LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Neurological Abnormalities Associated with Severity of Dementia in Alzheimer's Disease

Abnormal findings on neurological examination were evaluated in 165 patients with a clinical diagnosis of Alzheimer's disease who attended a memory disorders clinic. Severity of dementia was measured by the Blessed Dementia Scale, and associations of abnormalities with dementia severity were evaluated using logistic regression. Presence of aphasia, apraxia, and primitive reflexes on neurological examination were strongly associated with severity, and weak associations were observed for abnormalities of muscle tone and gait. Among these associated neurological features, only aphasia and apraxia were present in mildly demented cases with sufficient frequency to suggest utility as diagnostic signs early in the course of the disease. RESUME: Les anomalies neurologiques associees a la severite de la demence dans la maladie d'Alzheimer. On a evalue les anomalies observees a l'examen neurologique chez 165 patients avec un diagnostic clinique de maladie d'Alzheimer qui frequentaient une clinique pour les patients presentant des troubles de la memoire. La severite de la demence a 6t6 mesuree au moyen de l'echelle "Blessed" pour la demence (Blessed Dementia Scale) et l'association des anomalies avec la severite' de la demence a ete mesuree au moyen de la regression logique. La presence d'aphasie, d'apraxie et de reflexes primitifs a l'examen neurologique etait fortement associee a la severite de la demence et des associations faibles furent observees avec des anomalies du tonus musculaire et de la demarche. Parmi ces manifestations neurologiques associees, seulement l'aphasie et l'apraxie etaient presentes chez les patients 16gerement dements avec une frequence suffisante pour suggerer que ces signes peuvent etre utiles au diagnostic des le d6but de la maladie. Can. J. Neurol. Sci. 1986; 13:403-405 In order to be useful in early diagnosis of Alzheimer's disease, a neurological abnormality must occur commonly in the early stage of the disease, and likelihood of its occurrence should increase in patients with greater severity of dementia. In an effort to determine whether features of the neurological examination show such relationships with severity, we examined the clinical records of a group of patients with Alzheimer's disease diagnosed by contemporary research criteria. We evaluated the association of dementia severity with presence of aphasia, apraxia, primitive reflexes, and other abnormal findings on neurological examination.