Disease: Barnett N

McKeith IG, Rowan E, Askew K, Naidu A, Allan L, Barnett N, Lett D, Mosimann UP, Burn D, O'Brien JT. · Institute for Ageing and Health, Newcastle General Hospital, Newcastle-Upon-Tyne, UK. · Am J Geriatr Psychiatry. · Pubmed #16816011 No free full text.

Abstract: OBJECTIVE: The objective of this study was to compare functional impairments in dementia with Lewy bodies (DLB) and Alzheimer disease (AD) and their relationship with motor and neuropsychiatric symptoms. METHODS: The authors conducted a cross-sectional study of 84 patients with DLB or AD in a secondary care setting. Patients were diagnosed according to published criteria for DLB and AD. The Bristol Activities of Daily Living Scale (BADLS) was used to assess functional impairments. Participants were also assessed using the Unified Parkinson's Disease Rating Scale (motor section), the Neuropsychiatric Inventory, and the Mini-Mental Status Examination. RESULTS: Patients with DLB were more functionally impaired and had more motor and neuropsychiatric difficulties than patients with AD with similar cognitive scores. In both AD and DLB, there were correlations between total BADLS scores and motor and neuropsychiatric deficits. There was more impairment in the mobility and self-care components of the BADLS in DLB than in AD, and in DLB, these were highly correlated with UPDRS score. In AD, orientation and instrumental BADLS components were most affected. CONCLUSION: The nature of functional disability differs between AD and DLB with additional impairments in mobility and self-care in DLB being mainly attributable to extrapyramidal motor symptoms. Consideration of these is important in assessment and management. Activities of daily living scales for use in this population should attribute the extent to which functional disabilities are related to cognitive, psychiatric, or motor dysfunction.

Dudley R, O'Brien J, Barnett N, McGuckin L, Britton P. · Newcastle Cognitive Therapy Centre, Newcastle, NorthTyneside and Northumberland Mental Health NHS Trust, UK. · Int J Geriatr Psychiatry. · Pubmed #11802230 No free full text.

Abstract: OBJECTIVES: In later life, cognitive impairment is common in depression often making it difficult to distinguish a dementing illness from depression. We examined whether people with depression could be differentiated from those with dementia on their performance on a task that examines attentional bias to depression related material. METHODS: Twelve older adults who fulfilled DSM-IV criteria for major depression were compared with 12 people with Alzheimer's Disease (AD) and 12 age matched controls on a test of cognitive biases: the Emotional Stroop task. In this task participants were presented with words written in different coloured inks, and they had to name the colour the word was written in. Four types of material were presented-neutral, positive, and negative emotion words as well as a condition of meaningless symbols. RESULTS: People with depression and those with AD were both slower than the controls on the task generally. However, the depressed group alone showed a statistically significant and specific increase in response time when colour naming the negative emotion words. The other two groups did not demonstrate such a pattern and colour named neutral, positive and negative words equally quickly. CONCLUSIONS: The biased processing of depression related material may have a valuable role in distinguishing depression from dementia in later life. Although the Emotional Stroop in its present form is not sufficient for such a purpose. Furthermore, the demonstration that older adults with depression exhibit such biases helps provide a theoretical basis for the application of cognitive behavioural treatments with older adults.