We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Neuropsychological Deficits in Vascular Dementia vs Alzheimer's Disease Frontal Lobe Deficits Prominent in Vascular Dementia

Andrew Kertesz, MD, FRCP; Scott Clydesdale, MA
Arch Neurol. 1994;51(12):1226-1231. doi:10.1001/archneur.1994.00540240070018.
Text Size: A A A
Published online


Objective:  To detect neuropsychological differences between Alzheimer's disease (AD) and vascular dementia (VAD).

Design:  Neuropsychological measures were compared in clinically defined AD and VAD patient groups.

Setting:  Ambulatory and hospitalized patients were referred to a behavioral neurology clinic and to the neuropsychology department of a teaching hospital.

Patients:  Consecutive, referred patients who fulfilled National Institute of Neurological Disorders and Stroke/Alzheimer's Disease and Related Disorders Association and Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, criteria for AD and VAD were selected to participate in the study based on the history and clinical findings. A modified ischemie score of 3 or less was an independent selection criterion for AD (n=103) and a score of 4 or more for VAD (n=25). Computed tomography or magnetic resonance imaging was used to exclude other structural causes. Patients with cognitive changes related directly to a stroke were excluded. Patients were matched for age, education, age at onset, and severity of dementia.

Measures:  The variable measures were the subtests of the Wechsler Adult Intelligence Scale-Revised (WAISR), Wechsler Memory Scale-Revised, Mattis Dementia Rating Scale (MDRS), and Western Aphasia Battery (WAB). Patients were further stratified into mild and severe dementia categories, based on their performance on the MDRS.

Results:  Variables that were significantly different were selected for discriminant function analysis. The Writing subtest of the WAB, the Picture Arrangement subtest of the WAIS-R, and the Motor Performance subtest of the MDRS were the best discriminators of AD and VAD in the overall and severely affected populations. Patients with VAD performed significantly worse on the MDRS Motor Performance subtest, the WAIS-R Picture Arrangement subtest, the WAB Writing subtest, the WAIS-R Object Assembly subtest, and the WAB Block Design subtest. The AD group performed significantly worse on the WAB Repetition subtest, and patients with severe AD performed significantly worse on the Story Recall test.

Conclusions:  Patients with VAD performed worse on tests that are influenced by frontal and subcortical mechanisms. Patients with AD performed worse on memory and some language subtests.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.