Wechsler Memory Scale-Revised Research Articles

P.2.d.026 Impulsivity and character traits in bipolar disorder

There is marked interest to research neurocognitive functions in bipolar disorder during euthymia. Consequently we aimed to study cognitive functions in euthymic bipolar patients and factors affecting them.It is a cross sectional case-control study of 60 euthymic bipolar patients and 30 matched healthy controls. They were subjected to: Structured Clinical Interview for DSM-IV disorders, (SCID-I) to ascertain clinical diagnosis, Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HRSD) to validate euthymia. Wechsler Adult Intelligence Scale (WAIS) for general intellectual abilities, Wechsler Memory Scale-Revised (WMS-R) for memory, Wisconsin Card Sorting Test (WCST) for executive functions, Continuous Performance Test (CPT) for attention and impulsivity, and an information sheet gathering patient data.Bipolar patients had statistically significant lower mean IQ scores in all WAIS subscales (p=0.000), significantly lower memory abilities especially digit span and visual memory, higher impulsivity and inattention (p=0.000) but no significant difference in response time by CPT. They displayed significantly lower executive performance on WCST. Patients’ years of education correlated positively with IQ. Hospital admission, number, type of episodes and total number of episodes affected memory functions. Hospital admission and number of hypomanic episodes correlated with attention and impulsivity. Previous hospitalization correlated with executive functions.Euthymic bipolar patients exhibit cognitive deficits, which correlated with clinical variables as number, type of episodes and previous hospitalization, this knowledge could help minimize cognitive impairments for future patients.The small sample size, cross sectional design and lack of premorbid cognitive assessment limit generalization of findings.

Cognitive functions in euthymic Egyptian patients with bipolar disorder: Are they different from healthy controls?

BackgroundThere is marked interest to research neurocognitive functions in bipolar disorder during euthymia. Consequently we aimed to study cognitive functions in euthymic bipolar patients and factors affecting them. MethodsIt is a cross sectional case-control study of 60 euthymic bipolar patients and 30 matched healthy controls. They were subjected to: Structured Clinical Interview for DSM-IV disorders, (SCID-I) to ascertain clinical diagnosis, Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HRSD) to validate euthymia. Wechsler Adult Intelligence Scale (WAIS) for general intellectual abilities, Wechsler Memory Scale-Revised (WMS-R) for memory, Wisconsin Card Sorting Test (WCST) for executive functions, Continuous Performance Test (CPT) for attention and impulsivity, and an information sheet gathering patient data. ResultsBipolar patients had statistically significant lower mean IQ scores in all WAIS subscales (p=0.000), significantly lower memory abilities especially digit span and visual memory, higher impulsivity and inattention (p=0.000) but no significant difference in response time by CPT. They displayed significantly lower executive performance on WCST. Patients’ years of education correlated positively with IQ. Hospital admission, number, type of episodes and total number of episodes affected memory functions. Hospital admission and number of hypomanic episodes correlated with attention and impulsivity. Previous hospitalization correlated with executive functions. ConclusionsEuthymic bipolar patients exhibit cognitive deficits, which correlated with clinical variables as number, type of episodes and previous hospitalization, this knowledge could help minimize cognitive impairments for future patients. LimitationsThe small sample size, cross sectional design and lack of premorbid cognitive assessment limit generalization of findings.

Association between adjuvant regional radiotherapy and cognitive function in breast cancer patients treated with conservation therapy.

