The Japanese journal of neuropsychology

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ArticleTitle	Neuropsychological differentiation between dementia of Alzheimer type and vascular dementia using Alzheimer's disease assessment scale (ADAS)
Language	J
AuthorList	Nobuya Kawahata¹⁾, Chiharu Goto²⁾
Affiliation	1) Department of Neurology, Narita Memorial Hospital 2) Department of Speech Therapy, Narita Memorial Hospital
Publication	Japanese Journal of Neuropsychology: 17 (1), 69-75, 2001
Received	Jun 5, 2000
Accepted	Oct 10, 2000
Abstract	To detect neuropsychological evaluation of disease progression between dementia of Alzheimer type (DAT) and vascular dementia (VD), 68 patients with DAT, 36 patients with VD, and 137 control subjects without cognitive dysfunction were selected from the Memory Clinic. The neuropsychological measure was the Japanese version of Alzheimer's Disease Assessment Scale (ADAS-J cog.). The severity of dementia was assessed with the mini-mental state examination (mild stage: score greater than or equal to 20, 26 patients with DAT, 15 patients with VD; intermediate stage: score 10 to 19, 32 patients with DAT, 19 patients with VD; severe stage: score lower than or equal to 9, 10 patients with DAT, 2 patients with VD). In the mild stage of DAT, significant impairments of the word-recall task, orientation, and word-recognition task were found as compared with those in the control subjects. The intermediate stage showed significant declines in the tasks of the following commands, constructional praxis, ideational praxis, comprehension of spoken language, and word-finding difficulty in spontaneous speech. In the severe stage of DAT, significant impairments of spoken language ability, naming objects and fingers, and recall of test instructions were confirmed. Patients with the mild stage of VD, in the other hand, performed significantly worse on the word-recall task, orientation, and word-recognition task, following commands, constructional praxis, ideational praxis, and word-finding difficulty in spontaneous speech as compared with those in the control subjects. The constructional praxis, ideational praxis, and word-finding difficulty in spontaneous speech were the best discriminators of DAT and VD in the mildly affected populatios.
Keywords	dementia of Alzheimer type, Alzheimer's disease assessment scale (ADAS), cognitive function, vascular dementia (small vessel disease with dementia)