Visual Discrimination Predicts Naming and Semantic Association Accuracy in Alzheimer Disease

Abstract

Language impairment is a common symptom of Alzheimer disease (AD), and is thought to be related to semantic processing. This study examines the contribution of another process, namely visual perception, on measures of confrontation naming and semantic association abilities in persons with probable AD. Twenty individuals with probable mild-moderate Alzheimer disease and 20 age-matched controls completed a battery of neuropsychologic measures assessing visual perception, naming, and semantic association ability. Visual discrimination tasks that varied in the degree to which they likely accessed stored structural representations were used to gauge whether structural processing deficits could account for deficits in naming and in semantic association in AD. Visual discrimination abilities of nameable objects in AD strongly predicted performance on both picture naming and semantic association ability, but lacked the same predictive value for controls. Although impaired, performance on visual discrimination tests of abstract shapes and novel faces showed no significant relationship with picture naming and semantic association. These results provide additional evidence to support that structural processing deficits exist in AD, and may contribute to object recognition and naming deficits. Our findings suggest that there is a common deficit in discrimination of pictures using nameable objects, picture naming, and semantic association of pictures in AD. Disturbances in structural processing of pictured items may be associated with lexical-semantic impairment in AD, owing to degraded internal storage of structural knowledge.