Abstract
Background: Contribution of visuospatial abilities to the functional status in patients with Alzheimer’s disease (AD) has been controversial. Aim: To address whether visuospatial abilities have independent association with functional measures in patients with AD. Methods: We regressed performances on a global cognitive (the revised Hasegawa Dementia Scale: HDSR), executive/ visuoconstruction (Clock drawing), visuoperception (Clock reading: CRT), simple visuoconstruction (figure copying), and frontal behavioral tasks on measures of basic and instrumental activities of daily living (BADL and IADL) in 57 patients (78.0 + 6.1 years) with AD of various severity (mean HDSR score: 16.0 + 5.9). We sought independent contributions of these visuospatial measures to functional status. Results: Performance on the CRT contributed significantly to BADL and IADL and the results of HDSR contributed to IADL. Results of figure copying related significantly to BADL especially in mild AD. Conclusion: Visuospatial ability is one of the important contributors to functional status.
Keywords: Alzheimer’s disease, visuospatial function, executive function, Clock drawing test, Clock reading test, figure copying
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Contributor Information
Toshiya Fukui, Division of Neurology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, tfukui@med.showa-u.ac.jp .
Eiyai Lee, Department of Speech, Language and Hearing Clinical Welfare College, Tokyo Japan.
References
- Lawton MP, Brody EM Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-186. [PubMed] [Google Scholar]
- Cahn-Weiner DA, Farias ST, Julian L., et al. Cognitive and neuroimaging predictors of instrumental activities of daily living. J Int Neuropsychol Soc. 2007;13(5):747-757. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johnson JK, Lui LY, Yaffe K. Executive function, more than global cognition, predicts functional decline and mortality in elderly women. J Gerontol A Biol Sci Med Sci. 2007;62(10):1134-1141. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jefferson AL , Paul RH, Ozonoff A., Cohen RA Evaluating elements of executive functioning as predictors of instrumental activities of daily living (IADLs). Arch Clin Neuropsychol. 2006;21(4):311-320. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perry RJ, Hodges JR Relationship between functional and neuropsychological performance in early Alzheimer disease. Alzheimer Dis Assoc Disord. 2000;14(1):1-10. [DOI] [PubMed] [Google Scholar]
- Hill RD, Bäckman L., Fratiglioni L. Determinants of functional abilities in dementia. J Am Geriatr Soc. 1995;43(10):1092-1097. [DOI] [PubMed] [Google Scholar]
- Matsuda O., Saito M. Functional competency and cognitive ability in mild Alzheimer’s disease: relationship between ADL assessed by a relative/carer-rated scale and neuropsychological performance. Int Psychogeriatr. 2005;17(2):275-288. [DOI] [PubMed] [Google Scholar]
- Hosokawa T., Yamada Y., Isagoda A., Nakamura R. Psychometric equivalence of the Hasegawa Dementia Scale-Revised with the Mini-Mental State Examination in stroke patients. Percept Mot Skills. 1994;79(1 pt 2): 664-666. [DOI] [PubMed] [Google Scholar]
- Royall DR, Cordes JA, Polk M. CLOX: an executive Clock drawing task. J Neurol Neurosurg Psychiatry. 1998;64(5):588-594. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shulman KI Clock-drawing: is it the ideal cognitive screening test? Int J Geriatr Psychiatry. 2000;15(6): 548-561. [DOI] [PubMed] [Google Scholar]
- Freedman M., Leach L., Kaplan E., Winocur G., Shulman KI, Delis DC 1st ed. Clock Drawing. A Neuropsychological Analysis . New York, NY: Oxford University Press; 1994. [Google Scholar]
