Impairments in AD

Question 1

Episodic memory in AD

Answer 1

Particularly impairment on delayed recall and recognition. Retrieval is disturbed, despite presence of recall cues

Bc its often the first symptom, it could discriminate early AD from healthy controls

Question 2

Semantic memory in AD

Answer 2

Fluency; category or semantic fluency is more impaired than letter or phonemic fluency.

World knowledge overall is much lower in AD, but the effect is bigger in more recent events (better memory of older events)
- also combined w episodic as more recent events are no longer stored

for autobiographic memories;
- memories that are more freq. retrieved are less dependent on intact medial temporal structures thus remembered better

Question 3

EF

Answer 3

Compared to HC; impaired set shifting, flexibility, planning and inhibition

Stroop (inhibit)
- More errors in reading and interference score impaired.
- No diff in mild, moderate AD subgroups

WCST (flexibility)
- inconsistent deficits; floor effect

Question 4

Language

Answer 4

Production (naming and verbal fluency) is impaired.

Comprehension is relatively spared

Question 5

Visuospatial

Answer 5

Impairments typically mild in early stage, more severe as it progresses

Loss of orientation gets big, even when in own home

Seen in eg visual search and mental rotation; slower RT and more severe in more advanced AD

Question 6

Early predictors

Answer 6

Recall performance is below norm even 6 years before the diagnosis.

Mild impairments are an early predictor for AD, also explains why aMCI is more likely to develop AD

This is also the reason why the delayed free recall Rey Auditory Verbal Leanring test is the earliest predictor for AD (before hippo volume, AB, TAU etc)

Question 7

Rapid decline before diagnosis

Answer 7

There’s a steep decline in memory performance shortly before the diagnosis

Idea that the compensation of the gradual decline falls away because its becoming too severe.

Question 8

Behaviour disturbances

Answer 8

Large majority (80%) of people with AD experience behavioural disturbance

Perceived as biggest problem by family/caregivers. Most common;
Apathy, agitation, depression, sleep disturbances and irritability

Severity correlates with severity of AD