Although protracted cognitive impairment has been reported to occur after radiotherapy even when such therapy is not directed to brain areas, the mechanism remains unclear. This study investigated whether breast cancer patients exposed to local radiotherapy showed lower cognitive function mediated by higher plasma interleukin (IL)-6 levels than those unexposed. We performed the Wechsler Memory Scale-Revised (WMS-R) and measured plasma IL-6 levels for 105 breast cancer surgical patients within 1 year after the initial therapy. The group differences in each of the indices of WMS-R were investigated between cancer patients exposed to adjuvant regional radiotherapy (n = 51) and those unexposed (n = 54) using analysis of covariance. We further investigated a mediation effect by plasma IL-6 levels on the relationship between radiotherapy and the indices of WMS-R using the bootstrapping method. The radiotherapy group showed significantly lower Immediate Verbal Memory Index and Delayed Recall Index (P = 0.001, P = 0.008, respectively). Radiotherapy exerted an indirect effect on the lower Delayed Recall Index of WMS-R through elevation of plasma IL-6 levels (bootstrap 95% confidence interval = −2.6626 to −0.0402). This study showed that breast cancer patients exposed to adjuvant regional radiotherapy in conservation therapy might have cognitive impairment even several months after their treatment. The relationship between the therapy and the cognitive impairment could be partially mediated by elevation of plasma IL-6 levels.

ACE polymorphism and use of ACE inhibitors: effects on memory performance

Memory is an important cognition function, being fundamental to the development and independence of individuals. Our aim was to investigate the influence apolipoprotein E (APOE) and angiotensin I-converting enzyme (ACE) polymorphism and ACE inhibitors use, besides their interaction on memory performance of healthy subjects over 50 years. The sample consisted of 205 subjects assessed for five types of episodic memory, using Wechsler Memory Scale-Revised (WMS-R), who answered a questionnaire about drug use and were assessed for the ACE insertion/deletion polymorphism and APOE polymorphism. We found no influence of the APOE gene. The use of ACE inhibitors beneficially influenced learning ability scores (p = 0.02). Besides, I allele carriers of ACE polymorphism showed higher verbal memory scores compared with homozygous DD. Also, we observed an interaction influencing learning ability between the ACE polymorphism and the use of inhibitors, the beneficial influence of the I allele was present only in individuals who make use of ACE inhibitors. We conclude that the ACE gene has influence on memory performance, and that this influence is modulated by ACE inhibitors use.

Could Infection Effect Cognitive Function in Schizophrenia ? : One Egyptian Center Study

ackground: Numerous viral infections, in utero or in childhood, have been associated with an increased risk of later developing schizophrenia. This may be explained by chronic infections or an altered immune status. Objectives: The present study aimed to measure levels of serum antibodies to some infectious agents in a sample of Egyptian patients with schizophrenia and to assess if there is correlation of cognitive functioning with this serum titer. Methods: the Arabic Version of Wechsler Adult Intelligence Scale Revised; selected subtests from Wechsler Memory Scale-Revised; Trail making test and Self-Assessment Scale of Cognitive Complaints in Schizophrenia were used to assess cognitive function in 102 newly diagnosed drug naive patients with schizophrenia and 124 healthy matched individuals. Solid phase enzyme immuno-assay (EIA) techniques were used to measure IgG class antibodies to Rubella virus, cytomegalovirus (CMV), Herpes simplex virus type 1&2 (HSV-1&2), and to Toxoplasma gondii (T. gondii) in the sera of the study individuals. Associations between serological exposure to selected infectious agents and cognitive function in schizophrenia were evaluated. Results: All studied infectious agents were more prevalent in patients with schizophrenia than in the control group. Higher anti-HSV1&2, and anti-Rubella IgG antibodies titers were significantly correlated with impaired cognitive tests, while anti-T. gondii IgG titer was insignificantly correlated with any of the neuro-cognitive tests. Conclusions: The higher prevalence of serum IgG antibodies to all analyzed infectious agents with higher titers within patients with schizophrenia emphasizes a possible role of infectious agents in the etiopatho-genesis of schizophrenia. The data indicates that not one specific agent might be responsible for schizophrenic symptoms. Impairment of the cognitive functions in patients with schizophrenia was associated with higher IgG titers to HSV1&2, and Rubella virus.

