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Gertrude H. Sergievsky Center (Drs. Richards, Marder, Mayeux, and Stern), the Center for Alzheimer's Disease Research in the City of New York (Drs. Marder, Mayeux, and Stern), and the Departments of Neurology (Drs. Richards, Bell, Dooneief, Marder, Sano, Mayeux, and Stern) and Psychiatry (Drs. Mayeux and Stern) at the College of Physicians and Surgeons, Columbia University, New York, NY.
We investigated the relationship between extrapyramidal signs (EPS) and the cognitive function in 90 patients meeting NINCDS-ADRDA criteria for probable Alzheimer's disease (AD) by dividing them into those showing no evidence of EPS and those showing at least one EPS on the Unified Parkinson's Disease Rating Scale. Cognitive function was assessed by neuropsychological tests of verbal memory, orientation, abstract reasoning, language, and construction. Patients with EPS were significantly more impaired than patients without EPS on tests of short-term learning and memory, orientation, naming, verbal fluency, and construction, but not on tests of long-term memory, abstract reasoning, or verbal comprehension. These results could not be explained by any differences in age, education, or disease duration between the groups. Since this pattern of neuropsychological impairment resembles that of patients with Parkinson's disease and other EPS syndromes, we hypothesize that EPS are associated with neuropathologic and neuropsychological changes that are superimposed over the classic features of AD.
Address correspondence and reprint requests to Dr. Y. Stern, Gertrude H. Sergievsky Center, 630 West 168th Street, New York, NY 10032.
Supported by Federal Grants AG07232, AGO7370, AGO8702, and RR00645, the Charles S. Robertson Memorial Gift for Alzheimer's Disease, and the Parkinson's Disease Foundation of New York.
Received September 23,1992. Accepted for publication in final form January 13,1993.
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