Dysgraphia in dementia

Abstract

This paper reviews the spelling and writing deficits associated with the major forms of dementia.In dementia of the Alzheimer's type (DAT), the finding of surface dysgraphia is typical, although not universal, and with disease progression non-phonologlcally plausible errors often increase; additional difficulties with handwriting are common. Surface dysgraphia is a predictable feature in semantic dementia, but In contrast to DAT, the mechanics of handwriting are usually preserved. In patients with posterior cortical atrophy [Including some (atypical) DAT patients], spatial dysgraphia is an early symptom. Spelling and writing disorders have been documented, although not thoroughly studied, in other forms of dementia (e.g. vascular, frontal, dementia with Lewy bodies, etc.). Research on dysgraphia in dementias associated with movement disorders (e.g. cortico-basal degeneration, progressive supranuclear palsy, Huntington's disease, etc.) has focused mainly on problems with writing, which is often poorly formed, but spelling impairments have also been observed. The precise characteristics and prevalence of spelling disorders in these diseases are, however, unknown as there has been little systematic study. Additional investigations, which assess both central (linguistic) and peripheral aspects of writing, and which include a longitudinal component, will help to elucidate the nature and progression of dysgraphia in different types of dementia.