Depression, impulsiveness, sleep, and memory in past and present polydrug users of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy)

Ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is a worldwide recreational drug of abuse. Unfortunately, the results from human research investigating its psychological effects have been inconsistent. The present study aimed to be the largest to date in sample size and 5HT-related behaviors; the first to compare present ecstasy users with past users after an abstinence of 4 or more years, and the first to include robust controls for other recreational substances. A sample of 997 participants (52 % male) was recruited to four control groups (non-drug (ND), alcohol/nicotine (AN), cannabis/alcohol/nicotine (CAN), non-ecstasy polydrug (PD)), and two ecstasy polydrug groups (present (MDMA) and past users (EX-MDMA). Participants completed a drug history questionnaire, Beck Depression Inventory, Barratt Impulsiveness Scale, Pittsburgh Sleep Quality Index, and Wechsler Memory Scale-Revised which, in total, provided 13 psychometric measures. While the CAN and PD groups tended to record greater deficits than the non-drug controls, the MDMA and EX-MDMA groups recorded greater deficits than all the control groups on ten of the 13 psychometric measures. Strikingly, despite prolonged abstinence (mean, 4.98; range, 4-9 years), past ecstasy users showed few signs of recovery. Compared with present ecstasy users, the past users showed no change for ten measures, increased impairment for two measures, and improvement on just one measure. Given this record of impaired memory and clinically significant levels of depression, impulsiveness, and sleep disturbance, the prognosis for the current generation of ecstasy users is a major cause for concern.

The influence of shift work on cognitive functions and oxidative stress

Shift work influences health, performance, activity, and social relationships, and it causes impairment in cognitive functions. In this study, we investigated the effects of shift work on participants' cognitive functions in terms of memory, attention, and learning, and we measured the effects on oxidative stress. Additionally, we investigated whether there were significant relationships between cognitive functions and whole blood oxidant/antioxidant status of participants. A total of 90 health care workers participated in the study, of whom 45 subjects were night-shift workers. Neuropsychological tests were administered to the participants to assess cognitive function, and blood samples were taken to detect total antioxidant capacity and total oxidant status at 08:00. Differences in anxiety, depression, and chronotype characteristics between shift work groups were not significant. Shift workers achieved significantly lower scores on verbal memory, attention–concentration, and the digit span forward sub-scales of the Wechsler Memory Scale-Revised (WMS-R), as well as on the immediate memory and total learning sub-scales of the Auditory Verbal Learning Test (AVLT). Oxidative stress parameters were significantly associated with some types of cognitive function, including attention–concentration, recognition, and long-term memory. These findings suggest that night shift work may result in significantly poorer cognitive performance, particularly working memory.

Neuropsychological differentiation between Alzheimer's disease and dementia with Lewy bodies in a memory clinic

The aim of this study was to identify a useful neuropsychological instrument for making a differential clinical diagnosis between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). We examined 402 AD and 38 DLB patients with neuropsychological tests that covered general cognition, frontal lobe cognitive function, non-verbal abstract reasoning, working memory and attention, and verbal memory. Discriminant analysis using a stepwise method was performed to identify the measures best able to discriminate between AD and DLB. The AD patients performed significantly worse than the DLB patients on orientation to time, delayed recall subtests on the Mini-Mental State Examination, and logical memory subtests 1 and 2 of the Revised Wechsler Memory Scale. The DLB patients performed significantly worse than the AD patients on the attention, repetition, and pentagon copying subtests of the Mini-Mental State Examination, the constructional praxis subtests of the Alzheimer's Disease Assessment Scale-cognitive component-Japanese version, the Frontal Assessment Battery total score, Raven's Coloured Progressive Matrices (RCPM) sets A, AB, and B, and backward digit span. Discriminant analyses between AD and DLB established the key variables as Logical Memory 1, Logical Memory 2, backward digit span, RCPM, and delayed recall on the Mini-Mental State Examination. We inferred the AD-DLB discriminant index from the following discriminant analyses: AD-DLB discriminant index = (Backward digit span score + RCPM set B score) - (Logical Memory 1 score + Logical Memory 2 score), which offered a highly favourable value for diagnostic utility. The AD-DLB discriminant index, consisting of backward digit span, RCPM set B, and logical memory 1 and 2, is useful to differentiate between AD and DLB.

