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• W907757 abstract "Abstract Objective: Unlike cognitive function, clinical assessment of neurological deficits in Alzheimer's disease has received limited attention. This study aimed to determine the association between soft neurological signs and rate of clinical progression in Chinese people with Alzheimer's disease. Patients and Methods: 104 Chinese patients with late-onset Alzheimer's disease were followed up for an average of 22.5 months (SD, 5.2 months). Soft neurological signs were evaluated with the Cambridge Neurological Inventory. Outcome was determined by deterioration in Clinical Dementia Rating and mortality. Results: Motor coordination, sensory integration, and failure of suppression signs were more prevalent in participants with Alzheimer's disease than in controls without dementia (p Conclusions: The findings suggest that cortical soft neurological signs such as motor coordination and sensory integration, which were highly associated with cognitive performance in patients with Alzheimer's disease, represent overlapping clinical dimensions. The presence of subcortical extrapyramidal signs may signify poorer prognosis. Key words: Alzheimer's disease, Neurobehavioural manifestations, Neurological diagnostic techniques, Prognosis Introduction Alzheimer's disease (AD) is the commonest dementia worldwide. In a recent review of the prevalence of dementia in China, it was estimated that the prevalence rate of AD for people aged 60 years and over was 1.26%. (1) Although progressive cognitive deterioration is central to the diagnosis of AD, the clinical syndrome comprises complex behavioural and neurological manifestations reflecting continuous degeneration of the brain. In people with very early AD, cognitive deficits are also characterised by impaired delayed recall in episodic memory tests and reduced verbal fluency. (2-5) With increasing cognitive deterioration, patients' ability to evaluate their own cognitive abilities deteriorates. As dementia becomes more severe, very limited cognitive abilities remain and only basic functions are present. Neurological deficits reflecting cerebral degeneration are not uncommon in patients with AD. With increasing cortical atrophy, neurological signs become more prevalent. Focal neurological signs such as pyramidal signs, which represent localised lesions in the brain, are more commonly found in patients with vascular dementia. However, soft neurological signs (SNS) indicating diffuse damage are likely to be present in AD. The severity of SNS may be indicative of disease progression. The presence of extrapyramidal signs in patients with mild cognitive impairment is associated with a decline in cognitive function and the development of AD. (6) In established AD, the presence of extrapyramidal signs is also associated with faster cognitive decline, higher mortality, and more severe pathological changes in clinical autopsy studies. (7,8) Despite the presence of significant neurological deficits in patients with AD, the role of clinical neurological examination in the evaluation of AD remains limited. The aim of this study was to identify the pattern of SNS in AD and evaluate its potential clinical significance, particularly in terms of its ability to predict the trajectory of disease progression. Patients and Methods The study comprised a 2-year prospective naturalistic study of Chinese patients with AD. At baseline, cross-sectional assessment of cognitive and neurological characteristics was performed. Patients with AD who were referred to a clinic for first psychogeriatric assessment were enrolled in the study. …" @default.
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• W907757 modified "2023-09-23" @default.
• W907757 title "Association between Soft Neurological Signs and Clinical Progression in Alzheimer's Disease" @default.
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