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KMID : 0960920030020010049
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Dementia and Neurocognitive Disorders
2003 Volume.2 No. 1 p.49 ~ p.53
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Is Alzheimer’s Disease with Early Frontal Dysfunction Distinguishable from Usual Alzheimer’s Disease?
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Lee Jae-Hong
Ryu Kyoung-Hi
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Abstract
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Background: Some Alzheimer’s patients exhibit frontal lobe dysfunction early in the course of the disease. We compared this subgroup of Alzheimer’s disease (AD) with usual AD to see if there is any neuropsychological or anatomical differentiation.
Methods: Twenty patients diagnosed with probable AD using NINCDS-ADRDA criteria underwent a comprehensive neuropsychological test (Seoul Neuropsychological Screening Battery), neuropsychiatric inventory (NPI), and brain MRI. All patients were supposed to be in the early stage of dementia and their clinical dementia rating (CDR) score belonged to either 0.5 or 1. The presence of frontal dysfunction was defined when more than 2 of the 6 test categories were abnormal. Brain MRI was reviewed with regard to the severity of associated leukoaraiosis.
Results: Eleven patients belonged to “AD with frontal dysfunction” group, whereas 9 belonged to “AD without frontal dysfunction” group. There were no group differences in the age, CDR score, education level, NPI score, and associated leukoaraiosis on MRI. Mini-Mental State Exam score was lower in the frontal group than in the usual AD group (21.2 vs. 24.9). With respect to neuropsychological performance, naming (p=0.005) and calculation (p=0.04) were significantly impaired in the frontal group than in the usual AD group. There was also a difference in digit span and delayed verbal recall.
Conclusion: AD patients with frontal dysfunction tend to show a more severe cognitive impairment with some of the cognitive functions preferentially affected. This study suggests that AD with early involvement of frontal function may be a neuropsychologically distinct subgroup of Alzheimer’s disease. Further longitudinal study is warranted to look at whether these patients are a clinically identifiable subgroup of AD.
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KEYWORD
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Alzheimer’s disease, Frontal lobe dysfunction, Executive function, Neuropsychological test
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