Possible association between common variants of the phenylalanine hydroxylase (PAH) gene and memory performance in healthy adults

BackgroundPhenylalanine hydroxylase (PAH) is the enzyme that metabolizes phenylalanine, an essential amino acid required for catecholamine synthesis. Rare mutations in PAH are causal to phenylketonuria (PKU), an autosomal recessive disease characterized by neuropsychiatric symptoms including intellectual disability. We examined whether there is an association between common single nucleotide polymorphisms (SNPs) of PAH and memory performance in the Japanese population.MethodsSubjects were 599 healthy adults (166 males and 433 females; mean age 43.8 ± 15.5 years). The Wechsler Memory Scale-Revised (WMS-R) was administered to all participants to assess memory performance. Genotyping was performed for 6 selected tagging SNPs of PAH (rs1722387, rs3817446, rs1718301, rs2037639, rs10860936 and rs11111419).ResultsAnalyses of covariance controlling for sex and education years, indicated a significant association between a SNP (rs2037639) and age-corrected verbal memory index of WMS-R (nominal p = 0.0013) which remained significant after correction for multiple testing ( p = 0.0013 < 0.0017 = 0.05/30tests). Individuals with the GG genotype showed a significantly lower mean verbal memory score, compared with those individuals carrying the AA/AG genotype (106.0 ± 16.0 vs. 111.7 ± 13.4; p = 0.00099). A haplotype block containing two markers of rs2037639 and rs10860936 was associated with verbal memory index (permutation global p = 0.0091).ConclusionsOur findings suggest that common genetic variations in PAH are associated with verbal memory in healthy adults. Unknown functional polymorphisms in PAH or those in other genes nearby might affect memory performance.

Time course for memory dysfunction in early-life and late-life major depression: A longitudinal study from the Juntendo university mood disorder project

BackgroundPrevious studies have demonstrated that patients with depression also have memory dysfunctions during depressive episodes. These dysfunctions partially remain immediately after remission from a depressive state; however, it is unclear whether these residual memory dysfunctions may disappear through long-term remission from depression. The present study compared patients during early-life (age<60) and late-life (age≥60) depression while in their remitted stage with healthy controls to elucidate the impact of a long-term course on memory. MethodsLogical memory from the Wechsler Memory Scale-Revised was administered to 67 patients with major depressive disorder (MDD) (47 patients with early-life depression and residual 20 patients with late-life depression) and 50 healthy controls. MDD patients received memory assessments at the time of their initial remission and at a follow-up three years after remission. ResultsAt the time of initial remission, scores for logical memory were significantly lower in both patient groups compared to matched controls. At follow-up, memory dysfunction for early-life MDD patients disappeared, whereas scores in the late-life MDD group remained significantly lower than those of matched controls. LimitationsAll patients in the present study were on antidepressant medications. ConclusionsOur findings suggested that the progress of memory performance in late-life MDD patients may be different from early-life MDD patients.

The relationship between obesity and neurocognitive function in Chinese patients with schizophrenia