- Sunderland T., Hill JL, Mellow AM, et al. Clock drawing in Alzheimer’s disease. A novel measure of dementia severity. J Am Geriatr Soc. 1989;37(8):725-729. [DOI] [PubMed] [Google Scholar]
- Wolf-Klein GP, Silverstone FA, Levy AP, Brod MS Screening for Alzheimer’s disease by clock drawing. J Am Geriatr Soc. 1989;37(8):730-734. [DOI] [PubMed] [Google Scholar]
- Shulman KI, Gold DP, Cohen CA, Zucchero CA Clock-drawing and dementia in the community: a longitudinal study. Int J Geriatr Psychiatry. 1993;8(6):487-496. [Google Scholar]
- Schmidtke K. , Olbrich S. The Clock Reading Test: validation of an instrument for the diagnosis of dementia and disorders of visuo-spatial cognition. Int Psychogeriatr. 2007;19(2):307-321. [DOI] [PubMed] [Google Scholar]
- Kugo A., Terada S., Ata T., et al. Japanese version of the Frontal Assessment Battery for dementia . Psychiatry Res. 2007;153(1):69-75. [DOI] [PubMed] [Google Scholar]
- Dubois B., Slachevsky A., Litvan I., Pillon B. The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000;55(11):1621-1626. [DOI] [PubMed] [Google Scholar]
- Samton JB, Ferrando SJ, Sanelli P., Karimi S., Raiteri V., Barnhill JW The clock drawing test: diagnostic, functional, and neuroimaging correlates in older medically ill adults. J Neuropsychiatry Clin Neurosci . 2005;17(4):533-540. [DOI] [PubMed] [Google Scholar]
- Royall DR, Palmer R., Chiodo LK, Polk MJ Executive control mediates memory’s association with change in instrumental activities of daily living: the Freedom House Study. J Am Geriatr Soc. 2005;53(1):11-17. [DOI] [PubMed] [Google Scholar]
- Royall DR, Chiodo LK, Polk MJ An empiric approach to level of care determinations: the importance of executive measures. J Gerontol A Biol Sci Med Sci. 2005. ;60(8): 1059-1064. [DOI] [PubMed] [Google Scholar]
- Lavery LL, Starenchak SM, Flynn WB, Stoeff MA, Schaffner R., Newman AB The clock drawing test is an independent predictor of incident use of 24-hour care in a retirement community. J Gerontol A Biol Sci Med Sci. 2005;60(7):928-932. [DOI] [PubMed] [Google Scholar]
- Meijer R., Ihnenfeldt DS, van Limbeek J., Vermeulen M., Haan RJ Prognostic factors in the subacute phase after stroke for the future residence after six months to one year. A systematic review of the literature. Clin Rehabil. 2003;17(5):512-520. [DOI] [PubMed] [Google Scholar]
- Sveen U., Bautz-Holter E., Sødring KM, Wyller TB, Laake K. Association between impairments, self-care ability and social activities 1 year after stroke. Disabil Rehabil. 1999;21(8):372-377. [DOI] [PubMed] [Google Scholar]
- Razani J., Kakos B., Orieta-Barbalace C., et al. Predicting caregiver burden from daily functional abilities of patients with mild dementia. J Am Geriatr Soc. 2007;55(9):1415-1420. [DOI] [PMC free article] [PubMed] [Google Scholar]
- González-Salvador T., Lyketsos CG, Baker A., et al. Quality of life in dementia patients in long-term care. Int J Geriatr Psychiatry. 2000;15(2):181-189. [DOI] [PubMed] [Google Scholar]
- Hoe J., Hancock G., Livingston G., Orrell M. Quality of life of people with dementia in residential care homes. Br J Psychiatry. 2006;188(5):460-464. [DOI] [PubMed] [Google Scholar]
- Norton LE, Malloy PF, Salloway S. The impact of behavioral symptoms on activities of daily living in patients with dementia. Am J Geriatr Psychiatry. 2001. ;9(1): 41-48. [PubMed] [Google Scholar]
- Iavarone A. , Milan G., Vargas G., et al. Role of functional performance in diagnosis of dementia in elderly people with low educational level living in Southern Italy. Aging Clin Exp Res. 2007. ;19(2):104-109. [DOI] [PubMed] [Google Scholar]