Background: Executive dysfunction in Alzheimer's disease (AD) has been recently recognized as an early and prominent clinical sign. The Tower of London (ToL), a task specifically devised to test executive functions of visuospatial planning and problem solving, has frequently been used in neuropsychological experiments, but rarely in the clinical ground. Methods: One hundred and sixty-one AD patients and 212 nondemented healthy controls were administered a simplified ToL version. Results: AD patients were significantly impaired (p < 0.0001) in all ToL scores and in the total execution time. The 'accuracy' score of ToL at a cut off of <= 29/36 yielded a sensitivity of 71.2% and a specificity of 76.4% (AUC 0.79) for the diagnosis of AD versus controls. Conclusions: Visuospatial planning and problem solving are significantly impaired in early dementia of the Alzheimer's type. A successful sensitivity/specificity ratio, the independence of education and the simplicity of this version of ToL make it a useful executive functioning screening test for early AD. Copyright (c) 2007 S. Karger AG, Basel.
Visuospatial planning and problem solving in Alzheimer's disease patients: a study with the Tower of London Test / M., Franceschi; Caffarra, Paolo; L., De Vreese; O., Pelati; S., Pradelli; R., Savarè; R., Cerutti; E., Grossi; ToL Research, Group. - In: DEMENTIA AND GERIATRIC COGNITIVE DISORDERS. - ISSN 1420-8008. - 24:(2007), pp. 424-428. [10.1159/000109827]
Visuospatial planning and problem solving in Alzheimer's disease patients: a study with the Tower of London Test
CAFFARRA, Paolo;
2007-01-01
Abstract
Background: Executive dysfunction in Alzheimer's disease (AD) has been recently recognized as an early and prominent clinical sign. The Tower of London (ToL), a task specifically devised to test executive functions of visuospatial planning and problem solving, has frequently been used in neuropsychological experiments, but rarely in the clinical ground. Methods: One hundred and sixty-one AD patients and 212 nondemented healthy controls were administered a simplified ToL version. Results: AD patients were significantly impaired (p < 0.0001) in all ToL scores and in the total execution time. The 'accuracy' score of ToL at a cut off of <= 29/36 yielded a sensitivity of 71.2% and a specificity of 76.4% (AUC 0.79) for the diagnosis of AD versus controls. Conclusions: Visuospatial planning and problem solving are significantly impaired in early dementia of the Alzheimer's type. A successful sensitivity/specificity ratio, the independence of education and the simplicity of this version of ToL make it a useful executive functioning screening test for early AD. Copyright (c) 2007 S. Karger AG, Basel.File | Dimensione | Formato | |
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