title: [Cognitive and functional decline in the stage previous to the diagnosis of Alzheimers disease].
abstract: BACKGROUND
  The decline in the phase prior to diagnosis of Alzheimers disease (AD) is not well known, although this knowledge is necessary to evaluate the efficiency of new drugs that can influence in disease course prior to diagnosis.
  
  
  OBJECTIVE
  To contribute to better knowledge of the decline prior to diagnosis, we have investigated the cognitive and functional deterioration for 2-3 years before the probable AD diagnosis was established.
  
  
  METHODS
  We compared results obtained by 17 control subjects and 27 patients at the time of diagnosis of a probable AD with results obtained 2-3 years before (interval of 27.7 4 months). We compared memory functions (logical, recognition, learning and autobiographical memory), naming, visual and visuospatial gnosis, visuoconstructive praxis, verbal fluency and the Mini-Mental State Examination (MMSE), Informant Questionnaire and Blessed's Scale scores.
  
  
  RESULTS
  Performance of control subjects did not change. AD patients showed a significant decline in scores, except for verbal fluency. In order of importance, cognitive decline was more marked in scores of learning memory, visuospatial gnosis, autobiographical memory and visuoconstructive praxis.
  
  
  CONCLUSIONS
  Decline prior to diagnosis of AD is characterized by an important learning memory impairment. Deterioration of visuospatial gnosis and visuoconstructive praxis is greater than deterioration of MMSE and Informant Questionnaire scores.
authors.affiliation: Servicio de Neurología, Hospital de la Santa Creu i Sant Pau Universidad Autónoma de Barcelona, Spain. cgarcias@hsp.santpau.es
authors.forename: C
authors.initials: C
authors.lastname: García-Sánchez
authors.forename: A
authors.initials: A
authors.lastname: Estévez-González
authors.forename: A
authors.initials: A
authors.lastname: Boltes
authors.forename: P
authors.initials: P
authors.lastname: Otermín
authors.forename: M
authors.initials: M
authors.lastname: López-Góngora
authors.forename: A
authors.initials: A
authors.lastname: Gironell
authors.forename: J
authors.initials: J
authors.lastname: Kulisevsky
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013997:Time Factors