Dual task abilities in preclinical familial Alzheimers disease

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Dual task abilities in preclinical familial
Alzheimers disease

• Sarah E. MacPherson1, Mario Parra-Rodriguez1,
  Sonia Moreno2, Francisco Lopera2 Sergio Della
  Sala1
• 1Human Cognitive Neuroscience Centre for
  Cognitive Ageing and Cognitive Epidemiology
• 2Department of Neurology, University of
  Antioquia, Colombia

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Digit recall alone and with concurrent tracking
Baddeley et al. (1986). Quarterly Journal of
Experimental Psychology
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Tracking alone and with concurrent digit recall
100
90
80
time on target
Single
70
Dual
60
50
Younger
AD Patients
Older
Baddeley et al. (1986). Quarterly Journal of
Experimental Psychology
4
The multi-component model of working memory
Phonological Loop
Central Executive
Visuospatial sketchpad
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Digit Span

• 3715
• 62317
• 162539
• 8364925

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Tracking Task
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Behavioural Testing of Dual Task Performance
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Digit Recall - single task varying in demand
Logie et al. (2004). Neuropsychology.
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Tracking - single task varying in demand
Logie et al. (2004). Neuropsychology.
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Preclinical Familial Alzheimers Disease (FAD)

• The largest extended family in the world with a
  mutation of the E280A of the presenilin 1 gene
  (Lopera et al., 1997).

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Lopera et al. (1997)

• Abnormal expression of the codon 280 of the
  Preseniline-1 gene in chromosome 14.
• Early-onset variant with mean age of onset of
  46.8 years.
• Mean interval until death is 8 years.
• The pathological outcomes do not differ from
  those described in the late-onset sporadic
  Alzheimers Disease.
• High familiar interbreeding

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Genealogical Tree
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FAD Symptoms (Lopera et al. 1997)

• Memory complaints represent the earliest symptom.
  
• Followed by
• Personality and behavioural changes
• Language difficulties
• Depression
• Severe headache
• Gait disturbances and seizures.

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Aim

• To determine whether patients presenting with
  early onset and genetically transmitted forms of
  AD have a selective deficit of mechanisms
  involving the central executive.
• To determine if it is possible to differentiate
  between asymptomatic carriers and non-carriers of
  the disease using the dual task paradigm.

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Participants
MMSE Mini Mental State Examination
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Diagnosis

• Diagnosis of dementia
• Initial interview with a family member
• A standard neurological history
• NINCDS-ADRD
• DSM-IV (American Psychiatric Association, 1994)
• Mini Mental State Exam (MMSE)
• Functional Assessment Staging Test (FAST)

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Background Data
WAIS Weschler Adult Intelligence Scale RPM
Ravens Progressive Matrices WCST Wisconsin
Card Sorting Test
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Memory
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Digit Span

• 3715
• 62317
• 162539
• 8364925

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Paper Pencil Tracking
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û
û
û
û
û
û
û
û
û
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Finish
Start
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• All participants performed
• Digit recall at individual span for 90 seconds.
• Tracking for 90 seconds.
• Digit recall with tracking for 90 seconds.

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Digit Recall Performance


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Tracking


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Overall Dual Task Change


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• Both healthy control groups do not significantly
  differ in their dual task performance compared to
  single task performance.
• In contrast, the AD patients and asymptomatic
  carrier patients show a significant dual task
  decrement.
• Therefore, a possible clinical outcome of the
  dual task paradigm is to differentiate between AD
  and healthy adult ageing.

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Thank you
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Digit Recall Performance



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Tracking


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Overall Dual Task Change



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Overall Dual Task Change

• Percent change each task
• (Single task performance - dual task
  performance)/Single task performance x 100
• Combined percent change
• 100 (Percent change digit task Percent
  change tracking task)/2