Upper and lower face and ideomotor apraxia in patients with Alzheimer's disease.
BACKGROUND
Apraxia of face movement in Alzheimer's disease (AD) has been rarely investigated. This study aimed at investigating the frequency of lower (mouth, tongue and throat) and upper (eyes and eyebrows) face apraxia, in AD and its relationship with limb apraxia and severity of dementia.


METHODS
Fifty seven patients with AD were tested with a new standardised test of face apraxia including upper and lower face movements, which uses an item-difficulty weighted scoring procedure, the IMA test, a test of ideomotor apraxia and the M.O.D.A., a means to assess dementia severity.


RESULTS
Thirteen (23%) and 19 (33%) participants were below cut-off respectively on the upper and lower face apraxia test. Both sections of the Face Apraxia Test correlated significantly with the Ideomotor Apraxia Test. However, double dissociations between different types of apraxia were observed. Both the upper and lower face apraxia tests correlated significantly with the measure of dementia severity.


CONCLUSIONS
The finding show that a proportion of AD patients fails face apraxia tests. Their face apraxia is interlinked with ideomotor limb apraxia, although dissociations are possible. Severity of dementia deterioration accounts for a good proportion of the variability of AD patients' performance on face apraxia tests.
Third Neurology Ward, San Paolo Hospital, Department of Medicine, Surgery and Dentistry, University of Milan, Milan, Italy.
Jay Guido
JG
Capone
Sergio
S
Della Sala
Hans
H
Spinnler
Annalena
A
Venneri
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D020240:Apraxia, Ideomotor / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance; D012494:Sampling Studies; D012720:Severity of Illness Index; D013647:Task Performance and Analysis