BackgroundStudies have reported that up to 60% of individuals with schizophrenia are overweight or obese. This study explored the relationship between obesity and cognitive performance in Chinese patients with schizophrenia.MethodsOutpatients with schizophrenia aged 18–50 years were recruited from 10 study sites across China. Demographic and clinical information was collected. A neuropsychological battery including tests of attention, processing speed, learning/memory, and executive functioning was used to assess cognitive function, and these 4 individual domains were transformed into a neurocognitive composite z score. In addition, height and weight were measured to calculate body mass index (BMI). Patients were categorized into 4 groups (underweight, normal weight, overweight and obese) based on BMI cutoff values for Asian populations recommended by the World Health Organization.ResultsA total number of 896 patients were enrolled into the study. Fifty-four percent of participants were overweight or obese. A higher BMI was significantly associated with lower scores on the Wechsler Memory Scale-Revised (WMS-R) Visual Reproduction subscale, the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol subscale, and the composite z score (p’s ≤ 0.024). Obese patients with schizophrenia had significantly lower scores than normal weight patients on the Trail Making Test B, the WMS-R Visual Reproduction subscale, the WAIS Digit Symbol subscale, and the composite z score (p’s ≤ 0.004).ConclusionsOur study suggests that, in addition to its well established risk for various cardiometabolic conditions, obesity is also associated with decreased cognitive function in Chinese patients with schizophrenia. Future studies should explore if weight loss and management can improve cognitive function in obese patients who suffer from schizophrenia.

Visual Reproduction on the Wechsler Memory Scale-Revised as a Predictor of Alzheimer’s Disease in Japanese Patients with Mild Cognitive Impairments

Background: The Visual Reproduction (VR) test is used to assess mild cognitive impairment (MCI), but the characteristics of visual memory in Japanese MCI patients remain unclear. Methods: VR scores of 27 MCI patients were evaluated using the Wechsler Memory Scale-Revised. Scores of MCI, no-dementia, and Alzheimer’s disease (AD) groups were then compared. Results: The annual conversion rate of MCI to AD was 18.8%. Mean VR-I and VR-II baseline scores for MCI patients were 33.3 ± 5.6 and 20.5 ± 14.0, respectively. Mean VR-II scores for converted and nonconverted MCI patients were 7.2 ± 8.7 and 29.8 ± 9.3, respectively. Conclusions: It is likely that VR-II and VR-II/I scores are more sensitive for predicting conversion to AD in Japanese than in American MCI patients. Our results indicate that VR is a sensitive and useful measure for predicting the conversion of Japanese MCI patients to AD within 2 years.

Neuropsychological Detection of the Early Stage of Amnestic Mild Cognitive Impairment without Objective Memory Impairment

Aim: We investigate the assessment method to detect the early stage of amnestic mild cognitive impairment (aMCI) using Wechsler Memory Scale – Revised (WMS-R) and Wechsler Adult Intelligence Scale – Third Edition (WAIS-III). Methods: Three groups (normal group, aMCI group, and early aMCI group), controlled for age and years of education, underwent brain ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET), WAIS-III, WMS-R, and other tests. The early aMCI group does not fulfill the clinical diagnostic criteria of aMCI because patients do not have objective memory impairment, but their clinical symptoms and results of ¹⁸F-FDG PET indicate that they should be included in the category of aMCI. Results: The discrepancy of scores between Verbal IQ and General Memory had the highest accuracy in discriminating between normal and early aMCI groups. Conclusion: The cutoff point determined in this study is useful to detect an early stage of aMCI, which may be distinguished from aMCI using the current criteria.

Use of liothyronine in preventing electroconvulsive therapy-induced memory impairment: evaluation

Aims and methodTo evaluate the effect of liothyronine administration on the cognitive side-effects of electroconvulsive therapy (ECT), 30 participants with major depressive disorder that were suitable candidates for ECT were randomly allocated to either a liothyronine or a placebo group. Participants in the liothyronine group received a daily 50 μg dose for the whole period of receiving ECT starting the day before ECT, whereas the other group received a placebo. The Hamilton Rating Scale for Depression (HRSD) and the Wechsler Memory Scale – revised (WMS-R) were used for evaluating mood and memory before the first ECT session and after the sixth session (the HRSD was also used after the third session).ResultsThe results indicated that after the sixth ECT session, participants that received liothyronine achieved significantly better scores on the HRSD and WMS-R.Clinical implicationsFurther studies with a larger number of participants, through multicentre research projects, are indicated to obtain adequate data for meta-analysis and systematic review.

