   Anosognosia in very mild Alzheimer's disease but not in mild cognitive impairment; Salmon, Eric  ; et alin Dementia & Geriatric Cognitive Disorders (2005), 19(5-6), 349-356 Objective: To study awareness of cognitive dysfunction in patients with very mild Alzheimer's disease (AD) and subjects with mild cognitive impairment (MCI). Methods: A complaint interview covering 13 ... [more ▼] Objective: To study awareness of cognitive dysfunction in patients with very mild Alzheimer's disease (AD) and subjects with mild cognitive impairment (MCI). Methods: A complaint interview covering 13 cognitive domains was administered to 82 AD and 79 MCI patients and their caregivers. The patient groups were comparable according to age and education, and Mini Mental State Examination (MMSE) scores were ≥ 24 in all cases. The discrepancy between the patients' and caregivers' estimations of impairments was taken as a measure of anosognosia. Results: Self-reports of cognitive difficulties were comparable for AD and MCI patients. However, while in comparison to caregivers MCI patients reported significantly more cognitive impairment (p < 0.05), AD patients complained significantly less cognitive dysfunctions (p < 0.001). Conclusions: While most MCI patients tend to overestimate cognitive deficits when compared to their caregiver's assessment, AD patients in early stages of disease underestimate cognitive dysfunctions. Anosognosia can thus be regarded as a characteristic symptom at a stage of very mild AD (MMSE ≥ 24) but not MCI. Accordingly, medical history even in mildly affected patients should always include information from both patient and caregiver. Copyright (C) 2005 S. Karger AG, Basel. [less ▲] Detailed reference viewed: 29 (2 ULg)Impairment of neocortical metabolism predicts progression in Alzheimer's disease; ; Salmon, Eric et alin Dementia & Geriatric Cognitive Disorders (1999), 10(6), 494-504 Studied prediction of progression rates of Alzheimer's disease (AD) in a prospective multicenter cohort study of 186 patients (mean age 63.2 yrs) with possible or probable AD, mostly with presenile onset ... [more ▼] Studied prediction of progression rates of Alzheimer's disease (AD) in a prospective multicenter cohort study of 186 patients (mean age 63.2 yrs) with possible or probable AD, mostly with presenile onset. In a cross-sectional analysis at entry, impairment of glucose metabolism in temporoparietal or frontal association areas measured with positron emission tomography was significantly associated with dementia severity, clinical classification as possible vs probable AD, presence of multiple cognitive deficits and history of progression. A prospective longitudinal analysis showed a significant association between initial metabolic impairment and subsequent clinical deterioration. In patients with mild cognitive deficits at entry, the risk of deterioration was up to 4.7 times higher if the metabolism was severely impaired than with mild or absent metabolic impairment. [less ▲] Detailed reference viewed: 14 (1 ULg) |
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