title: Charting the decline in spontaneous writing in Alzheimer's disease: a longitudinal study.
abstract: OBJECTIVE
  This study aims to document the nature and progression of the spontaneous writing impairment observed in patients with Alzheimer's disease (AD) over a 12-month period using both a cross-sectional and prospective longitudinal design.
  
  
  METHODS
  Thirty-one minimal-moderate AD patients and 30 controls matched for age and socio-cultural background completed a simple and complex written description task at baseline. The AD patients then had follow-up assessments at 6 and 12 months.
  
  
  RESULTS
  Cross-sectional comparisons indicated that minimal-moderate AD patients produced more semantic paraphasias, phonological paraphasias, and empty and indefinite phrases, whilst producing fewer pictorial themes, repairing fewer errors, and producing shorter and less complex sentences than controls. The two groups could not be distinguished on visual paraphasias. Longitudinal follow-up, however, suggested that visual processing deteriorates over time, where the prevalence of visual errors increased over 12 months. Discussion The findings suggest that the deterioration of writing skills observed in the spontaneous writings of AD patients shows a pattern of impairment dominated by semantic errors with a secondary impairment in phonological processing, which is later joined by a disruption of visuospatial and graphomotor processing.
authors.affiliation: 1School of Applied Social Studies,The Robert Gordon University,Aberdeen,UK.
authors.forename: Katrina
authors.initials: K
authors.lastname: Forbes-McKay
authors.affiliation: 2Department of Neuroscience,University of Sheffield,UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Shanks
authors.affiliation: 2Department of Neuroscience,University of Sheffield,UK.
authors.forename: Annalena
authors.initials: A
authors.lastname: Venneri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006236:Handwriting; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012660:Semantics