2780 – The influence of shift work on cognitive functions and oxidative stress

Introduction The shift work has various negative influences on health, performance, activity, and social relationships as well as causing impairment in cognitive functions. Objective We aimed to investigate the effects of shift work on participants’ cognitive functions in terms of memory, attention and learning, and on oxidative stress indicated by total oxidant status, total antioxidant capacity, and oxidative stress index. Methods 90 health workers participated in the study (45 subjects were night shift workers). The neuropsychological tests were applied to the participants for assessing the cognitive functions and blood samples were taken to detect their total antioxidant capacity and total oxidant at 8.00 in the morning. Depression, anxiety, chronobiological characteristics, cognitive functions were assessed by using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Morningness- Eveningness Questionnaire (MEQ), Wechsler Memory Scale- Revised (WMS-R), Auditory-Verbal Learning Test (AVLT) and Stroop Test. Results Night shift workers reported significantly lower scores on the verbal memory, the attention-concentration, and the digit span forward sub-scales of the WMS-R as well as the immediate memory and the total learning sub-scales of the AVLT. Oxidative stress parameters were significantly associated with some types of the cognitive functions in both groups. Conclusion The findings suggest that health workers in night shift generally revealed significantly poorer performance in cognitive assessment as compared to day shift workers. The oxidative stress indicators associated with the cognitive functioning.

Predicting AD conversion with a computerized diagnostic tool

Predicting AD conversion with a computerized diagnostic tool

Cognitive functioning and depressive symptoms in adolescents with inflammatory bowel disease

To investigate cognitive functioning and depressive symptoms in adolescents with inflammatory bowel disease (IBD). A neuropsychological test battery, including subtests of the Wechsler Adult Intelligence Scale-Revised and III, Wechsler Memory Scale-Revised, California Verbal Learning Test (CVLT), Stroop Color-Word Test, and Trail Making Test, which assessed verbal and visual short- and long-term memory, processing speed, logical reasoning, verbal intelligence, attention, and executive functioning, was administered to 13- to 19-year-old patients with IBD (n = 34; active disease n = 20). Depressive symptoms were measured with the Beck Depression Inventory. The findings were compared with peers with non-acute juvenile idiopathic arthritis (JIA; n = 23). Patients with coexisting psychiatric disorders were excluded. The IBD group, especially patients in the acute phase, made more perseverative errors in the CVLT test that assessed verbal memory than the JIA group (6.0 ± 4.3 vs 3.3 ± 2.9, P < 0.01), but no other differences between the IBD and JIA groups were observed in the neuropsychological tests. The difference was close to statistical significance, even when glucocorticoid medication was controlled for (P < 0.052). The IBD group had more depressive symptoms than the JIA group (7.9 ± 7.6 vs 4.0 ± 4.0, P < 0.05). Approximately one third of the IBD group had at least mild depressive symptoms, and those with acute illness had the highest scores. However, depressive symptoms were not related to the difference in the verbal memory test (perseverative errors in the CVLT) between the IBD and JIA groups. Adolescents with acute IBD may have mild verbal memory problems but no major cognitive deficits compared to peers with JIA.

1323 – Cognitive function in major depressive disorder: the role of symptomatology, personality and stress hormones

