Journal

The Japanese journal of neuropsychology

[Vol.28 No.1 contents]
Japanese/English

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ArticleTitle Involving type of closing-in phenomenon in Alzheimer's disease
Language J
AuthorList Hiroyuki Abe1), Mai Sanpei2), Erina Yamazaki3), Takuya Sato4), Toru Imamura1)5)6)
Affiliation 1)Department of Speech Therapy, School of Health Sciences, Niigata University of Health and Welfare
2)Division of Speech Therapy, Department of Rehabilitation, Ohota Nishinouchi Hospital
3)Department of Rehabilitation, Toyama Rosai Hospital
4)Division of Speech Therapy, Department of Rehabilitation, Niigata Rehabilitation Hospital
5)Department of Neurology, Niigata Rehabilitation Hospital
6)Division of Speech, Hearing and Cognitive Sciences, Graduate School of Health Sciences, Niigata University of Health and Welfare
Publication Japanese Journal of Neuropsychology: 28 (1), 41-48, 2012
Received Jun 22, 2010
Accepted Feb 14, 2011
Abstract Closing-in phenomenon was assessed in 348 consecutive patients with Alzheimer's disease (AD). We retrospectively examined the patients who showed the involving type of closing-in phenomenon in the constructional tasks of the Mini-Mental State Examination (MMSE) and the Alzheimer's Disease Assessment Scale (ADAS) and in the copy task of the Rey-Osterrieth complex figure at the first visit. Twenty-five patients showed the involving type of closing-in phenomenon. The patients were heterogeneous, that is, according to the clinical and cognitive features, we found two patient groups: (1) patients who showed the clinical symptoms that are considered to be associated with dementia with Lewy bodies (DLB) (DLB-related group; 12 patients), (2) patients who showed transcortical sensory aphasia (TCSA) (TCSA group; 4 patients). The remaining 9 patients were not classified in either group. In the DLB-related group, eight patients were diagnosed as probable or possible DLB during the follow-up periods. Many patients in the group had shorter disease duration (less than two years) at the first visit. We considered that most of the patients in the DLB-related group were at the earliest stage of DLB. Since the involving type of closing-in phenomenon is observed more frequently in DLB than in AD, the closing-in phenomenon in the DLB-related group was attributable to cognitive dysfunctions of DLB. In the TCSA group, the patients had younger ages at onset (59-71 years old). Previous studies showed that AD patients with younger age at onset show worse performance both in visuocognitive and language tasks. Some authors discussed that the involving type of closing-in phenomenon is related to visuocognitive disturbance. This type of closing-in phenomenon in the TCSA group was attributable to visuocognitive disturbance.
Keywords closing-in phenomenon, Alzheimer's disease, dementia with Lewy bodies, visuocognitive disturbance

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