title: Persistent vegetative state in Alzheimer disease. Does it exist?
abstract: OBJECTIVE
  To determine if the published criteria for diagnosis of the persistent vegetative state could be applied to patients suffering from Alzheimer disease.
  
  
  METHODS
  Eighty-eight institutionalized patients with a diagnosis of possible or probable Alzheimer disease were evaluated for the presence of persistent vegetative state. Initial screening excluded patients who were able to do any of the following: feed themselves, respond to command, walk, or maintain continence of bowel and bladder. A sample of 12 of 28 patients unable to perform any of these functions was examined independently by 3 of us.
  
  
  RESULTS
  During the first examination, 2 patients were diagnosed as being in a vegetative state by 2 of us and 3 additional patients by 1 of us. One of us did not diagnose any patient as being in a vegetative state. A second evaluation of the same patients was performed 2 months later, after holding a consensus meeting to standardize the evaluation procedure. During the second evaluation, the vegetative state was diagnosed in 6 patients but only by 1 of us.
  
  
  CONCLUSIONS
  The diagnostic disagreement between the neurologists indicate that Alzheimer disease may only rarely progress to the persistent vegetative state.
authors.affiliation: Geriatric Research Education Clinical Center, E. N. Rogers Memorial Veterans Hospital, Bedford, Mass., USA.
authors.forename: L
authors.initials: L
authors.lastname: Volicer
authors.forename: S A
authors.initials: SA
authors.lastname: Berman
authors.forename: P B
authors.initials: PB
authors.lastname: Cipolloni
authors.forename: A
authors.initials: A
authors.lastname: Mandell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000175:diagnosis*; D003951:Diagnostic Errors; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D018458:Persistent Vegetative State / Q000175:diagnosis* / Q000209:etiology*