Neurological findings in Alzheimer's disease and normal aging
D. Galasko, P. F. Kwo-on-Yuen, M. R. Klauber and L. J. Thal
Department of Neurosciences, University of California, San Diego.
To determine the potential value of abnormal neurological findings as
markers of Alzheimer's disease (AD) and their relationship to the stage of
AD, we compared standardized neurological examinations in 135
community-dwelling patients with AD and 91 nondemented elderly individuals.
After correcting for differences in age and education between the two
groups, we found that rigidity, stooped posture, graphesthesia, neglect of
simultaneous tactile stimuli (face-hand test), and snout, grasp, and
glabella reflexes were present significantly more often in patients with AD
than in control subjects. These findings increased in prevalence in
patients with AD according to the severity of dementia. However, in a
multivariate logistic regression model only the grasp reflex,
graphesthesia, and the face-hand test were statistically significantly
associated with the degree of cognitive impairment. Although abnormal
neurological findings occur regularly in AD, they are too infrequent early
in the course of AD to serve as diagnostic markers. Prospective studies are
needed to determine whether patients with the early onset of extrapyramidal
or other findings form a distinct subgroup of AD.
