title: Extrapyramidal Signs and Cognitive Subdomains in Alzheimer Disease.
abstract: Extrapyramidal signs (EPS), commonly observed in Alzheimer disease (AD), predict cognitive impairment and functional decline. This study investigated the association between EPS and five cognitive subdomains in a large number of participants with AD.
  
  
  
  Cross-sectional analyses of the nationwide Clinical Research of Dementia of South Korea (CREDOS) study, 2005-2012.
  
  
  
  Multicenter clinical settings.
  
  
  
  1,737 participants with AD drawn from the CREDOS study.
  
  
  
  The EPS group was defined by the presence of at least one EPS based on neurologic examination. We assessed five cognitive subdomains: attention, language, visuospatial function, memory, and frontal/executive function using the Seoul Neuropsychological Screening Battery-Dementia version. The associations of EPS with each cognitive subdomain were analyzed with a multiple linear regression model after controlling for confounding factors: sex, age, years of education, severity of dementia (Clinical Dementia Rating Sum of Boxes), and white matter hyperintensities.
  
  
  
  164 AD participants (9.4%) had EPS. AD participants with EPS showed lower performance compared with those without EPS in two cognitive subdomains: attention and visuospatial function. The language, memory, and frontal/executive subdomains did not differ between the EPS-positive and the EPS-negative groups. In addition, we found a significant moderating relationship between EPS and deep white matter hyperintensities on visuospatial function score.
  
  
  
  EPS in AD are associated with severe cognitive impairment in attention and visuospatial function. Careful screening for EPS in patients with AD may assist in prediction of cognitive profile.
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Woojae
authors.initials: W
authors.lastname: Myung
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Junbae
authors.initials: J
authors.lastname: Choi
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sangha
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Chung
authors.affiliation: Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Republic of Korea.
authors.forename: Hyo Shin
authors.initials: HS
authors.lastname: Kang
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Duk L
authors.initials: DL
authors.lastname: Na
authors.affiliation: Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Hong
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurology, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seol-Heui
authors.initials: SH
authors.lastname: Han
authors.affiliation: Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Seong Hye
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Yun
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: paulkim@skku.edu.
authors.forename: Doh Kwan
authors.initials: DK
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000523:psychology*; D001480:Basal Ganglia Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007802:Language; D016014:Linear Models; D008297:Male; D008606:Mental Processes; D011569:Psychiatric Status Rating Scales; D056910:Republic of Korea / Q000453:epidemiology; D012720:Severity of Illness Index
keywords: Alzheimer disease; attention; cognition; extrapyramidal signs; visuospatial