Bak article on cognitive profiles – AD, PSP, CBD, MSA, DLB

Thomas Bak from the UK wrote a great article in Nov/Dec ’06 providing the cognitive profiles of those with AD, PSP, CBD, MSA, and DLB, based upon the subtests of ACE (Addenbrooke’s Cognitive Examination).

You can find it for free online here:
http://www.acnr.co.uk/NO06/ND06_review_cog.pdf

In that article, he says:

“There are two serious problems connected with the use of MMSE in this patient group [with parkinsonian syndromes]. Firstly, MMSE has been demonstrated to be particularly insensitive to frontal-executive dysfunction, which, as will be shown below, constitutes the most common cognitive deficit in basal ganglia diseases. Secondly, based on the unitary concept of dementia, it does not examine different cognitive domains but confines itself to one global ‘dementia score’. It is, therefore, unable to determine qualitative differences between diseases.”

He advocates the use of other tests besides or in addition to the MMSE. In particular, he likes Addenbrooke’s Cognitive Examination (ACE) test, which includes verbal fluency among other cognitive batteries. He says this test “has been validated in PSP, CBD
and MSA.”

Check out Figure 1 of his short, two-page article. Figure 1 shows the impairment levels of those with (clinical diagnoses of) AD, PSP, CBD, MSA, and DLB on the various ACE subtests of Orientation, Attention, Memory, Verbal Fluencies, Language, and Visuospatial functions.

I have referred to this article in other posts but I think it deserves it’s own topic!