AD compared to DSD

1. Possible fam hx of AD no psych hx slow progression of sxs long sx duration no complaints of deficits vague complaints conceals deficits variable emotional reaction decreased awareness of deficits behavior congruent Fam hx of MD prev psych hx rapid progression of sxs short sx duration complains of deficits complains in detail emphasizes complaints distressed aware of deficits behavior incongruent AD compared to DSD

2. relies on notes, calendars, etc mood environmentally responsive night confusion variable early am awakening topographical disorientation temporal disorientation dress apraxia variable loss of libido does not try to keep up persistent mood disorder variable night confusion early am awakening topographically oriented fluctuating temporal disorientation no dress apraxia severe loss of libido AD compared to DSD

3. Poor free verbal recall flat learning curve no primacy effect impaired recency effect frequent extra-list errors few “don’t know” errors perseverative errors Impaired recog memory false positives semantic organization unhelpful prompting unhelpful Variable free verbal recall reduced U learning curve reduced primacy effect reduced recency effect infrequent extra-list errors “don’t know” errors few perseverative errors Intact recog memory few/no false positives semantic organization helpful prompting helpful AD versus PDP on NP testing

4. Good effort on tasks impaired on “automatic” encoding impaired on “effortful” encoding consistent perform across tasks of similar difficulty memory performance worse than complaints rapid rate of forgetting need frequent reminders of task directions Poor effort on tasks intact on “automatic” encoding impaired at “effortful” encoding variable performance across tasks of similar difficulty memory performance better than complaints normal rate of forgetting remembers task directions AD versus PDP on NP testing

5. bilateral temporoparietal hypometabolism (PET) bilateral temporoparietal hypoperfusion (SPECT) cortical atrophy (MRI) enlarged sulci (MRI) decreased density in white matter abnormal EEG bilateral frontal lobe hypometabolism (PET) bilateral frontal lobe hypoperfusion (SPECT) white matter hyperintensities (MRI) basal ganglia periventricular area normal EEG Ad vs DSD on Neurophysiological measures