The emergence of cognitive discrepancies in preclinical Alzheimer's disease: a six-year case study.
We present neuropsychological data from an 81-year-old individual who was followed over a six-year period, initially as a healthy control participant. She performed above age-adjusted cutoff scores for impairment on most neuropsychological tests, including learning and memory measures, until the final assessment when she received a diagnosis of probable Alzheimer's disease (AD). Despite generally normal scores on individual cognitive tests, her cognitive profile revealed increasingly large cognitive discrepancies when contrasting verbal versus visuospatial tasks, and complex versus basic-level tasks. The present case provides intriguing evidence that cognitive-discrepancy measures could improve our ability to detect subtle changes in cognition at the earliest, preclinical stages of AD.
Jacobson
Mark W
MW
Veterans Affairs San Diego Healthcare System, Department. 151B, 3350 La Jolla Village Dr., San Diego, CA 92151, USA. mjacobson@vapop.ucsd.edu
Delis
Dean C
DC
Peavy
Guerry M
GM
Wetter
Spencer R
SR
Bigler
Erin D
ED
Abildskov
Tracy J
TJ
Bondi
Mark W
MW
Salmon
David P
DP
D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology / Q000523:psychology; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D001284:Atrophy / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007806:Language Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D008137:Longitudinal Studies; D008569:Memory Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D011594:Psychometrics; D012680:Sensitivity and Specificity; D014705:Verbal Behavior / Q000502:physiology