A comparison of dementia in Alzheimer's disease and multiple sclerosis
C. M. Filley, R. K. Heaton, L. M. Nelson, J. S. Burks and G. M. Franklin
Department of Psychiatry, University of Colorado School of Medicine, Denver.
We compared results of comprehensive neuropsychological testing in 42
patients with clinically diagnosed Alzheimer's disease (AD) and in an equal
number of patients with clinically definite chronic-progressive multiple
sclerosis. Age, sex, and education were controlled using demographically
corrected T scores based on a large normal sample. Both groups showed
significant impairment on the test battery, but the degree of dementia was
more severe in the patients with AD. A deviation score analysis,
controlling for overall level of cognitive impairment, revealed significant
differences between the groups. Alzheimer's disease was associated with
relatively greater impairment of learning, memory, and verbal skills,
whereas the MS group showed greater relative impairment of attention,
incidental memory, and psychomotor functions. These data suggest that both
the degree and pattern of mental impairement differ in patients with AD and
patients with multiple sclerosis. Our results support a distinction between
"gray matter" and "white matter" dementia, and may help clarify the issue
of "cortical" vs "subcortical" dementia by demonstrating neuropsychological
differences based on secure neuropathologic distinctions.
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