Persistent vegetative state in Alzheimer disease. Does it exist?
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.
Volicer
L
L
Geriatric Research Education Clinical Center, E. N. Rogers Memorial Veterans Hospital, Bedford, Mass., USA.
Berman
S A
SA
Cipolloni
P B
PB
Mandell
A
A
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*