It has been reported that cognitive functioning in major depressive disorder (MDD) can be affected by various factors, such as symptom severity, personality dimensions and stress hormone activity. However, the relative role of each is largely unknown. Seventy-six non-remitted patients with MDD were recruited. Symptomatology was assessed by the 21-item version of the Hamilton Rating Scale for Depression and the Hopkins Symptom Checklist (HSCL). Personality was assessed by the Temperament and Character Inventory (TCI). Neurocognitive functions, including verbal and visual memory, delayed recall and attention/working memory were measured by the full version of the Wechsler Memory Scale-Revised. Neuroendocrine function was determined by the reactivity of cortisol and dehydroepiandrosterone-sulfate (DHEAS) to the combined dexamethasone/corticotropin releasing hormone test. To quantify cognitive impairments in patients, age-, sex- and education- matched 187 healthy controls were also recruited and administered the same neuropsychological test. MDD patients performed significantly worse than controls on visual memory and delayed recall. A stepwise multiple regression analysis predicting performance of each cognitive domain from five HSCL dimensions, seven TCI dimensions and hormonal variables, controlling for age, gender and education, revealed that higher cooperativeness was the only significant predictor towards better verbal memory, that less somatization symptoms and lower self-directedness were significant predictors towards better visual memory, and that lower age, less anxiety symptoms and lower DHEAS levels after dexamethasone administration were significant predictors towards better delayed recall. Besides symptomatology, some personality dimensions and neuroendocrine function may, at least partly independently, contribute to memory impairment in MDD.

Necessity of normative data on the Japanese version of the Wechsler Memory Scale‐Revised Logical Memory subtest for old‐old people

Episodic memory is vulnerable to deterioration in people suffering from Alzheimer's disease. Currently, the Logical Memory (LM) subtest of the Wechsler Memory Scale-Revised (WMS-R) is used internationally as an operational definition to identify people with mild cognitive impairment (MCI). However, the Japanese version of the LM has not been adequately normalized for old-old people. Therefore, norms of the LM for people aged 75 years and over are required, and the effects of sex, age and education on performance were evaluated. A total of 50 (27 female and 23 male) participants without a history of dementia and symptomatic stroke events recruited from the community and hospital populations were investigated using the Mini-Mental State Examination, the LM and some interference tasks. The mean scores (standard deviations) of the sample were 15.5 (5.4) on LM-I and 9.9 (6.6) on LM-II. The distributions of the LM-I and -II scores satisfied the normality assumption. The LM-I and LM-II scores correlated with age and the LM-I score correlated with educational background. For the Japanese version of the LM, the means, standard deviations and distribution features of the old-old sample are presented. Although the normal sample was chosen to closely match the demographic profile of the Japanese population, the present sample might have had a higher educational background than the age-matched population, especially the males. Further study is required to standardize the Japanese version of the LM subtest for each 5-year interval for latter-stage elderly people.

Correlations between atrophy of the entorhinal cortex and cognitive function in patients with Alzheimer's disease and mild cognitive impairment

In order to confirm the utility of the voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) in assessing the atrophy of the entorhinal cortex, we investigated whether there were correlations between VSRAD and the scores of neuropsychological tests in the patients with Alzheimer's disease (AD) and mild cognitive impairment. Thirty patients, including 18 AD and 12 mild cognitive impairment patients, were included in this study. VSRAD was performed to assess the atrophy of the entorhinal cortex. The patients were carefully screened with the neuropsychological tests, including Wechsler Adult Intelligence Scale-III (WAIS-III), the Wechsler Memory Scale-Revised, the Alzheimer's Disease Assessment Scale-Cognitive Part (ADAS-cog) and the revised version of Hasegawa's Dementia Scale. All patients showed atrophy with different degrees in the entorhinal cortex except one case. Z-scores had significant positive correlation with ADAS-cog, and negative correlation with Information subset of WAIS-III (respectively, P = 0.0129 and P = 0.0294). The revised version of Hasegawa's Dementia Scale and the Similarities subsets of the WAIS-III had a tendency of negatively correlating with Z-scores of VSRAD (respectively, P = 0.0532 and P = 0.0635). The Delayed Visual Reproduction subset of the Wechsler Memory Scale-Revised was also found to have a weak negative correlation with Z-scores (P = 0.0609). Z-scores of VSRAD were revealed to have a close relation with many neuropsychological tests, especially ADAS-cog and the Information subset of WAIS-III. The results meant that VSRAD was a useful indictor of early diagnosis of AD, closely correlating with the changes of cognitive functions and the progression of the disease.